PhD in Nursing Science Program

Factors Associated with Safe-Sex Behavioral Intention In People Living with HIV/AIDS

Dissertation under the direction of Professor Vaughn G. Sinclair

Human immunodeficiency virus (HIV) is a sexually transmitted disease with opportunity for transmission when barrier protection is not used during sex. The incidence rate for infections in the US has been approximately 45,000 per year for the past several years. There are significant social, psychological, and physical health costs associated with each infection. Given these realities, better methods for influencing safe­ sex behavioral intention are needed in order to minimize transmission of HIV.

The purpose of this descriptive correlational study was to assess the strength and direction of possible associations among psychological adjustment characteristics (depressive symptoms, impulsivity, overall psychological adjustment, and condom use self-efficacy) with safe-sex behavioral intention. In addition, this study examined the strength and direction of possible associations among gain-framed and loss-framed safe­ sex messages related to personal health or relationship risks with safe-sex behavioral intention.

A convenience sample of 150 men and women with HIV receiving care in a large Southeastern HIV clinic provided the data analyzed in this study. In this cross-sectional study, depressive symptoms, impulsivity, psychological adjustment, condom use self­ efficacy, message framing preferences and safe-sex behavioral intention were measured.

After controlling for demographic characteristics (age, race, gender, years with HIV), findings did not support hypothesized associations among the majority of c psychological characteristics and safe-sex behavioral intention. However, there was a statistically significant positive association between condom use self-efficacy related to relationship concerns with safe-sex behavioral intention. After controlling for demographic variables, findings revealed a statistically significant association between net scores on relationship statements and safe-sex behavioral intention, with higher scoring of relationship-focused statements correlating positively with higher scores for safe-sex behavioral intention. An analysis controlling for both demographic and psychological characteristics revealed statistically significant positive associations among both gain-framed and loss-framed relationship-focused statements with safe-sex behavioral intention. Findings related to personal health-focused statements and safe-sex behavioral intention were not statistically significant.