The idiographic study of inconsistent condom use behavior of persons living with HIV

Abstract

A pilot study was conducted to assess the feasibility of using, in a multiply disadvantaged population, an electronic daily diary to test hypotheses linking affective states to variability in psychosocial determinants of condom use. Twenty-one mostly non-Caucasian individuals reporting profound economic disadvantage, heavy alcohol use and HIV infection completed a 5–7 minute interactive voice response (IVR) telephone-based survey daily for three weeks. Potentially affect-related within-person variability was observed in HIV-preventive attitudes, intentions and self-efficacy. Surprisingly, in this sample, HIV-preventive attitudes, intentions and self-efficacy exhibited as much, or greater, variability within persons as compared to between persons. Positive affect was found to significantly co-vary with self-efficacy to practice safer sex B=0.20, t (199)=2.14, p=0.03. For each unit increase in daily positive affect, daily self-efficacy increased by 0.20. Results suggest that a daily diary methodology is both feasible in a high-risk population and may offer new insights into understanding unprotected sexual behavior.