Using Social Action Theory to Explore Sexual Transmission Risk Behavior: A Multisite Study
Presentation
Overview
Overview
Description
Abstract
Background: The sexual transmission of HIV is complex and multi-factorial. Social Action Theory (SAT) provides a practical framework to view HIV-transmission risk behavior among sexually active persons living with HIV (PLWH). SAT highlights self-regulation of modifiable health-promoting behaviors, such as condom use and serostatus disclosure, that occur within an environment of social interaction and interdependence (Figure 1). One objective of this study, framed in SAT, was to explore factors influencing sexual risk behaviors among PLWH. An exemplar of how self-efficacy (SE) for condoms use fit the SAT model is presented.
Methods: Using a cross sectional survey design, a convenience sample of 2,182 PLWH was enrolled, from HIV/AIDS clinics and service organizations nationally and internationally, between February 2010 and July, 2011. This analysis is limited to 17 U.S. sites and Puerto Rico (n =1773). Data analyses include descriptive statistics, chi square, and logistic regression modeling (backward selection).
Results: Participants were mostly male (72%) (sex identified at birth), and of African American (43%), Caucasian (25%), Hispanic (24%), and Asian/Pacific Islander (A/PI) (3%) descent. Sex with multiple partners (SPs) without consistent condom use was reported significantly more frequently among males (26.1%, n = 330) than females (21.2%, n = 104) (p = .035). Lower scores for condom use self-efficacy was associated with less condom use (β = -3.2; p = 0.02), and compared to Caucasians, A/PIs were less likely to engage in sex with multiple partners without a condom (β = -.067, p = 0.21). Other outcome behaviors identified in SAT include SP serostatus and self-disclosure.
Conclusions: The multidimensional SAT is a useful model for exploring and explaining HIV-related sexual transmission risk behaviors of seropositive persons. Prevention interventionists can use the SAT model to during treatment and care planning, to target contextual, behavioral and self-change processes including self-efficacy for condom use.
