Walch and Rudolph (2006) explored the relationship between HIV-related risk behavior and negative affective symptomatology among 185 consecutively recruited men and women who presented for anonymous HIV testing. The investigators found that "[g]reater HIV-related risk behavior was associated with high levels of anxiety and moderate or high levels of depression for bisexual women. Greater HIV-related risk behavior was also associated with low levels of anxiety and mild to moderate levels of depression for bisexual men" (italics added; p. 324).
The findings ... suggest that simple, linear models may not accurately capture the nature of the relationship between negative affective states and sexual risk behavior. Results indicated that depression and anxiety were significantly related to HIV-related risk behavior among bisexual men and bisexual women but not among heterosexual men, heterosexual women, or homosexual men, suggesting that the relationship between negative affect and HIV-related risk behavior is moderated by gender and behavioral sexual orientation. (p. 332)
Walch and Rudolph astutely observe that, "[w]hether depression and anxiety are the cause or consequence of HIV-related risk behavior, interventions aimed at reducing these uncomfortable and potentially debilitating affective states are warranted. Given an association among these variables, interventions that influence one factor may also have an influence on the other factor ..." (p. 331).
Noar, Carlyle, and Cole (2006) conducted a meta-analysis
to quantitatively synthesize the growing literature on the relationship between safer sexual communication (SSC) among sexual partners and condom use, and to systematically examine a number of conceptual and methodological moderators of this relationship. Data from 53 articles published [between 1989 and 2003] in 27 journals met criteria for the study. Fifty-five independent effect sizes coded from samples totaling N = 18,529 were meta-analyzed. Results indicate that the mean sample-size weighted effect size of the SSC-condom use relation was r = .22. (p. 365)
"An effect of this magnitude suggests that communicating with a sexual partner about safer sex is important, and suggests that this may be an important determinant of safer sexual behavior. In addition, the effect held up in longitudinal (r = .20) as well as cross-sectional studies (r = .22), suggesting that the effect is robust" (p. 380). Moreover, several conceptual variables were found to moderate the relationship between SSC and condom use.
Specifically, communication about condom use (r = .25) and sexual history (r = .23) had significantly ... larger effect sizes than communication about safer sex (r = .18). In addition, SSC measures operationalized differently had significantly ... different effect sizes. From largest to smallest, these were behavioral format (r = .29), intentional format (r = .18), and self-efficacy format (r = .13).1 Measures that tried to assess persuasion attempts as compared with informational exchanges were not found to have significantly different effect sizes ... . Further, methodological moderators tended to be unrelated to effect size. (pp. 365-366)
Noar and colleagues emphasize that
[t]he data from this meta-analysis ... suggest that behavioral skills such as SSC must be a major focus of HIV preventive interventions. ... Although the current meta-analytic data are correlational in nature, they may represent the strongest evidence yet that possessing and using communication skills … [are] related to increased safer sexual behavior. ... Interventions ... to ... teach ... individuals how to talk about safer sex ... should attempt to build individuals' self-efficacy to talk about and negotiate condom use as well as other important sexual risk reduction skills such as refusal of unwanted intercourse. (pp. 383-384)
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Fall 2006 Newsletter / Volume 8, Issue 1
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