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Harvey and Henderson (2006) investigated the influence of a variety of factors on the use of condoms in a community-based sample of 191 young Latino men (of primarily Mexican descent) living in greater Los Angeles. Interestingly, the investigators found that
relationship factors were more predictive of men's condom use behaviors than were intrapersonal factors. More specifically, ... [Harvey and Henderson] found that in addition to more positive attitudes toward condoms, stronger partner condom norms and greater participation in decision-making about condom use were significantly associated with both condom use and condom use intentions. Moreover, men reporting lower expectations of negative partner reactions to condom requests were more likely to use condoms, and condom use intentions were higher among men reporting more health protective communication in the relationship. Taken together, these findings indicate that men's protective behaviors are influenced by their female sexual partners and the dynamics within their relationships. (p. 566)
Drawing on these findings, Harvey and Henderson stress that
interventions to prevent HIV among Latinos need to include men as well as women and address the role of relationship factors and dynamics in safer sex practices. Interventions may also need to engage both members of a sexually active couple in order to improve communication about sexual needs and safer sex strategies. By providing couples with opportunities to discuss these issues, encouraging them to share responsibility for these decisions and promoting positive attitudes towards condom use, programs and services could potentially increase protective behavior among young Latino women and men at risk for HIV. (p. 568)
The National Institute of Mental Health (NIMH) Multisite HIV Prevention Trial Group (2006) conducted a new study of Project LIGHT (Living in Good Health Together), a seven-session, small-group HIV prevention intervention originally tested in a large, randomized, controlled trial involving low-income women and men served in 37 public health settings across the United States (NIMH Multisite HIV Prevention Trial Group, 1998). In this new study, 99 adult men receiving outpatient mental health services in Los Angeles or New York City were randomized to either Project LIGHT or a one-session video intervention. "The seven [Project LIGHT] sessions covered the following topics: (a) knowledge of HIV; (b) personal triggers for risk behavior; (c) use of problem solving skills to reduce risk; (d) condom use; (e) assertiveness in negotiating safer sex; (f) negotiation strategies for risk reduction; and (g) relapse prevention ..." (p. 145).
Consistent with other studies, individuals with mental health problems in this study responded to the intervention with significant decreases in the number of unprotected sexual risk acts. The effect size (78.7%) indicated that these changes were not just statistically significant, but also clinically meaningful. ... [Moreover], the effects of Project LIGHT were sustained at similar levels across 12 months with little variation in effects over time. The sustainability of the results of the intervention at 12 months is an important advance over earlier interventions tested with [persons with mental health problems] and is similar to the findings with participants in the [original] NIMH HIV Prevention Trial ... .
While there were also significant intervention effects for condom use, these effects were observed only among African Americans, the large majority [72.4%] of the participants. Condom use increased significantly among African Americans, rising 264.8% following the intervention, and consistent condom use increased by 50.1% among African Americans. ... Similar to the decreases in risk acts, the effect sizes were large and both clinically and statistically significant, and persisted at the same level over 12 months. (pp. 149-150)
The investigators conclude that "HIV risk reduction groups such as Project LIGHT may have utility in public mental health care settings [that serve clients with moderate to severe dysfunction] (p. 142).
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Fall 2006 Newsletter / Volume 8, Issue 1
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