Incorporating Communication into the Theory of Planned Behavior to Predict Condom Use Among African American Women.

The present research extends the theory of planned behavior (TPB) to investigate how communication-related variables influence condom use intention and behavior among African American women. According to the TPB, attitudes, subjective norms, and self-efficacy are associated with behavioral intent, which predicts behavior. For women, it was argued that condom negotiation self-efficacy was more important than condom use self-efficacy in predicting consistent condom use. Moreover, an important environmental factor that affects condom use for African American women is fear or worry when negotiating condom use because the sex partners might leave, threaten, or abuse them. Fears associated with negotiating condom use were predicted to be negatively associated with attitudes, subjective norms, and self-efficacy. African American women (N = 560; M age = 20.58) completed assessments of TPB variables at baseline and condom use 3 months later. Condom negotiation self-efficacy was a significant indicator of behavioral intent, while condom use self-efficacy was not. Fear of condom negotiation was negatively associated with all TPB components, which was in turn significantly associated with behavioral intent and condom use. Implications for the TPB, safer sex literature, and sexually transmitted infection prevention intervention design are discussed.

Sexual Risk Among African American Women: Psychological Factors and the Mediating Role of Social Skills.

Prior research demonstrates a positive association between mental health problems and sexual risk for African American women. Using the social skills deficit hypothesis, we proposed that social skills mediate this relationship. African American women (n = 557, M age = 20.58) completed measures of depression, stress, emotional dysregulation, sexual risk behaviors, and perceptions of their social skills with their primary sexual partner. Social skills mediated the link between the mental health assessments and a composite sexual risk index. Theoretical implications of extending the social skill deficit hypothesis are discussed as well as implications for interventions.

Do As I Say: Using Communication Role-Plays to Assess Sexual Assertiveness Following an Intervention.

Sexual risk reduction interventions are often ineffective for women who drink alcohol. The present study examines whether an alcohol-related sexual risk reduction intervention successfully trains women to increase assertive communication behaviors and decrease aggressive communication behaviors. Women demonstrated their communication skills during interactive role-plays with male role-play partners. Young, unmarried, and nonpregnant African American women (N = 228, ages 18-24) reporting unprotected vaginal or anal sex and greater than three alcoholic drinks in the past 90 days were randomly assigned to a control, a sexual risk reduction, or a sexual and alcohol risk reduction (NLITEN) condition. Women in the NLITEN condition significantly increased assertive communication behavior compared to women in the control condition, yet use of aggressive communicative behaviors was unchanged. These data suggest assertive communication training is an efficacious component of a sexual and alcohol risk reduction intervention. Public health practitioners and health educators may benefit from group motivational enhancement therapy (GMET) training and adding a GMET module to existing sexual health risk reduction interventions. Future research should examine GMET's efficacy in combination with other evidence-based interventions within other populations and examine talking over and interrupting one's sexual partner as an assertive communication behavior within sexual health contexts.