Stages of Change, Decisional Balance, and Self-Efficacy in Condom Use Among Rural African-American Stimulant Users

Abstract

This pilot study (a) examined the stages of change (SOC) for condom use with primary and casual partners among rural heterosexual African American stimulant users, (b) identified gender differences in variables associated with SOC, and (c) assessed the association of SOC with decisional balance and self-efficacy. Seventy-two participants completed the study. SOC with a primary partner was much lower than SOC with a casual partner, indicating more consistent condom use with casual partners. Significant gender differences existed in decisional balance for condom use for both primary (p = 0.02) and casual partners (p = 0.03), with women having higher decisional balance scores than men. Women also reported higher self-efficacy scores for condom use with casual partners than men. In regression models, age, decisional balance, and self-efficacy were significantly associated with SOC for condom use with a primary partner; however, only self-efficacy was significantly associated with SOC with casual partners. The findings provide support for the development of interventions that promote the advantages of and increase self-efficacy for condom use.Correspondence to: Donna L. Gullette. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The Centers for Disease Control and Prevention (CDC, 2008) has estimated that there are over 1.1 million cases of HIV in the United States. African Americans, Hispanics, and men who have sex with men are disproportionately affected by HIV infection (CDC, 2008; CDC, 2007a). The rates of new HIV infections are estimated to be 83.8 per 100,000 population among African Americans, 29.4 per 100,000 among Hispanics, and 11.5 per 100,000 among Caucasians (CDC, 2008; CDC, 2007b). The HIV prevalence rate for African American men is 6 times the rate of Caucasian men. The HIV prevalence rate for African American women is 18 times the rate of Caucasian women (CDC, 2008). The CDC (2008) has estimated that approximately 21% of people living with HIV are unaware of their infection, placing others at risk for contracting HIV through unprotected sexual contact. High-risk heterosexual contact remains the primary mode of transmission for HIV among African American women and accounts for 80% of the new infections compared to 13% of new infections among African American men (CDC, 2008). NIH Public AccessThe South has the largest number of AIDS cases (40%) of any region in the United States (CDC, 2008). Of those who have died from HIV infection, there has been a steady increase from 28% to 51% of the proportion who reside in the South. The South shares a substantial...

Differences between Men and Women in Condom Use, Attitudes, and Skills in Substance Abuse Treatment Seekers

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Concurrent partnering and condom use among rural heterosexual African-American men

“…21-23 A study that examined condom use by casual and primary relationship status found that African-American men were less likely to use condoms with primary partners. 24 The current study findings that a) reported consistent condom use was significantly greater among those reporting current monogamy and b) odds of consistent condom use increased in proportion to the number of recent female sex partners reported, may indicate a positive response to the AIDS epidemic in rural Florida from African-American men. Despite engaging in concurrent partnerships, these men may indeed be aware of HIV risk.…”

Use trajectories of amphetamine-type stimulants (ATS) in Shanghai, China

“…ATS use can increase individuals' sexual desire and pleasure responses, weaken their self-control, and result in failure to use condoms. Self-efficacy and gender empowerment have been reported to be important factors that determine condom use among drug users (Gullette et al, 2009; Tony et al, 2010). The findings of this study provide clinical evidence that prevention and treatment need to target these behaviors and problems.…”