Resource Logo

Relapse-prevention theory increases understanding of consistent condom use with casual partners among gay men.


Int Conf AIDS. 1998;12:210-1 (abstract no. 14142). Unique Identifier :

BACKGROUND: Relapse-Prevention Theory (RPT) states that to maintain safe sexual behavior, it is important that behavioral change becomes internalized (as opposed to remain brooding over what has been 'lost'); to reinforce oneself when reducing risk behavior; and to prevent an 'Abstinence Violation Effect'. This may occur when a person attributes relapse to internal, uncontrollable and/or stable factors, leading to helplessness and reduced self-efficacy, possibly followed by even giving up trying. An appropriate coping-response in potential 'high-risk' situations is also thought to be important in RPT. We investigated whether a selection of factors from RPT increases explained variance in condom use with casual partners among gay men, compared to the main factors from the Model of Planned Behavior (MPB). METHODS: The current data were collected in 1996 with a self-administered questionnaire among 331 HIV- and 82 HIV+ men who participated in the Amsterdam Cohort Study of gay men; mean age was 46 years. RESULTS: There were 148 men who had had anal sex with casual partners in the preceding 6 months; of whom 49 (33%) had not always used a condom. From the variables in the MPB, condom use (a 5-point scale) was only explained by self-efficacy (beta = .50, R2 = 25%, p < .001). Adding factors from the RPT increased explained variance (R2) to 36% (Pchange < .001). Particularly important were: safer sex is internalized (scale of 6 items, e.g. "In my case, safe sex occurs automatically, even without thinking," beta = .21); personal reinforcement (not attributing safe behavior merely to chance, beta = -.17); and feeling upset in case relapse would occur (instead of feeling helpless, beta = -.17). The coping-response "When I'm tempted to have unsafe sex I think about my own and my partner's health" was most successful in maintaining safe sex (r = .29, p < .001) from a list of 10 such coping responses. CONCLUSIONS: It appears one should not only possess the right attitudes and have high self-efficacy and intention, but maintaining consistent condom use may also be furthered by factors which specifically focus on preventing relapse. Explaining and promoting condom use among gay men who have sex with casual partners may therefore be improved when attention is also paid to factors derived from Relapse-Prevention Theory, in addition to factors derived from the Model of Planned Behavior.

MEETING ABSTRACTS Adaptation, Psychological Adult Attitude to Health Condoms/*UTILIZATION Emotions Habits Homosexuality, Male/*PSYCHOLOGY Human HIV Infections/PREVENTION & CONTROL/PSYCHOLOGY HIV Seronegativity HIV Seropositivity Male Middle Age Models, Psychological Netherlands Reinforcement (Psychology) *Risk-Taking Safety Sex Behavior/*STATISTICS & NUMER DATA Sexual Partners


Information in this article was accurate in December 30, 1998. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.