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CONTEXT: Little research has explored how teenagers think about abstinence and how it functions in their lives. These questions are particularly salient in light of widespread funding of abstinence-only programs in the United States. METHODS: Data on attitudes and intentions related to abstinence and sex were collected from 365 adolescents aged 12–15 who participated in an HIV risk reduction program in Seattle in 2001–2003. Logistic regression analyses assessed associations between these cognitions, as measured six months after the program, and teenagers’ likelihood of having vaginal or anal sex in the subsequent six months. RESULTS: Adolescents who had positive attitudes and intentions about abstinence had a reduced likelihood of subsequently engaging in sex (odds ratio, 0.6 for each), whereas those with positive attitudes and intentions about having sex had an elevated likelihood of engaging in sex (2.2 and 3.5, respectively). A regression model including only sex cognitions accounted for substantially more variation in sexual activity than did one including only abstinence cognitions (15–26% vs. 6–8%). Significant interaction effects were also seen: Among teenagers with low levels of sex intention, greater abstinence intention had little relationship to the predicted probability of having sex, but among teenagers with high levels of sex intention, greater abstinence intention was associated with increases in the predicted probability of having sex. CONCLUSIONS: Youth do not consider abstinence and sexual activity opposing constructs, and solely instilling positive abstinence attitudes and intentions in youth may not have robust effects in preventing sexual activity. [ABSTRACT FROM AUTHOR]

Although the majority of prevention efforts have focused on women, reduction of heterosexual transmission of STDs also requires interventions for men, necessitating understanding of men's safer sex decision making. In a random sample of 486 heterosexually active men, the theory of reasoned action (TRA) was used to predict intentions to use condoms with casual partners, as well as 2 steady-partner safer sex behaviors: mutual monogamy and condom use. The basic TRA model fit the data well. Expanded models identified the mediated (via attitudes, social norms, and self-efficacy) and, for some, direct effects on intentions and behavior of selected intrapersonal, interpersonal, and sociocultural variables. Results suggest that the role of external variables might vary depending on the behaviors in question. [ABSTRACT FROM AUTHOR]

Is daily data collection of sexual and other health-related behaviors reactive? This question was examined by exploring trends in daily reports of sexual intercourse, condom use, drinking, smoking, and vegetable and fruit consumption over a 2-month period. The trends were examined for evidence of fatigue effects and socially desirable responding. The effects of data collection method and gender were also examined. Results from a hierarchical linear modeling analysis showed a significant trend toward decreased reporting of drinking, smoking, and sexual intercourse, but no significant trends in fruit and vegetable consumption or condom use. These patterns are not consistent with fatigue effects or socially desirable responding. The results are discussed in relation to choosing data collection methods that minimize error. [ABSTRACT FROM AUTHOR]

Objective: Retrospective reports of the association between drinking and high-risk sexual behavior can be biased by implicit theories of the effects of drinking or may represent post hoc justifications instead of accurate reports of behavior. Using data from a daily diary study, we compared daily reports of condom use when drinking and not drinking with the same participants' reports of these behaviors from a retrospective questionnaire administered after diary collection was complete. Method: Participants included adolescents (n = 145), adult sexually transmitted disease clinic clients (n = 167), college students (n = 145), and men who have sex with men (n = 147). All participants reported their alcohol consumption and sexual activity daily for 8 weeks and then completed a retrospective questionnaire about their behavior over the diary period. Results: Participants' retrospective judgments about whether they used condoms more or less when drinking were not significantly related to their behavior as reported in the diary. Fewer than two thirds of the participants were accurate in their recollection of the association of condom use and drinking. Teenagers and men who have sex with men were more likely to retrospectively overestimate the negative effect of alcohol on condom use. Conclusions: Retrospective questions about the association between drinking and condom use were consistent with actual behavior only among people who consistently either never or always used condoms. These individuals correctly reported that drinking had no effect on their condom use. For people whose condom use varies, questions about associations between drinking and sex may be difficult to answer, owing to their conditional nature, and may lead to error. [ABSTRACT FROM AUTHOR]