S. Marie Harvey

We developed and tested a multifaceted model of condom use intentions with cross-sectional data from 435 heterosexual women at risk for HIV/STIs. In addition to traditional intrapersonal variables drawn from established models of HIV prevention (e.g. attitudes, norms, self-efficacy), the present study examined the role of relationship factors and dynamics (i.e. relationship commitment, duration, condom use and pregnancy prevention decision-making) in shaping condom use intentions. In some cases, relationship variables were directly associated with condom use intentions. In other cases their effects on condom use intentions were mediated by intrapersonal constructs. The final model accounted for 66% of the variance in condom use intentions and confirmed the importance of integrating intrapersonal variables and relationship characteristics and dynamics in understanding women's intentions to use condoms. These results offer important insights for the design of interventions directed at promoting condom use among young women at risk for HIV/STIs and underscore the need to design prevention programs that address relationship characteristics and dynamics.

This paper describes the development and evaluation of the Abortion Attributes Questionnaire (AAQ), an instrument designed to assess the perceived importance of specific characteristics of abortion methods. Women receiving medical abortions (n= 186) and women who chose surgical procedures (n= 118) completed the AAQ. Participants were asked to rate how important each of 21 characteristics would be “when choosing between surgical and medical abortion.” Factor analyses revealed that the AAQ consists of four factors and, as subscales, the factors have good internal reliability. The validity of the AAQ was established through discriminant function analysis and results indicated that three of the four factors predicted choice. Taken together, these findings provide empirical support for the constructs measured by the AAQ.

Many Hispanic women are at elevated risk for HIV infection because of the sexual behavior of their male partner. Yet, couple-based risk-reduction interventions for this population have not been developed and scientifically evaluated. A sample of 146 Hispanic couples who received either a risk reduction intervention or the community educational standard of care were followed up at three months (men and women) and six months (women only) to measure the consistency of both condom use and effective contraceptive use, and the frequency of unprotected vaginal sex. Analyses were conducted to identify differences between the two groups at baseline and follow-up interviews, and changes over time. At follow-up, the two groups did not differ on any risk-related outcomes; over time, both groups increased the reported consistency of condom use and of use of effective contraceptive methods, and reduced their frequency of unprotected sex. If further research confirms that simply bringing couples together for a single-session, culturally appropriate risk reduction intervention helps them adopt protective behaviors, more intensive (and costly) interventions may not be necessary.

Because of the importance of relationship power and cultural norms on women's ability to protect themselves from HIV/STDs, effective interventions must address power differentials among men and women. These programs need to be informed by and adapted to the cultural values of the target population. Accordingly, we conducted exploratory interviews with 22 young African American women at risk of HIV/STDs and unintended pregnancy and their male partners regarding the meaning of power in heterosexual relationships, what makes a woman feel powerful in a relationship with a man, and who makes sexual and reproductive decisions in their relationships. Content analyses suggested that relationship power was linked to control and decision-making for most participants; yet, others appeared to associate power with positive relationship qualities such as respect and security. In addition, most participants reported that they shared decision-making about sexual and reproductive matters with their partners. Subs...

Background Most studies of sexual behavior and risk are based on self-reports of individuals. Goal The goal of this study was to assess interpartner concordance on self-reported sexual behavior, condom use, and relationship characteristics; and agreement between individuals’ perceptions of their partners’ sexual risks and the partners’ actual reports. Study Design Interviews were conducted separately but concurrently with 112 heterosexual couples at increased risk for HIV/sexually transmitted infections recruited through women at clinics and community locations. Results Couples were concordant on reports of relationship characteristics (kappa ≥0.84), sexual behavior, and condom use (r ≥0.62), but disagreed on who has more power and sexual decision-making dominance (kappa ≤0.26). We found substantial agreement between men’s perceptions and their partners’ reported risky behavior (kappa = 0.62), but only fair agreement between women’s perceptions and their partners’ reports (kappa = 0.30). Conclusion Individual self-reports could be reliable measures of sexual behavior. Additionally, prevention interventions need to address women’s misperceptions about their partners’ risky behaviors.

Although male condoms are the best form of protection against HIV/STDs, they are not the most effective method for preventing unintended pregnancy. Consequently, use of condoms and a highly effective contraceptive–referred to as dual use–is recommended as the optimal protection against both disease and pregnancy. However, little is known about the factors that promote dual use. This study examined associations of dual method use with women's background characteristics, intrapersonal factors, and relationship characteristics. Data are from a random sample of women selected from a large managed care organization in the Pacific Northwest. The analytic sample contained 371 women who completed a telephone survey and reported use of contraceptives in the past 3 months. Three mutually exclusive method use groups were constructed: effective contraceptive only (hormonal methods, intrauterine device, surgical sterilization) (59%), condom only (24%), and dual use (18%). Variables hypothesized to influence d...

Data from interviews with 94 young women who were injection drug users (IDUs) or partners of IDUs were analyzed to examine associations between self‐reported sexual decision making and condom use, contraceptive use, and relationship characteristics. Most women (73–85%) reported participating in decisions about condom use, contraception, and when to have sex. Adjusting for potential covariates, respondents who reported participating in decisions about condom use and when to have sex were 7 and 19 times, respectively, more likely than others to report recently using condoms. Respondents who reported participating in decisions about contraception were 20 times more likely than others to report recently using contraceptives. Longer sexual relationships were associated with decreased likelihood, of condom or contraceptive use.

This study examines the associations among relationship power, sexual decision-making dominance, and condom use within a sample of women at risk of HIV/STDs. Data from face-to-face interviews with 112 women were analyzed to (a) describe who women perceive as more powerful and who makes sexual decisions within their heterosexual relationships, (b) explore the association between relationship power and sexual decision-making dominance, and (c) examine the relationship of power and decision making regarding condom use to condom use behavior. Women were recruited from clinics and community locations in Atlanta, Los Angeles, Oklahoma City and Portland, OR. Participants were 18–25 years of age and were primarily Hispanic and African American. Over half (58.2%) reported that they share power with their partner, 25.5% said they have more power, and 16.4% reported that their partner has more power in their relationship. For the five domains of sexual decision-making examined, over half (50.5%-75.7%) of th...