Implicit Attitudes and HIV Risk Behavior

本修订后的申请提出了一些研究，以纠正当前艾滋病毒性风险研究的局限性。先前的研究侧重于审慎的、基于信念的对性危险行为的态度。然而，性方面的情况是一个人对避孕套和艾滋病毒预防的信念的系统检索可能往往是最低限度的。最近的理论进展表明，在这种情况下，内隐态度应该能更好地预测行为。内隐性态度是一种评价性反应，它是由性情境中的线索自动、毫不费力地唤起的，涉及感觉而不是口头表达的思想。本研究将使用新的反应潜伏期方法来评估隐式安全套态度。在两项研究中，300名hiv阳性个体将完成基线自我报告测量，以评估他们的性行为和明确的（基于信念的）安全套态度。计算机化的启动和内隐联想任务也将在基线上用于评估对避孕套和风险相关行为的内隐态度。在一家诊所的个人将继续接受常规治疗；在另一家诊所的个人将开始更密集的心理干预，旨在使态度和性行为变得不那么危险。6个月后，所有措施将再次完成。对于两组人来说，内隐态度应该比外显态度更能预测自发性情境（例如，偶尔的伴侣）中随后的性行为（例如，避孕套的使用），而在深思熟虑的情境（例如，主要的伴侣）中则相反。接受强化干预的个体应最大程度地改变内隐态度，减少危险性行为。另外四项研究将使用910名额外的参与者来测试其他假设：(1)将特定的情感联系与避孕套联系起来的隐性测量将与性行为和避孕套使用的相关动机（例如，享乐、社交、恐惧）的个体差异相关联。(2)实验操作（认知可及性和情感启动技术）会导致内隐态度的短暂变化，从而导致避孕套相关行为的短期增加。最终，理解与情感和动机状态相关联的自动唤起的安全套态度是如何影响性风险行为的，可能建议重新检查可能影响内隐（以及外显）态度的干预方面，例如，技能培训的直接经验方面。

This revised application proposes studies to redress limitations in current research on HIV sexual risk. Previous research focuses on deliberative, belief-based attitudes toward sexual risk behaviors. Sexual contexts, however, epitomize situations in which systematic retrieval of one's beliefs about condoms and HIV prevention might often be minimal. Recent theoretical advances suggest that in such contexts, behavior should be better predicted by implicit attitudes. Implicit sexual attitudes are evaluative responses that are automatically and effortlessly evoked by cues in a sexual situation and involve feelings rather than verbally articulated thought. This research will use new response latency methods to assess implicit condom attitudes. In two studies, three hundred HIV-positive individuals will complete baseline self-report measures to assess their sexual behavior and explicit (belief-based) condom attitudes. Computerized priming and implicit association tasks will also be used at baseline to assess implicit attitudes toward condoms and risk-related behavior. Individuals at one clinic will continue to receive their regular treatment; individuals at the other clinic will begin a more intensive psychological intervention designed to make attitudes and sexual behavior become less risky. Six months later, all measures will be completed again. For both groups, implicit attitudes should predict subsequent sexual behavior (e.g., condom usage) in spontaneous contexts (e.g., occasional partners) better than will explicit attitudes, and the reverse is expected for deliberative situations (e.g., main partners). Individuals exposed to the intensive intervention should change implicit attitudes and reduce risky sexual behavior the most. Four other studies will test other hypotheses using 910 additional participants: (1) Implicit measures linking specific affective associations to condoms will be correlated with individual differences in relevant motives for sexual behavior and condom use (e.g., hedonic, social, fear). (2) Experimental manipulations (cognitive accessibility and affective priming techniques) that create transient changes in implicit attitudes will lead to short-term increases in condom-related behavior. Ultimately, understanding how automatically evoked condom attitudes associated with affective and motivational states impact sexual risk behavior may suggest a reexamination of aspects of interventions that might be impacting implicit (as well as explicit) attitudes-for example, the direct experience aspect of skills training.