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Change Trajectories in Women's STD/HIV Risk Behaviors Following Intervention

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Abstract

Three 16-month sexual risk-taking trajectories were identified in 287 women in an STD/HIV intervention study. The Risk Eliminator group reported no sex risk following intervention while the Risk Reducer group reported continuous drops over time. The High Risk group reported higher initial risk than the other two and no subsequent changes. The trajectory groups showed no between- or within-group effects of intervention exposure. Trajectory groups were compared on baseline characteristics. No differences were seen in demographics or STD/HIV knowledge. Compared to one or both of the other groups, the High Risk women reported more lifetime partners, recent paying partners, adult rape, and recent substance use. Their steady partners were more likely to be abusive, intoxicated during sex (as were the women themselves), and believed to be non-monogamous. The Risk Eliminator group differed from the other two by being less likely to report a history of childhood sexual abuse.

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References

  • Abel, E. L., Kruger, M. L., & Friedl, J. (1998). How physicians define “light”, “moderate”, and “heavy” drinking. Alcoholism, Clinical and Experimental Research, 22, 979–984.

    Article  PubMed  CAS  Google Scholar 

  • Ajzen, I. (2002). Residual effects of past on later behavior: Habituation and reasoned action perspectives. Personality and Social Psychology Review, 6(2), 107–122.

    Article  Google Scholar 

  • Albarracin, D., Johnson, B. T., Fishbein, M., & Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: A meta-analysis. Psychological Bulletin, 127, 142–161.

    Article  PubMed  CAS  Google Scholar 

  • Allers, C. T., & Benjack, K. J. (1991). Connections between childhood abuse and HIV infection. Journal of Counseling and Development, 70, 309–313.

    Google Scholar 

  • Amaro, H. (1995). Love, sex, and power: Considering women's realities in HIV prevention. American Psychologist, 50, 437–447.

    Article  PubMed  CAS  Google Scholar 

  • Bagozzi, R. P., & Kimmel, S. K. (1995). A comparison of leading theories for the prediction of goal-directed behaviours. British Journal of Social Psychology, 34, 437–461.

    Google Scholar 

  • Baker, S. A., Beadnell, B., Stoner, S., Morrison, D. M., Gordon, J., Collier, C., Knox, K., Wickizer, L., & Stielstra, S. (2003). Skills training versus health education to prevent STDs/HIV in heterosexual women: A randomized controlled trial utilizing biological outcomes. AIDS Education and Prevention, 15, 1–14.

    Article  PubMed  Google Scholar 

  • Beadnell, B., Baker, S. A., Gordon, J., Collier, C., Morrison, D., & Ryan, R. (1997). Preventing sexually transmitted diseases (STD) and HIV in women: Using multiple sources of data to inform intervention design. Cognitive and Behavioral Practice, 4, 325–347.

    Article  Google Scholar 

  • Beadnell, B., Baker, S.A., Knox, K., Stielstra, S., Morrison, D.M., DeGooyer, E., Wickizer, L., Doyle, A., & Oxford, M. (2003). The influence of psychosocial difficulties on women's attrition in an HIV/STD prevention program. AIDS Care, 15, 807–820.

    Article  PubMed  CAS  Google Scholar 

  • Beadnell, B., Baker, S. A., Morrison, D. M., & Knox, K. (2000). HIV/STD risk factors for women with violent male partners. Sex Roles, 42, 661–689.

    Article  Google Scholar 

  • Belcher, L., Kalichman, S., Topping, M., Smith, S., Emshoff, J., Norris, F., & Nurss, J. (1998). A randomized trial of a brief HIV risk reduction counseling intervention for women. Journal of Consulting and Clinical Psychology, 66, 856–861.

    Article  PubMed  CAS  Google Scholar 

  • Carey, M. P., Kalichman, S. C., Forsyth, A. D., Wright, E. M., & Johnson, B. T. (1997). Enhancing motivation to reduce the risk of HIV infection for economically disadvantaged urban women. Journal of Consulting and Clinical Psychology, 65, 531–541.

    Article  PubMed  CAS  Google Scholar 

  • Centers for Disease Control and Prevention. (1988). Guidelines for prevention and control of congenital syphilis. Morbidity and Mortality Weekly Report, 37 (No.S-1). Atlanta, GA: U.S. Department of Health and Human Services.

  • Centers for Disease Control and Prevention. (December, 1999). Prevention of Genital HPV Infection and Sequelae: Report of an External Consultants’ Meeting. Atlanta, GA: U.S. Department of Health and Human Services.

  • Centers for Disease Control and Prevention. (September, 2004). Sexually Transmitted Disease Surveillance, 2003. Atlanta, GA: U.S. Department of Health and Human Services.

    Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Conner, M., & Armitage, C. J. (1998). Extending the theory of planned behavior: A review and avenues for further research. Journal of Applied Social Psychology, 28(15), 1429–1464.

    Article  Google Scholar 

  • Cooper, M. L. (2002). Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence. Journal of Studies on Alcohol, (Suppl 14), 101–117.

  • Cunningham, R. M., Stiffman, A. R., & Dore, P. (1994). The association of physical and sexual abuse with HIV risk behaviors in adolescence and young adulthood: Implications for public health. Child Abuse & Neglect, 18, 233–245.

    Article  PubMed  CAS  Google Scholar 

  • Derogatis, L. R. (1993). Brief Symptom Inventory: Administration, scoring and procedures manual. Minneapolis: National Computer Systems, Inc.

    Google Scholar 

  • El Bassel, N., Ivanoff, A., Schilling, R. F., Gilbert, L., Borne, D., & Chen, D. R. (1995). Preventing HIV/AIDS in drug-abusing incarcerated women through skills building and social support enhancement: Preliminary outcomes. Social Work Research, 19(3), 131–141.

    PubMed  CAS  Google Scholar 

  • Exner, T. M., Seal, D. W., & Ehrhardt, A. A. (1997). A review of HIV interventions for at-risk women. AIDS and Behavior, 1, 93–124.

    Article  Google Scholar 

  • Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS-risk behavior. Psychological Bulletin, 111, 455–474.

    Article  PubMed  CAS  Google Scholar 

  • Fisher, J. D., Fisher, W. A., Williams, S. S., & Malloy, T. E. (1994). Empirical tests of an Information-Motivation-Behavioral Skills Model of AIDS preventive behavior with gay men and heterosexual university students. Health Psychology, 13, 238–250.

    Article  PubMed  CAS  Google Scholar 

  • Fisher, W. A., Williams, S. S., Fisher, J. D., & Malloy, T. E. (1999). Understanding AIDS risk behavior among sexually active urban adolescents: An empirical test of the Information-Motivation-Behavioral Skills Model. AIDS and Behavior, 3, 13–23.

    Article  Google Scholar 

  • Fleming, D. T., & Wasserheit, J. N. (1999). From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually Transmitted Infections, 75, 3–17.

    PubMed  CAS  Google Scholar 

  • Follingstad, D. R., Rutledge, L. L., Berg, B. J., Hause, E. S., & Polek, D. S. (1990). The role of emotional abuse in physically abusive relationships. Journal of Family Violence, 5, 107–120.

    Article  Google Scholar 

  • Greenberg, J. B. (2001). Childhood sexual abuse and sexually transmitted diseases in adults: A review of and implications for STD/HIV programmes. International Journal of STD and AIDS, 12, 777–783.

    Article  PubMed  CAS  Google Scholar 

  • Hays, W. L. (1987). Statistics (4th ed). New York: Holt, Rinehart & Winston.

    Google Scholar 

  • Hearst, N., & Hulley, S. B. (1988). Preventing heterosexual spread of AIDS: are we giving our patients the best advice? Journal of the American Medical Association, 259, 2428–2432.

    Article  PubMed  CAS  Google Scholar 

  • Ickovics, J. R., & Yoshikawa, H. (1998). Preventive interventions to reduce heterosexual HIV risk for women: Current perspectives, future directions. AIDS, 12(Suppl A), S197–208.

    PubMed  Google Scholar 

  • Johnsen, L. W., & Harlow, L. L. (1996). Childhood sexual abuse linked with adult substance use, victimization, and AIDS-risk. AIDS Education and Prevention, 8, 44–57.

    PubMed  CAS  Google Scholar 

  • Jones, B. L., Nagin, D. S., & Roeder, K. (2001). A SAS procedure based on mixture models for estimating developmental trajectories. Sociological Methods and Research, 29(3), 374–393.

    Article  Google Scholar 

  • Keppel, G. (1991). Design and analysis (3rd ed.). Englewood Cliffs: Prentice Hall.

    Google Scholar 

  • Leigh, B. C. (2002). Alcohol and condom use: a meta-analysis of event-level studies. Sexually Transmitted Diseases, 29, 476–482.

    Article  PubMed  Google Scholar 

  • Lodico, M. A., & DiClemente, R. J. (1994). The association between childhood sexual abuse and prevalence of HIV-related risk behaviors. Clinical Pediatrics, 33, 498–502.

    Article  PubMed  CAS  Google Scholar 

  • Maisto, S. A., Carey, M. P., Carey, K. B., & Gordon, C. M. (2002). The effects of alcohol and expectancies on risk perception and behavioral skills relevant to safer sex among heterosexual young adult women. Journal of Studies on Alcohol, 4, 476–485.

    Google Scholar 

  • Maisto, S. A., Carey, M. P., Carey, K. B., Gordon, C. M., & Schum, J. L. (2004). Effects of alcohol and expectancies on HIV-related risk perception and behavioral skills in heterosexual women. Experimental Clinical Psychopharmacology, 4, 288–297.

    Article  Google Scholar 

  • Marlatt, G. A., & Gordon, J. R. (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York: Guilford.

    Google Scholar 

  • Morrill, A. C., & Ickovics, J. R. (1996). Surviving abuse and HIV risk: How women's experiences of abuse shape their heterosexual risk for HIV. Poster presented at the XI International Conference on AIDS, Vancouver, Canada.

  • Mullen, P. D., Ramirez, G., Strouse, D., Hedges, L. V., & Sogolow, E. (2002). Meta-analysis of the effects of behavioral HIV prevention interventions on the sexual risk behavior of sexually experienced adolescents in controlled studies in the United States. Journal of Acquired Immune Deficiency Syndromes, 30, S94–S105.

    PubMed  Google Scholar 

  • Nagin, D. S., & Land, K. C. (1993). Age, criminal careers, and population heterogeneity: Specification and estimation of a nonparametric, mixed Poisson model. Criminology, 31(3), 327–359.

    Article  Google Scholar 

  • Nagin, D., & Tremblay, R. E. (1999). Trajectories of boys’ physical aggression, opposition, and hyperactivity on the path to physically violent and non-violent juvenile delinquency. Child Development, 70, 1181–1196.

    Article  PubMed  CAS  Google Scholar 

  • National Institute of Mental Health. (2002). Predictors of sexual behavior over one year among persons at high risk for HIV. Archives of Sexual Behavior, 31(2), 165–176.

    Article  Google Scholar 

  • Neumann, M. S., Johnson, W. D., Semaan, S., Flores, S. A., Peersman, G., Hedges, L. V., & Sogolow, E. (2002). Review and meta-analysis of HIV prevention intervention research in the United States. Journal of Acquired Immune Deficiency Syndromes, 30, S106–S117.

    PubMed  Google Scholar 

  • Paxton, K. C., Myers, H. F., Hall, N. M., & Javanbakht, M. (2004). Ethnicity, serostatus and psychosocial difference in sexual risk behavior among HIV-seropositive and HIV-seronegative women. AIDS and Behavior, 8, 405–416.

    Article  PubMed  Google Scholar 

  • Pequegnat, W., & Stover, E. (2000). Behavioral prevention is today's AIDS vaccine! AIDS, 14(Suppl. 2), S1–S7.

    PubMed  Google Scholar 

  • Platt, R., Rice, P. A., & McCormack, W. M. (1993). Risk of acquiring gonorrhea and prevalence of abnormal adnexal findings among women recently exposed to gonorrhea. Journal of the American Medical Association, 250, 3205–3209.

    Article  Google Scholar 

  • Pulerwitz, J., Amaro, H., DeJong, W., Gortmaker, S. L., & Rudd, R. (2002). Relationship power, condom use and HIV risk among women in the USA. AIDS Care, 14, 789–800.

    Article  PubMed  CAS  Google Scholar 

  • Quinn, T. C. (1996). Global burden of the HIV pandemic. The Lancet, 348, 99–106.

    Article  CAS  Google Scholar 

  • Raj, A., Silverman, J. G., & Amaro, H. (2002). Abused women report greater male partner risk and gender-based risk for HIV: findings from a community-based study with Hispanic women. AIDS Care, 16, 519–529.

    Article  Google Scholar 

  • Roffman, R. A., Downey, L., Beadnell, B., Gordon, J. R., Craver, J. N., & Stephens, R. S. (1997). Cognitive-behavioral group counseling to prevent HIV transmission in gay and bisexual men: Factors contributing to successful risk reduction. Research on Social Work Practice, 7(2), 165–186.

    Google Scholar 

  • Roffman, R. A., Beadnell, B., Ryan, R., & Downey, L. (1995). Telephone group counseling in reducing AIDS risk in gay and bisexual males. Journal of Gay and Lesbian Social Services, 3/4, 145–158.

    Article  Google Scholar 

  • Stamm, W. E., Guinan, M. E., & Johnson, C. (1984). Effect of treatment regimens for neisseria gonorrhoeae on simultaneous infections with chlamydia trachomatis. New England Journal of Medicine, 310, 545–549.

    Article  PubMed  CAS  Google Scholar 

  • Suarez-Al-Adam, M., Raffealli, M., & O’Leary, A. (2000). Influence of abuse and partner hyper-masculinity on the sexual behavior of Latinas. AIDS Education and Prevention, 12, 263–274.

    PubMed  CAS  Google Scholar 

  • Wang, J., Siegal, H. A., Falck, R. S., Carlson, R. G., & Rahman, A. (1999). Evaluation of HIV risk reduction intervention programs via latent growth model. Evaluation Review, 23, 648–662.

    Article  PubMed  CAS  Google Scholar 

  • Weinhardt, L. S., & Carey, M. P. (2001). Does alcohol lead to sexual risk behaviors? Annual Review of Sex research, 12, 125–157.

    Google Scholar 

  • Wells, E. A., Beadnell, B., Calsyn, D. A., Rosengren, D. B., Nahom, D., Ricardo-Bulis, E., Peterson, P. L., & Jackson, R. (2005). Motivational enhancement to decrease drug use among cocaine users: Six month follow-up results. Manuscript submitted for publication.

  • Wingood, G. M., & DiClemente, R. J. (1996). HIV sexual risk reduction interventions for women: A review. American Journal of Preventive Medicine, 12, 209–217.

    PubMed  CAS  Google Scholar 

  • Wingood, G. M., & DiClemente, R. J. (1997). The effects of an abusive primary partner on the condom use and sexual negotiation practices oaf African American women. American Journal of Public Health, 87, 1016–1018.

    PubMed  CAS  Google Scholar 

  • Wyatt, G. E., Myers, H. F., & Loeb, T. B. (2004). Women, trauma, and HIV: an overview. AIDS and Behavior, 8, 401–403.

    Article  PubMed  Google Scholar 

  • Yzer, M. C., Siero, F. W., & Buunk, B. P. (2001). Bringing up condom use and using condoms with new sexual partners: Intentional or habitual? Psychology and Health, 16, 409– 421.

    Article  Google Scholar 

  • Zierler, S., Feingold, L., Laufer, D., Velentgas, P., Kantrowitz-Gordon, I., & Mayer, K. (1991). Adult survivors of childhood sexual abuse and subsequent risk of HIV infection. American Journal of Public Health, 81, 572–575.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This research was funded by a grant from the National Institutes of Mental Health (#MH5 0422) and received approval by the Human Subjects Division at the University of Washington.

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Correspondence to Blair Beadnell.

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Beadnell, B., Baker, S.A., Morrison, D.M. et al. Change Trajectories in Women's STD/HIV Risk Behaviors Following Intervention. Prev Sci 7, 321–331 (2006). https://doi.org/10.1007/s11121-006-0043-4

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