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Chapter 6

Health- Chapter 6.docx

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PSYC 3110
Kieran O' Doherty

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Ch 6 – 116-134, 137-139 Chapter 6: Sexual Health Sexually transmitted infections (STIs): - passed on through intimate sexual contact - passed through vaginal, oral and anal sex as well as genital contact - common STIs are chlamydia , genital warts and gonnorhea - more serious but rare are syphilis and HIV - greatest affected age is 16-24years - in the UK, it has been steadily rising since the 1990s - the number of AIDs cases in adolescent boys has doubled - HIV has been rising across the globe steadily - Most of the funds for HIV/AIDs prevention programs are posters but there is little evidence for the affectiveness Knowledge/ awareness & condom use: - survey showed that more than 1/5 people in the UK could not identify the main ways in which HIV is transmitted - survey revealed that FEWER people in 2007 were unable to identify the correct ways in which HIV is transmitted o over 1/5 didn’t understand that they could get HIV from having unprotected sex o 31% did not know that sharing a needle/ syringe is a way of contracting HIV - survey found that increase in the percentage of people would only stop using condoms in a relationship once they’ve both been tested - 24% say they rarely use a condom with a new partner - Africa – highest AIDs rate in world - Risky sexual behavior has been studied in relation to social and educational status and to habits such as dirnking, smoking and drugs - Associated with poor academic performance - Poor grades in highschool predicted high risk sexual behavior - 3 barriersto suing modern contraceptives were o misinformation and negative perceptions o gaps in knowledge o concern about social opposition from male partners - college students – many have multiple sex partners and limited condom use - alcohol and drug use prior to sexual activity is a predictor of unsafe sex  poor decision making - negative psychological consequences, guilt and reduced self esteem tend to follow unplanned sexual activity - frequent condom use was reported about 40 percent of men and women - lack of condom use is also by motivational and emotional factors, as well as culture Individual level theories - basic interventions using this approach are based on preconceived theoretical ideas  “top-down” o the interventions of this approach are constructed without any involvement of the intended participants The Health Belief Model - developed by Rosenstock - example of a cognition model which examines the predictors and precursors to health beahviour - contains four constructs o perceived susceptibility o perceived severity o perceived barriers o perceived benefits - the likelihood of a bhaviour is influenced by “cues to action” which are reminders or prompts to take action with intention - these cues can be internal or external - the HBM takes into account factors to predict the likelihood of implementing health related behavior - demographic factors (eg. Age, sex, socio-economic background), psycho- social factors (personality traits, peer influence etc. ) and structural factors (knowledge) have been added to the model - the HBM has been tested in several studies of sexual health  show inconsistent results of the various studies o predicting condom use and risk sexual practices in heterosexual college students  did not specifically predict condom use and only partially explained risky sexual behaviours o predictors of HIV antibody testing among gay, lesbian and bisexual youth  moderately positive outcome o studied perceptions of HIV and STI risk among low-income heterosexual adults (somewhat neglected group)  perceived their vulnerability to infection declining with increasing age and decreasing frequency of coitus, condom use sig. declined with increasing age o investigated social-cognitive determinants of condom use among ethnic minority communities in Amsterdam  perceived susceptibility and severity of HIV and of condom use and cues of actions did not help to explain condom use which disconfirms the HBM in the sample Protection Motivation Theory - developed by Rogers to describe coping with a health threat in light of two appraisal processes  threat appraisal and coping appraisal - according to PMT, behavior change is BEST achieved by appealing to an individual’s fears - four constructs which are said to influence the intention to protect oneself against a health threat: 1) the perceived severity of a threatened event (ie. HIV infection) 2) the perceived probability of the occurrence, or vulnerability 3) the efficacy of the recommended preventive behavior (ie. effectiveness of wearing a condom) 4) the perceived self efficacy (the person’s confidence in putting on a condom to protect) - this theory takes into account both costs and benefits of behavior in predicting the likelihood of change, PMT assumes that protection and motivation is maximized when o the threat to health is severe o the individual feels vulnerable o the adaptive response is believed to be an effective means for averting the threat o the person is confident in his or her abilities to complete successfully the adaptive response o the rewards associated with the maladaptive behavior are small o the costs associated with the adaptive response are small - Li et al. studied HIV/STD risk behavior and perceptions among sexually active rural to urban migrants in China o Migration often places indivdiuals at increased risks for HIV and STI o More sexual risk factors for males than females with regards to the mobility index - PMT components may be useful for both individual and community interventions Theory of Reasoned Action - includes three constructs – beahvioural intention, attitude and subjective norm - based on the assumption that a person is likely to do what he/she intends to do - this theory assumes that a person’s behavioural inteion depends on the person’s attitude about the behavior and subjective norms The Theory of Planned Behaviour - Ajzen added the variable of perceived behavioural control to produced TPB - Perceived behavioural control refers to one’s perception of control over the behavior and reflects the obstacles and successes encountered in past experiences with this behavior - Important factors are missing from the TPB such as culture and religion - Findings have suggested that sexual behavior is mediated by gender, religion and youth in multiple ways not incl. in TPB The Informatiion-Motivation-Behavioural Skills Model - proposed by Fisher and Fisher - this model focuses on informational, motivational and behavioural skills factors that are found to be associated with sex-related problem-prevention and wellness-promotion behaviours - according to this model, the learning of sexuality-related info is a prerequisite to action in these areas - this model assumes that having the motivation to practice specific sex- related behaviours is necessary for the production of problem-prevention or wellness-promotion - the behavioral skills construct focuses on the person’s self efficacy in performing problem-prevention or well-being related behaviors (absistence, contraceptive use, etc.) - “motivational interviewing” (MI) is a widely used strategy for building up a persons drive to change their behavior in accorda
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