"Predictors for readiness to engage in low-risk HIV behaviors in men wh" by Steven Lee White

Date of Award

2003

Degree Type

Dissertation

First Advisor

Colleen Redding

Second Advisor

Joseph Rossi

Abstract

The main purpose of this research was to investigate Transtheoretical Model (TTM) predictors of condom use in a sample of sexually active young men who have sex with men (MSM). A secondary purpose was to investigate the applicability of specific Multifaceted Model of HIV Risk (MMOHR) predictors of condom use and other interpersonal predictors of condom use in this sample of young MSM. A third purpose was to explore the impact of various behavioral factors and psychoattitudinal factors on condom use in this sample of young MSM. The sample (N = 185) was young men aged 18 to 30 who reported being sexually active with at least one male during the two months prior to consenting and participating in the research project. Participation was defined as completing the Young Men's Sexual Behavior and Health Survey. The various contextually based staging instruments were evaluated. In this sample, a general staging algorithm for condom readiness for anal sex with men were comparable to more specific staging tools assessing condom readiness for insertive anal sex and receptive anal sex. Individual standard multiple regression analyses indicated that TTM constructs, MMOHR constructs, condom negotiation strategies, and internalized homophobia/sexuality distress were significant predictors of condom use readiness. Of particular interest, higher levels of internalized homophobia/sexuality distress were associated with consistent condom users. Hierarchical regression revealed that the strongest variable accounting for observed variance in condom use was the TTM process of change, liberation a scale that taps awareness of community norms of condom use, a commitment to use condoms, and feeling good about protected sex. At the same time, the internalized homophobia subscale assessing social discomfort with other gay men was predictive of condom use. This research underscores the need for more model-based research to provide a framework for relating and organizing potential predictors of unprotected sex in MSM, a community with many pressures to conform to a culture of "safer sex." A greater understanding of risk taking could strengthen the foundation for augmenting current and future large-scale theory-based HIV interventions with MSM.

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