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Mustanski (2007) compared retrospective and daily diary data drawn from a convenience sample of 113 men who have sex with men (MSM) who were recruited through a variety of Internet sites, to explore the association between Internet sex-seeking and sexual risk-taking. Surprisingly, "[t]he retrospective and daily diary data produced opposite results. In the retrospective data, a history of online sex-seeking was associated with greater numbers of sexual partners in the last year, one-time sex partners, sex without condoms and failure to discuss partners' sexual histories. In the daily diary data, unprotected anal intercourse (UAI) was less likely to occur with partners met online than with partners met by other means" (p. 822).
These results indicate that, in this sample, safer sex behaviours have a higher probability on occasions when sex partners are met through the Internet relative to other means. In contrast, individuals who seek partners online more frequently are more likely to have higher HIV/STI risk profiles, a finding that has fairly consistently emerged from previous research using retrospective data. This pattern of findings suggests that Internet sex-seeking may help identify risk-prone individuals but not risk-prone occasions and therefore that intervention to reduce the prevalence of HIV and STIs among MSM should not focus on reducing the use of the Internet to seek sexual partners. On the contrary, if the processes by which using the Internet to find a sex partner lead to lower rates of UAI – possibly by facilitating conversations about safer sex in advance of sex occurring – can be identified, they may serve as new prevention tools as increasing numbers of MSM use the Internet to seek sex partners. (pp. 826-827)
Dutch investigators (van Kesteren, Hospers, van Empelen, van Breukelen, & Kok, 2007) examined the determinants of intended condom use with both steady and casual sex partners among 296 MSM living with HIV.
Given the proposition that safer sex behavior among HIV-positive people is a form of prosocial behavior, the present study extended the general framework of the Theory of Planned Behavior6 with Schwartz’s norm-activation theory7 and tested the assumption that personal norms would mediate the effects of other psychosocial factors on intended condom use for anal sex. In addition, it was hypothesized that, depending on the context in which sex occurs, specific motives for unprotected anal sex may have a negative influence on intended condom use and, as such, undermine a prosocial tendency to practice safer sex. Therefore, ... [van Kesteren and colleagues] also investigated the influence of sexual motives for unprotected anal sex on intended condom use with steady and casual sex partners. Results indicated that the Theory of Planned Behavior adequately predicted condom use intentions (for casual sex partners and steady sex partners, the explained variance was 52% and 53%, respectively). However, ... [van Kesteren and colleagues'] proposed model of sexual decision-making significantly improved the prediction of behavioral intentions.8 For steady and casual sex partners, the assumption of the mediating role of personal norms on condom use intention was confirmed empirically. Additionally, sexual motives for unprotected anal sex exerted, as expected, a direct, negative effect on condom use intention with casual sex partners. ... (p. 437)
Drawing on these findings, the investigators offer recommendations regarding the promotion of safer sex behavior among MSM living with HIV:
When addressing condom use behavior with steady and casual sex partners, it seems particularly crucial to enhance feelings of moral obligation to use condoms for anal sex. Feelings of moral obligation could be addressed by inducing HIV-positive MSM to reflect on their own personal risk and personal standards for safer sex ... . The findings of this study further suggest that desirable changes in subjective norms and self-efficacy expectations might lead to corresponding changes in personal norms and intentions ... . Therefore, preventive interventions should focus on helping HIV-positive MSM to cope with an unsupportive social environment and to encourage them to build the skills and confidence required for communicating and negotiating condom use. For promotion of condom use with casual sex partners, personal norms may be further increased by urging HIV-positive MSM to accept responsibility for safer sexual behavior. Moreover, especially within casual sex encounters, it is imperative to help HIV-positive MSM to deal with feelings that may conflict with the goal of safer sex. Possible methods that can help HIV-positive MSM to identify and control high risk situations are, for example, action planning and coping planning ... . Action plans and coping plans are detailed plans of what a person needs to do when a specific situation occurs. When such [a] situation arise[s], it is likely to function as a cue for the execution of those precise plans of implementation. Additionally, stimulating HIV-positive MSM to imagine how they would feel if they were in their sex partner[']s shoes (i.e., perspective taking) may evoke a mixture of egoistic and altruistic motivation and, as such, lead to more protected sex ... . (p. 448)
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6 The Theory of Planned Behavior (TPB) "posits that the most proximal determinant of whether or not a person performs a behavior is his intention to do so. According to the theory, behavioral intention is determined by attitude, subjective norm, and perceived behavioral control. Attitude is the person's overall evaluation of the advantages and disadvantages of a particular behavior whereas subjective norms are determined by the perceived social pressure to perform the behavior. Perceived behavioral control is the person's conviction about whether or not the required skills and resources to perform the behavior are at his disposal ..." (p. 438).
7 "According to norm-activation theory, personal norms are the immediate determinant of behavior. Personal norms are considered as strong intrinsic motivators, as they trigger an individual's internal value system and are tied to one's self-concept. In the case of sexual behavior, these aspects reflect the feeling of moral obligation to practice safer sex because of concern about the welfare of sex partners" (p. 439).
8 "The results showed that, compared with the TPB[,] ... [this] proposed model of sexual decision-making led to a significant increase of explained variance from 53% to 62% for steady sex partners and from 52% to 68% for casual sex partners" (p. 447).
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Fall 2007 Newsletter / Volume 9, Issue 1 
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