Life Optimism, Substance Use, and AIDS-Specific Attitudes Associated with HIV Risk Behavior among Disadvantaged Innercity Women

Abstract

The development of more effective human immunodeficiency virus (HIV) prevention programs for disadvantaged women requires identification of factors associated with risk. In the present study, 158 women - all of whom met criteria indicative of HIV risk - were recruited in innercity primary healthcare clinics and administered measurements that assessed variables in three domains believed pertinent to HIV sexual risk behavior: (1) substance use in the past 3 months, (2) acquired immunodeficiency syndrome (AIDS)-specific cognitive and attitudinal factors, including AIDS risk knowledge, condom attitudes, perceived risk for AIDS, behavior change intentions, and perceived self-efficacy, and (3) life context variables, including self-esteem, fatalism, personal optimism toward the future, and current life satisfaction. When women were categorized into highest and lower groups based on their recent risk behavior, AIDS-specific cognitive and attitudinal factors, as expected, differentiated the groups. However, women at highest risk for HIV also most often used a variety of substances and scored lower in self-esteem, held views more characterized by personal fatalism and low optimism concerning the future, and had greater life dissatisfaction than women at lower risk. HIV prevention programs for disadvantaged women require attention not only to AIDS-specific knowledge, attitudes, and skills development but also to broader issues of life context that, if unaddressed, may limit women's ability and motivation to reduce risk for HIV/AIDS.

The Role of Self-Regulation and Life-Optimism in Sexual Risk Behaviour in University Students From Hungary, Lithuania and Slovakia

“…Despite some studies showing sexual risk behaviour to be associated with low optimism [14,27], this study did not support this assumption. This could be explained by different study samples or ways of measuring optimism.…”

“…Women at high risk of HIV infection demonstated low self-esteem, low optimism about the future and tended to be less satisfied with life than women at low risk of HIV [14].…”

“…Sexual risk patterns may be influenced not only by behavioural, cognitive and attitudinal factors such as AIDS risk-behaviour knowledge, risk perception, attitudes and intentions to use condoms, and perception of selfefficacy but also by broader contextual factors such as one's assessment of self-esteem, self-regulation, optimism or fatalism toward the future, and degree of satisfaction with present life [14][15][16].…”

Screening for sexually transmitted infections in substance abuse treatment programs

“…Detox clients were 3.7 times more likely than MM clients to engage in high-risk sexual behavior (95% CI 1.6-8.1, P = 0.002), an effect that remained constant even when controlling for the younger mean age of Detox clients. This may reflect the role of the Detox as a substance abuse treatment entry point, in which clients are actively using drugs or alcohol and therefore are more likely to be engaging in risky sexual behavior (Ross et al, 1999;Aktan et al, 2001;Bagnall et al, 1990;Ericksen and Trocki, 1992;Fitterling et al, 1993;Flom et al, 2001;Morrill et al, 2001;Purcell et al, 2001;Scheidt and Windle, 1995;Somlai et al, 2000;Zenilman et al, 1994). It also may reflect the lower motivation to enter meaningful treatment, and thus reflect repeated and long-standing patterns of risky behavior associated with chronic drug use.…”

Provider Fatalism Reduces the Likelihood of HIV-Prevention Counseling in Primary Care Settings

“…Studies from the psychological literature have shown that providers' and patients' expectations about the likelihood of success are associated with actual outcomes in experimental or therapeutic interventions (Martin et al, 1977a,b;Stewart-Williams and Podd, 2004). Additionally, multiple studies in the HIV-prevention literature have documented a relationship between an individual's fatalistic attitudes and his or her HIV-risk behaviors (Kalichman et al, 1997;Somlai et al, 2000). In light of these findings, we expected that fatalistic beliefs among providers, as identified in our qualitative interviews, would be associated with less frequent administration of HIV-prevention counseling.…”