Negative affect and sexual risk behavior: Comment on Crepaz and Marks (2001).

Abstract

In this commentary, the authors highlight the findings of the meta-analysis by N. Crepaz and G. Marks (2001). The role of affect in sexual risk behavior, although intuitively obvious, is not well understood and has been largely ignored by HIV prevention researchers in favor of social-cognitive models of behavior. Crepaz and Marks synthesized the results from studies that have examined the relation of negative affect (e.g., depression, anxiety, anger) to sexual risk behavior and concluded that in the literature to date, these variables appear unrelated. The authors suggest that the Crepaz and Marks findings are not surprising given the methods used in the reviewed studies and suggest methodological approaches that will allow more sensitive analyses of the association between affect and sexual risk behavior.

Affect and Sexual Behavior in Adolescents: A Review of the Literature and Comparison of Momentary Sampling With Diary and Retrospective Self-Report Methods of Measurement

“…However, in their discussion of the analysis and in the accompanying editorial comment, 55 important limitations were raised and directions for future research were suggested. Most studies have had cross-sectional designs and could not determine the temporal nature of the associations.…”

“…In addition, global measures of affect have been used; thus, NA immediately before sexual thoughts and behaviors as well as indirect effects of NA (eg, through substance use) could not be assessed. In their comment, Kalichman and Weinhardt 55 urged the study of NA and sexual behavior at the event level, using methods such as momentary assessments.…”

Depression and Its Relation with HIV Risk and Social Well-Being among the Brothel-Based Female Sex Workers in Kolkata, India

“…Psychiatric patients tend to be less well informed about STIs [24], poorly motivated to adopt risk reduction strategies [25,26], and lacking the interpersonal and social skill needed to negotiate safer sex [27]. Kalichman and Weinhardt [28] noted that the negative impact of depression on HIV risk behavior has largely been ignored. A meta-analysis on the modifying effects of depression on HIV interventions found that individuals are less likely to engage in HIV risk taking behavior if they are not depressed [29].…”

Reliability and Validity of the Haitian Creole PHQ-9

“…Depressive symptomatology was measured using the PHQ-9, which asks whether a symptom has been present more than half the time, over the past two weeks. The instrument uses a Likert type response format ranging from 0 (not at all) to 3 (everyday), and the total score ranges from 0 to 27 with five severity categories: minimal (0-4), mild (5-9), moderate (10)(11)(12)(13)(14), moderately severe (15)(16)(17)(18)(19) and severe (20)(21)(22)(23)(24)(25)(26)(27). 40 Translation and Content Validity of the PHQ-9.…”

“…A meta-analysis reported that HIV-positive gay men are nearly twice as likely to have experienced a recent episode of major depressive disorder as their HIV-negative counterparts, 9 and other literature reports that depression is associated with sexual risk behavior, [10][11][12][13][14][15][16] underutilization of HIV primary care services, 17 poor adherence to antiretroviral therapy, [18][19][20][21][22][23][24][25][26][27] and lower selfefficacy in one's ability to take antiretroviral therapy. 28,29 Hence, measurement of depression amongst both MSM and HIV infected populations is warranted.…”