The purpose of this study was to examine the psychological processes pertaining to sexuality and sexual risk behavior among HIV-positive men who have sex with men (MSM). The authors analyzed transcripts of 30 semistructured interviews. Findings suggest that sexual problems in HIV-positive MSM might be primarily caused by the perceived risk of transmitting HIV to others. Furthermore, safer sexual behavior seems to be related to feelings of personal responsibility for safer sex. This study illustrates that although some men might have a clear notion of personal responsibility for safer sex, contextual factors can influence whether behavior is consistent with their norms of personal responsibility. The implications of the study are discussed for the practice of HIV prevention for HIV-positive MSM.
Determinants of intended condom use with steady and casual sex partners were examined among Dutch HIVpositive men who have sex with men (MSM) (N = 296). Given the proposition that safer sex behavior among HIVpositive people is a form of prosocial behavior, the present study extended the general framework of the Theory of Planned Behavior with Schwartz's norm-activation theory 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, we 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
Objective: To study the effects of school lessons about healthy food on adolescents' self-reported beliefs and behaviour regarding the purchase and consumption of soft drinks, water and extra foods, including sweets and snacks. The lessons were combined with the introduction of lower-calorie foods, food labelling and price reductions in school vending machines. Design: A cluster-randomized controlled design was used to allocate schools to an experimental group (i.e. lessons and changes to school vending machines) and a control group (i.e. 'care as usual'). Questionnaires were used pre-test and post-test to assess students' self-reported purchase of extra products and their knowledge and beliefs regarding the consumption of low-calorie products. Setting: Secondary schools in the Netherlands. Subjects: Twelve schools participated in the experimental group (303 students) and fourteen in the control group (311 students). The students' mean age was 13·6 years, 71·5 % were of native Dutch origin and mean BMI was 18·9 kg/m 2 . Results: At post-test, the experimental group knew significantly more about healthy food than the control group. Fewer students in the experimental group (43 %) than in the control group (56 %) reported bringing soft drinks from home. There was no significant effect on attitude, social norm, perceived behavioural control and intention regarding the consumption of low-calorie extra products. Conclusions: The intervention had limited effects on students' knowledge and selfreported behaviour, and no effect on their beliefs regarding low-calorie beverages, sweets or snacks. We recommend a combined educational and environmental intervention of longer duration and engaging parents. More research into the effects of such interventions is needed.
Thirty years after the first diagnosis, people living with HIV (PLWH) around the world continue to report stigmatizing experiences. In this study, beliefs contributing to HIV-related stigma in African and Afro-Caribbean diaspora communities and their cultural context were explored through semistructured interviews with HIV-positive (N = 42) and HIV-negative (N = 52) African, Antillean and Surinamese diaspora community members in the Netherlands. Beliefs that HIV is highly contagious, that HIV is a very severe disease, and that PLWH are personally responsible for acquiring their HIV infection were found to contribute to HIV-related stigma, as did the belief that PLWH are HIV-positive because they engaged in norm-violating behaviour such as promiscuity, commercial sex work, and, for Afro-Caribbean diaspora, also homosexuality. These beliefs were found to be exacerbated and perpetuated by cultural taboos on talking about HIV and sexuality. HIV-related stigma reduction interventions should focus on changing these beliefs and breaking cultural taboos on HIV and sexuality in a manner that is participatory and consistent with the current theory and empirical findings.
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