Western Michigan University ScholarWorks at WMU Dissertations Graduate College 12-1994 HIV Prevention and Heterosexual College Students: The Impact of Video Instruction on the "Safer" Sexual Behaviors of Sexually Active Men Cheryl L. Knight Western Michigan University Follow this and additional works at: https://scholarworks.wmich.edu/dissertations Part of the Health Psychology Commons Recommended Citation Knight, Cheryl L., "HIV Prevention and Heterosexual College Students: The Impact of Video Instruction on the "Safer" Sexual Behaviors of Sexually Active Men" (1994). Dissertations. 1824. https://scholarworks.wmich.edu/dissertations/1824 This Dissertation-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Dissertations by an authorized administrator of ScholarWorks at WMU. For more information, please contact [email protected]. HIV PREVENTION AND HETEROSEXUAL COLLEGE STUDENTS: THE IMPACT OF VIDEO INSTRUCTION ON THE "SAFER" SEXUAL BEHAVIORS OF SEXUALLY ACTIVE MEN by Cheryl L. Knight A Dissertation Submitted to the Faculty of The Graduate College in partial fulfillment of the requirements for the Degree of Doctor of Philosophy Department of Psychology Western Michigan University Kalamazoo, Michigan December 1994 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. HIV PREVENTION AND HETEROSEXUAL COLLEGE STUDENTS: THE IMPACT OF VIDEO INSTRUCTION ON THE "SAFER" SEXUAL BEHAVIORS OF SEXUALLY ACTIVE MEN Cheryl L. Knight, Ph.D. Western Michigan University, 1994 Despite increasing evidence of the heterosexual transmission of the human immunodeficiency virus (HIV) among young adults, research with college students has been primarily restricted to descriptions of the levels of risky behavior and the correlates of that behavior. To date, few experimentally validated HIV prevention programs have been reported. Furthermore, the existing experimental investigations have seldom based an inter­ vention on a thorough analysis of the barriers to the practice of safer sex. Experiment One surveyed 195 heterosexual college students to assess HIV risk factors, including sexual behavior, risk perception, knowledge and 10 barriers to the consistent practice of "safer" sex. The results of Experiment One showed that heterosexual college students reported high levels of sexual intercourse, thus placing them at risk for the sexual transmission of HIV. An analysis of barriers to the consistent practice of "safer" sex showed that men most frequently reported two Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. barriers related to attitudes that "safer" sex practices reduced the erotic value of sexual intercourse. The top barrier cited by females was the belief that they would not contract a sexually transmitted disease. Based on these results, two versions of a "safer" sex video for heterosexual males were developed and experimentally evaluated. One version provided verbal instructions about how to use condoms and erotically incorporate them into sexual activity. The second version was identical to the first, but incorporated sexually explicit video clips to model the erotic techniques discussed in the video. Subjects included 80 male, heterosexual, college students, randomly assigned to one of the two video conditions or a control group. Analysis of self-reported barriers and sexual behaviors showed minimal changes between and within groups as a function of viewing the video tapes. These results suggest the need to consider alternative inter­ ventions (e.g., multicomponent interventions) to increase "safer" sexual behavior and decrease "risky" sexual behavior. Despite the limited impact of the intervention, the ranking of barriers to the practice of safer sex provides some guidance as to which factors might be prioritized in efforts to promote "safer" sex. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely afreet reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. 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Further reproduction prohibited without permission. Order Number 9517444 HTV prevention and heterosexual college students: The impact of video instruction on the “safer” sexual behaviors of sexually active men Knight, Cheryl L., Ph.D. Western Michigan University, 1994 Copyright ©1994 by Knight, Cheryl L. All rights reserved. UMI 300 N. Zeeb Rd. Ann Arbor, MI 48106 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Copyright by Cheryl L. Knight 1994 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ACKNOWLEDGMENTS I wish to express my gratitude to all the members of my dissertation committee: R. Wayne Fuqua (chairperson), Malcolm Robertson, Bradley Huitema, and Gillian Stoltman. Dr. Fuqua contributed to the development of all aspects of this dissertation. I appreciate the numerous opportu­ nities he gave me, as a student and research assistant. I also wish to thank Dr. Robertson for lessons in therapy and life, and Dr. Huitema for consistently directing me toward data-based solutions. Suzanne L. Keller served as project administrator during my year's absence from campus. She also provided valuable editorial comments and emotional support. Peter F. Carey assisted with project conceptualiza­ tion, editing and preservation of a productive emotional state. Julie Isenberg, Jack Michael and Michael XJrbach provided editorial assistance and/or consultation. Many research assistants participated in various aspects of this study. They include: Nicole Goodrum, Tim Nolan, Tony Maniscalco, and Susan Schultz. John Hampel contributed countless hours taping and editing both versions of the video. In addition to ii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Acknowledgements— Continued people already named, my friends and colleagues, Julie Glasser and Iser G. DeLeon, played crucial roles in video production and development. I extend special appreciation to the following people and video production companies, who generously permitted the use of their videos in my research: 1. Candida Royale's assistance with "The Pick-Up" (copyright 1987) and "Fortune Smiles" (copyright 1988), used by permission of Femme Productions, New York, New York. 2. Mitchell Spinelli's assistance with "The Last Condom," copyright 1988 by Plum Productions, used by permission of Plum Productions, Northridge, California. 3. Jeff Armstrong's assistance with "Behind the Green Door— the Sequel," copyright 1986 by Cinema 7, Inc., used by permission of The Mitchell Brothers Film Group, San Francisco, California. Cheryl L. Knight iii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS ACKNOWLEDGEMENTS....................................... ii LIST OF TABLES......................................... viii LIST OF FIGURES........................................ ix CHAPTER I. EXPERIMENT ONE: INTRODUCTION............... 1 Seroprevalence-Based Identification of At-Risk Populations....................... 2 Behavior-Based Identification of At-Risk Populations....................... 4 Factors Associated With the Practice of Safer Sex.................................. 6 Knowledge............................... 6 Attitudes About Condom Use............ 8 Perceived Vulnerability............... 10 Alcohol and Drugs...................... 11 Assertiveness.......................... 12 Summary................................. 12 Endnotes................................... 14 II. EXPERIMENT ONE: METHOD...................... 15 Subjects................................... 15 Procedure.................................