HIV prevention heuristics and condom use among African-Americans at risk for HIV

Abstract

The goal of this study was to improve understanding of whether incorrect HIV/AIDS heuristics and characteristics-based risk theories are barriers to HIV prevention among young African-Americans at increased risk for HIV. We explored: (1) the beliefs of men and women regarding disease prevention strategies, and (2) the relationship of such beliefs to safer sexual behaviours. In Phase I, semi-structured individual interviews were conducted with both members of 22 heterosexual couples at increased risk for HIV/STIs. Subsequently, in Phase II, structured individual interviews were conducted with another 40 women and 40 men (not couples). Participants in Phase I reported use of condoms and monogamy as major strategies for disease prevention. The beliefs that were endorsed by the largest percentage of Phase II participants were related to the ‘known partners are safe partners’ and ‘trusted partners are safe partners’ heuristics. Moreover, stronger endorsement of the ‘known partners’ heuristic was negatively associated with measures of condom use and pregnancy prevention behaviour. Our findings highlight the need for interventions and programmes to encourage intimate partners to consistently use condoms until both members of the dyad are tested and agree to mutual monogamy.

Acknowledgments

This research was conducted as part of the PARTNERS Project, supported by cooperative agreements #U30/CCU 915062-1-0 and #U30/CCU 615166-1-0 with the Centers for Disease Control and Prevention (CDC). Members of the PARTNERS Project include S. Marie Harvey, Principal Investigator for the Los Angeles and Portland, Oregon sites; Heather C. Huszti, Principal Investigator for the Oklahoma City and Atlanta sites; and Christine Galavotti, Katina A. Pappas-DeLuca and Joan Marie Kraft, CDC Project Officers.

We thank all members of the PARTNERS Project for their contributions to this study. We give special thanks to Nancy H. Vuckovic, PhD, and staff at the Kaiser Permanente Center for Health Research in Portland, Oregon, for conducting the interviews. We also thank Dr Vuckovic and Meredith Roberts Branch, MPH for their participation in data analysis.