Long-term effects of HIV counseling and testing for women: behavioral and psychological consequences are limited at 18 months posttest.

Behavioral and psychological consequences of HIV counseling and testing (HIV C&T) for women were examined in a longitudinal, prospective study. Women who received HIV C&T at community health clinics (n = 106) and a comparison group of never-tested women (n = 54) were interviewed five times over 18 months. There was no change in risk behaviors as a consequence of testing: tested and untested women engaged in high-risk sexual behavior at baseline and 18 months later. Tested women reported more anxiety, depression, and intrusive thoughts about AIDS than did untested women. Although tested women were more concerned about AIDS, their potential risk factors over the study period generally were equivalent to those for untested women. HIV counseling and testing should be considered one aspect of a broader program of HIV prevention. Identification of alternative interventions must be a public health priority.

Safer sex: social and psychological predictors of behavioral maintenance and change among heterosexual women.

Women of diverse backgrounds from 4 community health clinics in southern Connecticut were involved in a longitudinal, prospective study (n = 189). Data from interviews 3 months apart were used for the current analyses. The purpose of this study was to develop predictive models of safer sexual behavior among heterosexual women. Specifically, there was an interest in identifying factors to predict the maintenance or initiation of safer behavior over time. Relationship involvement and attitudes toward condoms were important in both models. Beyond this, differences in explanatory models emerged, reflecting the importance of examining behavior maintenance and change independently. Depression, health locus of control, and outcome efficacy belief made significant contributions to understanding the maintenance of safer sexual behavior. HIV counseling and testing, partner risk, and optimism helped to explain the initiation of safer sexual behavior. Implications for future interventions are discussed.

Limited effects of HIV counseling and testing for women. A prospective study of behavioral and psychological consequences.

OBJECTIVES: To assess the consequences of human immunodeficiency virus (HIV) counseling and testing for seronegative women in terms of sexual behavior and psychological outcomes. DESIGN: The design is prospective and longitudinal, using repeated measures. Participants were interviewed at recruitment, 2 weeks later (when tested women received results), and 3 months later. SETTING: Four community health clinics in southern Connecticut; all provide HIV counseling and testing and other specialized and primary health care services. STUDY PARTICIPANTS: A sequential sample of women were recruited for two study groups: those seeking HIV counseling and testing (n = 152), and a comparison group never tested for HIV (n = 78), matched by clinic, race, and age. MAIN OUTCOME MEASURES: A composite measure of sexual risk was developed, based on sexual activity, condom use, and partner risk factors. Psychometrically valid and reliable measures of general psychological functioning and acquired immunodeficiency syndrome (AIDS)--specific psychological indicators were also used. RESULTS: Average level of sexual risk was lower for tested than nontested women at all three interviews. For both groups, there was no significant change in sexual risk from baseline to 3-month follow-up. At the individual level, there was no difference in the number of women who decreased or increased sexual risk. For tested women, intrusive thoughts about AIDS and estimated chance of getting AIDS decreased after counseling and testing. CONCLUSIONS: Behavioral and psychological consequences of HIV counseling and testing for women at risk for HIV were limited. These results have implications for further prevention interventions.

The influence of sexual orientation on body dissatisfaction in adult men and women.

OBJECTIVE: Whereas gay culture's presumed emphasis on physical appearance may potentiate body dissatisfaction, lesbian culture's seeming lack of emphasis on appearance may protect against body dissatisfaction. We examined body dissatisfaction, associated psychosocial variables, and affiliation with the gay and lesbian community. METHOD: Self-report measures were administered to 257 subjects (69 lesbians, 72 heterosexual women, 58 gay men, and 58 heterosexual men). RESULTS: Compared with heterosexual men, gay men reported significantly more body dissatisfaction and more distress in many of the psychosocial areas related to body dissatisfaction. In contrast, lesbians and heterosexual women did not differ in these areas. Although affiliation with the gay community was associated with body dissatisfaction in gay men, affiliation with the lesbian community was unrelated to body dissatisfaction in lesbians. DISCUSSION: It seems that aspects of the gay community increase vulnerability to body dissatisfaction, yet the values of the lesbian community do not seem to be protective against body dissatisfaction.