Women HIV sexual risk takers: related behaviors, interpersonal issues, and attitudes.

HIV and AIDS is a growing health risk for heterosexual women, particularly women of color (Centers for Disease Control and Prevention, 1997). Our research identified 5 types of HIV sexual risk taking in 3 independent samples of adult women from a New England Community: Group A women were noted by low to moderate levels of the 4 risk markers (i.e., unprotected vaginal sex, perceived partner-related risk, number of sexual partners, and unprotected anal sex); Group B women reported very high frequency of unprotected vaginal sex; Group C women were characterized by unprotected anal sex; Group D women had high perceived partner risk; and Group E women reported extremely high levels on all 4 HIV risk markers. Sexual risk groups were validated by demonstrating significant differences among groups on relevant behaviors, interpersonal experiences, and attitudes. Compared to other women, higher risk types reported greater behavioral risk practices (substance use, prostitution, diverse sexual experience), interpersonal risk experiences (sexual abuse, violence), initiation sexual assertiveness, and attitudinal risks (psychosocial distress). They reported less interpersonal assurance (surety of own and partner's HIV status), sexual assertiveness (for condom use and partner communication), psychosocial strengths (sexual self-acceptance), and transtheoretical readiness for change (condom use efficacy, readiness to consider condoms). Results provide additional support for the multifaceted model of HIV risk and the transtheoretical model. Suggestions for specifically focused interventions are given, depending on the pattern of sexual risk taking.

Sexual Assertiveness Scale (SAS) for women: development and validation.

Four studies were conducted to develop and validate the Sexual Assertiveness Scale (SAS), a measure of sexual assertiveness in women that consists of factors measuring initiation, refusal, and pregnancy-sexually transmitted disease prevention assertiveness. A total of 1,613 women from both university and community populations were studied. Confirmatory factor analyses demonstrated that the 3 factors remained stable across samples of university and community women. A structural model was tested in 2 samples, indicating that sexual experience, anticipated negative partner response, and self-efficacy are consistent predictors of sexual assertiveness. Sexual assertiveness was found to be somewhat related to relationship satisfaction, power, and length. The community sample was retested after 6 months and 1 year to establish test-retest reliability. The SAS provides a reliable instrument for assessing and understanding women's sexual assertiveness.

PIP: The construct of sexual assertiveness has potential for codifying the strategies women use to achieve sexual autonomy. The Sexual Assertiveness Scale (SAS) was developed to measure initiation of wanted sexual experience, refusal of unwanted sexual experience, and prevention of pregnancy and sexually transmitted diseases (STDs) with a regular partner. Four independent studies were conducted to establish the stability of the factor structure of the SAS, evaluate the set of predictors of sexual assertiveness, further assess construct validity in a population at high risk of STDs, and test reliability through two follow-ups. A total of 1613 US women from university and community populations were included in the studies. Confirmatory factor analyses indicated that Initiation, Refusal, and Pregnancy/STD Prevention remained stable across samples. Consistent predictors of sexual assertiveness were sexual experience, anticipated negative partner response, a history of sexual victimization as an adolescent or adult, and self-efficacy. Relationship satisfaction, power, and length were moderately related to sexual assertiveness. Finally, test-retest reliability was confirmed. Use of the SAS could facilitate the design of programs to help women to become more able to negotiate condom use, for example.

Daily moods and symptoms: effects of awareness of study focus, gender, menstrual-cycle phase, and day of the week.

Evaluated changes in daily ratings of moods and symptoms in 30 normally cycling women and 23 men. Women were randomly assigned to two groups for manipulating awareness of the study focus (aware vs. unaware). Principal-components analysis revealed six factors (Dysphoric Moods, Well-being, Physical Symptoms, Personal Space, Food Cravings, Depression) that accounted for 70% of the variance in daily ratings. Repeated-measures analyses revealed cyclic variation on each factor and no significant differences between aware and unaware women during premenstrual or menstrual phases on any measure. Unaware women reported less well-being than men during the premenstrual phase but did not differ on any other measure. Aware women did not differ from men in premenstrual or menstrual ratings on any measure. The way these findings relate to retrospective symptom reports, menstrual attitudes, and changes in moods and symptoms across the week was examined.

Effectiveness of a procedure for disinfecting the vaginal photoplethysmograph contaminated with herpes simplex virus type 2.

To test the effectiveness of a disinfecting procedure involving 2% glutaraldehyde, a vaginal photoplethysmograph was contaminated with a known amount of herpes simplex type 2 (HSV-2). The vaginal photoplethysmograph was then put through the disinfection procedure. Two virus solutions were tested, one designed to approximate the concentration found in a naturally occurring infection (low inoculum), the other with 100 times more virus (high inoculum). Varying lengths of exposure to glutaraldehyde were tested. Results of assays for the virus after the device was disinfected showed that no measurable infectious virus remained even at the shortest exposure to glutaraldehyde, 1 min. A second experiment was conducted in which glutaraldehyde was added directly to a virus solution. Results confirmed those of the first experiment.

Effects of chronic unemployment and acute psychological stress on sexual arousal in men.

Effects on sexual arousal of unemployment and acute stress were studied in men. Ten unemployed (high-chronic-stress) and 9 employed (low-chronic-stress) men were exposed to two erotic videotapes in the laboratory. Acute stress was induced by telling the men that they would have to give a talk on their own sexual behavior and fantasies. Half the men were told about the talk before seeing either erotic tape, the other half were told in between the two erotic tapes. Cardiovascular measures confirmed the stressful nature of this manipulation. Results showed that the unemployed men achieved less penile tumescence than the employed men when stressed prior to erotic stimulation. Presentation of the stressor between the erotic videotapes (after sexual arousal occurred) produced no differences between the employed and unemployed men. These results suggest that impairment of erection occurs as a result of a combination of chronic and acute stress.

Performance of breast self-examination by women at high risk for breast cancer.

Women at high risk for breast cancer were compared to low risk women with respect to frequency of breast self-examination (BSE), knowledge and quality of BSE, and attitudinal variables. The women at high risk did not practice BSE more frequently than women at low risk, although they were more knowledgeable about BSE, more focused on breast cancer, and less confident in physician proficiency in conducting a breast exam. The rate of monthly BSE practice was low in both groups. Self-confidence about performing BSE was most strongly associated with BSE frequency in both groups. No other variables predicted BSE frequency in the high risk group. In the low risk group, knowledge of BSE technique and breast cancer focus were additional significant predictors.