This revised application proposes studies to redress limitations in current research on HIV sexual risk. Previous research focuses on deliberative, belief-based attitudes toward sexual risk behaviors. Sexual contexts, however, epitomize situations in which systematic retrieval of one's beliefs about condoms and HIV prevention might often be minimal. Recent theoretical advances suggest that in such contexts, behavior should be better predicted by implicit attitudes. Implicit sexual attitudes are evaluative responses that are automatically and effortlessly evoked by cues in a sexual situation and involve feelings rather than verbally articulated thought. This research will use new response latency methods to assess implicit condom attitudes. In two studies, three hundred HIV-positive individuals will complete baseline self-report measures to assess their sexual behavior and explicit (belief-based) condom attitudes. Computerized priming and implicit association tasks will also be used at baseline to assess implicit attitudes toward condoms and risk-related behavior. Individuals at one clinic will continue to receive their regular treatment; individuals at the other clinic will begin a more intensive psychological intervention designed to make attitudes and sexual behavior become less risky. Six months later, all measures will be completed again. For both groups, implicit attitudes should predict subsequent sexual behavior (e.g., condom usage) in spontaneous contexts (e.g., occasional partners) better than will explicit attitudes, and the reverse is expected for deliberative situations (e.g., main partners). Individuals exposed to the intensive intervention should change implicit attitudes and reduce risky sexual behavior the most. Four other studies will test other hypotheses using 910 additional participants: (1) Implicit measures linking specific affective associations to condoms will be correlated with individual differences in relevant motives for sexual behavior and condom use (e.g., hedonic, social, fear). (2) Experimental manipulations (cognitive accessibility and affective priming techniques) that create transient changes in implicit attitudes will lead to short-term increases in condom-related behavior. Ultimately, understanding how automatically evoked condom attitudes associated with affective and motivational states impact sexual risk behavior may suggest a reexamination of aspects of interventions that might be impacting implicit (as well as explicit) attitudes-for example, the direct experience aspect of skills training.
| Scott-Sheldon, L A J; Marsh, K L; Johnson, B T et al. (2006) Condoms + pleasure = safer sex? A missing addend in the safer sex message. AIDS Care 18:750-4 |
