Conceptualizing Women's Attitudes Toward Condom Use with the Tripartite Model

Background: The Centers for Disease Control and Prevention (2011) estimated that women represent 24% of HIV diagnoses in the United States, with most infections resulting from heterosexual contact. However, consistent condom use is highly effective in preventing the spread of HIV. The current study examined women's attitudes toward condom use and potential inconsistencies related to the conceptualization and measurement of attitudes. Method: Data were collected from October 2009 through March 2010. Researchers included 556 female undergraduate students from the Southeast region of the United States. Exploratory and confirmatory factor analyses were used to determine whether women's condom use attitudes were composed of an affective and a cognitive component. Results: Evidence for a two-factor model of condom use attitudes consisting of an affective and cognitive component was found, with participants reporting slightly negative feelings toward condom use but favorable beliefs about using condoms. Affect accounted for more variance (42%) than cognition (8%) in condom use attitudes. Notably, affect and cognition were differentially associated with past behavior and intentions to use condoms. Conclusion: Understanding the structure of women's attitudes toward using condoms can aid in the creation of appropriate HIV prevention and condom use messaging targeted toward promoting positive attitudes and normative change. Changing women's attitudes in this manner could enhance the effectiveness of condom use interventions.     

Implicit Attitudes in Sexuality: Gender Differences

This study examined the role of gender in both implicit and explicit attitudes toward sexuality. Implicit attitudes are judgments or evaluations of social objects that are automatically activated, often without the individual's conscious awareness of the causation. In contrast, explicit attitudes are judgments or evaluations that are well established in awareness. As described in Oliver and Hyde's (1993) meta-analysis of self-report (explicit) data, women report greater negative attitudes toward sexuality than do men. In the current study, we used the Sexual Opinion Survey (SOS) developed by Fisher, Byrne, White, and Kelley (1988) to index explicit attitudes and the Implicit Association Test (IAT) developed by Greenwald, McGhee, and Schwartz (1998) to index implicit attitudes. Research has demonstrated that the IAT reveals attitudes that participants may be reluctant to express. Independent variables examined were participant gender, social acceptability of sexual words, and order of associated evaluations in the IAT (switching from positive to negative evaluations or the reverse). The IAT data revealed a significant Order × Gender interaction that showed that women had more negative implicit attitudes toward sexuality than did men. There was also a significant Order × Acceptability interaction, indicating that implicit attitudes were more strongly revealed when the sexual words used in the IAT were more socially unacceptable. As expected, on the SOS, women had more negative explicit attitudes toward sexuality. There was no significant correlation between explicit and implicit attitudes. These data suggest that at both automatic (implicit) and controlled (explicit) levels of attitudes, women harbor more negative feelings toward sex than do men. Portions of this article were presented as a poster at the meeting of the International Academy of Sex Research, Bloomington, Indiana, July 2003.     

Gender Differences in Condom Usage Among Rural Crack-Using Men and Women

SUMMARY

Consistent condom use is an important aspect of decreasing HIV transmission risk in heterosexual crack cocaine using populations. This study explores gender differences in attitudes and motivations to use condoms within a rural, economically disadvantaged sample. Qualitative data analysis identified recurrent themes regarding condom use and assessed how themes varied among men and women. Analyses showed that men and women exhibit different rationales for condom use, while both reported inconsistencies between their knowledge about safe sex, receptivity to condom use, and applications in practice. The findings suggest that prevention programs should be tailored to increase consistent condom use among main partners of crack smokers at risk for HIV.     

Ethnic and Gender Differences in Psychosocial Risk,Protection, and Adolescent Alcohol Use

Theoretical models suggest that many diverse psychosocial factors contribute to the etiology of substance use among youth. It has been suggested that substance use is a function of the total number of etiologic factors, rather than a specific type or set of factors. This study examined whether cumulative psychosocial risk and protection measured in the 7th grade predicted alcohol use in the 9th grade across ethnically diverse samples of adolescents. Participants consisted of black (n = 775) and Hispanic (n = 467) inner-city youth and white suburban youth (n = 708). Prevalence rates for alcohol use and risk/protection varied more widely based on ethnic group compared to gender. Black youth reported the fewest risk factors and lowest levels of alcohol use, white youth reported the most risk factors and highest levels of alcohol use, and Hispanic youth reported the fewest protective factors and intermediate levels of alcohol use. Despite these differences, structural equation modeling indicated that a latent factor consisting of cumulative risk, protection, and their interaction significantly predicted later alcohol use for the combined sample as well as for each ethnic/gender subgroup. However, the proportion of variance explained in alcohol use varied across subgroups, and moderator analyses indicated that protection significantly buffered the effects of risk differentially across subgroups. The strongest protective effects were observed among black inner-city youth. Findings suggest that prevention approaches should focus on enhancing protection in addition to reducing risk, particularly among youth with lower levels of psychosocial protection.     

Ethnic and Gender Differences in Alcohol Use Among a Longitudinal Sample of Inner-City Adolescents

The purpose of this study was to determine if ethnic and gender differences in alcohol use exist among a cohort of inner-city adolescents during each of the 3 years of middle school. Students in 22 urban schools completed self-report questionnaires with measures of alcohol use (frequency of drinking, amount of drinks per occasion, and frequency of drunkenness) at three annual assessments. Of the participating students, 2312 identified themselves as Asian, Black, Hispanic or White. Analyses of variance were conducted to test for ethnic group (Asian, Black, Hispanic, White) and gender differences in alcohol use. Ethnic differences were found for all three alcohol measures at each assessment point. Boys drank more frequently than girls during the first 2 years. Asian and Black adolescents appeared to be at lower risk for alcohol use.     

Ethnic and Gender Differences in Ideal Body Size and Related Attitudes among Asians,Native Hawaiians,and Whites

Often overlooked explanations for the varied obesity rates across ethno-cultural groups include differences in attitudes toward excess weight, with certain populations assumed to have larger ideal body sizes (IBS). Past studies found ethnic and gender difference in IBS across and within different groups. This study examined the effects of ethnicity and gender, and their interaction, in accounting for differences in IBS and attitudes toward those ideals. Multiple regression analyses were used to better understand the effects of ethnicity and gender in accounting for differences in perceived IBS according to ethnic-specific and Western ideals and attitudes in 1,124 people of Native Hawaiian, Filipino, Japanese, and White ancestry. The analyses controlled for socio-demographics, body mass index, health-related behaviors, and psychosocial variables. The results indicated that Native Hawaiians selected larger ethnic IBS, Filipinos selected smaller ethnic IBS, and Native Hawaiians selected slightly smaller Western IBS than other ethnic groups. Overall, males selected larger IBS compared to females. Interaction analyses indicated that the relationship between ethnic IBS and attitude toward that IBS varied as a function of ethnicity, such that Native Hawaiians who selected a larger ethnic IBS held less favorable attitudes toward that IBS. The discrepancy between Native Hawaiians'' selection of larger ethnic IBS as ideal and their less positive attitude toward that selection warrants more investigation. However, it does suggest that Native Hawaiians, on a personal level, do not prefer larger body sizes, which contradicts their perceptions of social norms. These findings have important implications for obesity interventions among Native Hawaiians.     

Ethnic and Gender Differences in Request For and Use of Low/Non-Fat Foods in Bag Lunches

This study examined ethnic and gender differences in frequency of use and request for low-fat or non-fat foods in bag lunches, while controlling for socioeconomic status. Questionnaires were completed by 1,678 middle school students and their parents (72% response). Ethnic distribution included White (51%), Latino (17%), Asian (11%), Multi-ethnic (11%), and African American (8%). Forty-five percent of students (N = 712, 59% female) brought lunch to school a mean of 3.6 (SD = 1.5) days per week. Boys brought lunch more often (M = 3.8 days/week vs. 3.4, respectively), yet requested less low-fat foods than girls. Whites brought lunches with the most low/non-fat items. Ethnic differences also were found in the use of seven specific bag lunch foods and whether these items were regular or low-fat. Because of ethnic and gender differences, different strategies for reducing fat in bag lunches are needed for different groups.     

Gender Differences in Children's Internet Use

This paper analyses comparative empirical data from across Europe on gender differences in children's Internet use, and through a new interpretive framework on young people's experiences, seeks to add new findings to this growing international knowledge base. Linking feminist theory on gender and technology with theories of youth gender identity construction, four key areas are investigated. Firstly, the impact of increased Internet access and use in schools and in homes on gender equality is examined. Secondly, youth communication and content creation practices are investigated to explore whether the Internet is facilitating flexibility in gender identity and the transcendence of traditional gender roles. Thirdly, gender differences in skills and perceptions of expertise are discussed. Finally, Internet activities which demonstrate overtly gender-stereotypical masculine attributes—pornography and action/violent game playing—are discussed. We argue that gender remains a salient factor in researching the complexity of young people's Internet use and call for multiple theoretical perspectives to contribute to further research on this topic.     

Normative Youth's Attitudes Toward Integrating Detached Youth Within Normative Youth Settings: Gender and Field of Studies Differences

This two-phase study examines normative youth's attitudes toward integrating detached youth within normative youth settings. Phase I deals with high school students and focuses on sex differences in attitude. Demographic and attitude questionnaires were administered. Two hypotheses were assumed for this phase: (a) Females would show greater positive attitudes toward integrating detached youth than males; (b) Females' attitudes toward integrating detached youth would be similar at both individual and societal levels, whereas males' attitudes toward integrating detached youth would be more positive at the societal level than at the individual level. In Phase II, the same questionnaires were administered to college students. Two hypotheses were assumed: (a) females would demonstrate more positive attitudes than males toward integrating detached youth within normative youth settings; (b) students in the social sciences would demonstrate more positive attitudes than students in the natural sciences. Both Phase I hypotheses were supported. Normative youth's attitudes toward integrating detached youth within normative youth settings were found to be positive. In contrast, neither of the Phase II hypotheses were supported; there were no gender differences, nor any differences between social science students and natural science students. Theoretical and operative conclusions of these findings are presented.     

Gender Matters: Condom Use and Nonuse Among Behaviorally Bisexual Men

Although frequently cited as being at high risk for HIV/STI transmission, little is known about behaviorally bisexual men’s patterns and experiences of condom use and nonuse with male and female sexual partners. Using a variety of recruitment techniques informed by a Community Advisory Committee, a total of 77 behaviorally bisexual men were recruited from Indianapolis, Indiana to participate in semi-structured interviews focused on sexual health. Qualitative data were collected containing detailed information on their patterns and experiences of condom use and nonuse with both male and female partners. Participants described numerous commonly reported barriers for consistent condom use, as well as distinct bisexual-specific barriers. The majority reported consistent condom use with male and female casual partners, but many who did not use condoms described doing so in the context of ongoing relationships. In addition, participants provided reasons for condom use and nonuse that varied based on the gender of the partner and the type of relationship with the partner. Future interventions focused on increasing condom use among behaviorally bisexual men should take into account the unique complexities of gender and relationship configurations in this distinct population.     

Ethnic Differences in Sexual Attitudes of U.S. College Students: Gender,Acculturation, and Religiosity Factors

Although it has been hypothesized that culture and religion play an important role in sexuality, the relative roles of acculturation and religiosity on ethnic differences in sexual attitudes have not been often empirically explored. The present study assessed differences in sexual attitudes in Euro-American, Asian, and Hispanic American populations using measures of acculturation to analyze the relative effects of heritage and mainstream cultures, as well as religiosity, within each ethnic group. A total of 1,415 college students (67% Euro-American, 16% Hispanic, 17% Asian; 32% men, 68% women) completed questionnaires which assessed attitudes towards homosexuality, gender role traditionality, casual sex, and extramarital sex. In concordance with previous studies, Asians reported more conservative sexual attitudes than did their Hispanic and Euro-American peers. Hispanics reported sexual attitudes similar to that of Euro-Americans. For both Hispanic and Asians, higher acculturation predicted sexual attitudes similar to that of Euro-Americans. For Asian, Hispanic, and Euro-American women, there was a significant interaction between intrinsic religiosity and spirituality such that the relationship between conservativism of sexual attitudes and intrinsic religiosity was stronger at higher levels of spirituality. In Euro-Americans and Asians, intrinsic religiosity and religious fundamentalism strongly predicted conservative sexual attitudes; while still significant, these relationships were not as pronounced in the Hispanic sample, implying an ethnic-by-religious effect. Novel to this study, acculturation did not mediate the relationship between religiosity and sexual attitudes, indicating that ethnic differences in religiosity effects were distinct from acculturation.     

Gender Differences in Beliefs and Attitudes Towards Complementary and Alternative Medicine Use Among a Non-urban,Malaysian Population

Journal of Community Health - The choice to take-up specific complimentary and alternative medicine (CAM) modalities is influenced by many factors including cultural background, experience and...     

Differences in Black and White Adolescents'' Perceptions About Cancer

This study determined if black and white adolescents differed significantly in cancer knowledge, attitudes, and beliefs. Using the Health Belief Model, a 97-item questionnaire was developed by the researchers and completed by 573 black and 297 white junior and senior high school students from a large, midwest school district. Chi-square analyses yielded nine significant differences (p less than .01) between blacks and whites on cancer knowledge (etiology, warning signs, and prevention techniques). Further significant differences were found when items comprising the separate Health Belief Model subscales were analyzed. Blacks and whites differed significantly on cues to action (one item), perceived susceptibility (two items), perceived severity (one item), perceived barriers (two items), perceived benefits (three items), and interpersonal relationships (three items). Blacks and whites received cancer information from the same sources, with the exception of books, which was reported more by blacks.     

Correlates of Temperate and Intemperate Attitudes Toward Alcohol Use

The relationship between alcohol attitudes and the personality variables of locus of control and authoritarianism was investigated for a sample of 791 high school students. Authoritarianism was negatively related to indiscriminate attitudes and positively related to responsible attitudes toward alcohol use for both males and females. The locus of control dimension correlated with alcohol attitudes for females only. The findings provide information useful in the identification of adolescents at risk for problematic drinking.     

Validation of Brief Condom Use Attitudes Scales for Spanish-Speaking People Who Use Crack Cocaine in El Salvador

People who use crack cocaine (PWUCC) are a population severely impacted by a concentrated epidemic of HIV. Behavioral interventions to prevent and treat HIV among PWUCC have been implemented around the world including in low- and middle-income countries which have been disproportionately affected by HIV. However, few studies have validated and assessed psychometric properties of measures on PWUCC, especially in transnational populations. Our sample was comprised of 1324 PWUCC, Spanish mono-lingual speakers, residing in the metropolitan area of San Salvador, El Salvador. Exploratory factor analysis and subsequent confirmatory factor analysis using statistical softwares SPSS and Amos were conducted on three abbreviated and translated condom use attitude measures (i.e., Condom Use Attitudes Scale—Spanish Short Form, Condom Use Social Norm—Spanish Short Form [CUSN-SSF], Condom Use Self-Efficacy—Spanish Short Form). Convergent validity was examined by computing bivariate correlations between the scales and condom use and sexually transmitted disease diagnosis. Results indicated that a two-factor, 8-item correlated model for the CUAS-SSF scale had an excellent fit and adequate reliability (α?=?.76). The confirmatory factor analysis for the 5-item CUSN-SSF scale indicated a satisfactory fit with 3 of 6 fit indices indicating adequate fit. Analysis of the two-factor 5-item CUSE-SSF scale indicated satisfactory fit and adequate reliability (α?=?.84). There were significant correlations between all measures and with self-reported condom use. Results indicate that these brief measures are reliable and valid and can be utilized to assess the effectiveness of HIV risk reduction interventions among Spanish-speaking PWUCC.

     

Gender and Ethnic Differences in Survival in a Cohort of HIV Positive Clients

Objectives: The purpose of this study was to examine gender and ethnic differences in survival of persons receiving treatment for HIV infection to determine if differences existed, and if they did, to assess the possibility of explaining these differences by examining other factors, such as age, disease severity when beginning treatment, alcohol, illicit drugs, tobacco, educational level, living arrangements, antiretroviral treatment, PCP prophylaxis, sexually transmitted diseases, mode of transmission and opportunistic infections.

Design: A retrospective cohort study of all clients receiving treatment at an HIV only clinic from its opening in early 1988 until the end of May 1993. Statistical methods used to examine the data included incidence density ratios, Kaplan‐Meier survival curves, Breslow (generalized Wilcoxon) tests of equality of survival curves and Cox proportional hazards models both with and without time dependent covariates.

Results: In the cohort (37% African American, 7% Hispanic American and 25% female), 220 deaths occurred during 1223 person years of follow‐up. Compared to European American males, the following incidence density ratios were observed: European American females: 0.50, Hispanic American females: 0.70, Hispanic American males: 0.96, African American females: 1.28 and African American males: 2.38. The differences were noted above for gender/ethnicity groups were significant at the p < 0.0001 level. After adjusting for disease stage (as measured by laboratory testing of CD4 positive T‐lymphocytes), educational level, and age, no differences in survival by gender or ethnicity remained. Disease stage and educational level had the greatest prognostic significance.

Conclusions: European Americans entered treatment at a much earlier disease stage (as measured by CD4 positive T‐lymphocyte counts) and had higher educational levels (a surrogate for socioeconomic status) than African Americans. These factors may explain the longer survival in European Americans as compared to African Americans in this cohort.