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Eroticizing Safer Sex Improves Emerging Adults’ Sexual Health: A Meta-Analysis. Lori A. J. Scott-Sheldon, Ph.D. Centers for Behavioral and Preventive Medicine The Miriam Hospital and Department of Psychiatry and Human Behavior Alpert Medical School Brown University.
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Eroticizing Safer Sex Improves Emerging Adults’ Sexual Health: A Meta-Analysis Lori A. J. Scott-Sheldon, Ph.D. Centers for Behavioral and Preventive Medicine The Miriam Hospital and Department of Psychiatry and Human Behavior Alpert Medical School Brown University Presented at the XIX International AIDS Conference, Washington, DC
Emerging Adults are at Risk for HIV • age: 18 – 29 (Arnett, 2000) • Emerging adults are vulnerable to HIV: • psychological • developmental • behavioral • >50% of all new HIV infections (UNAIDS, 2010)
HIV Diagnoses in the U.S., 2010 Emerging adults: ~31% of HIV diagnoses Centers for Disease Control and Prevention (2012)
Intervening with Emerging Adults • Reducing HIV among emerging adults is a public health priority. • Condom use is effective at reducing HIV • Behavioral HIV interventions typically focus on prevention rather than pleasure.
Condom Use • Less sexual pleasure • Loss of intimacy • Condoms = disease • Condoms + pleasure = safer sex?
Meta-Analytic Methods(Scott-Sheldon, Johnson, et al., in preparation) • Educational, psychosocial, or behavioral interventions eroticizing safer sex • Outcomes: • knowledge, attitudes, and intentions • condom use, sexual frequency • Cohen’s d
Study and Sample Characteristics • k = 19 studies and 36 interventions • N = 5,049 • 1983 – 2007 • 74% published in journals • 79% theory-based • 89% located in the U.S. • 68% small to medium-sized cities • 67% conducted at universities/schools • Samples: 50% women, 82% White, 20 yrs old
Intervention Characteristics • Interventions • 47% individual, 53% small groups • median of 1 session, 30 minutes • 58% education • 58% skills training (43% active, 57% passive) • Eroticizing safer sex component: • median = 15 minute (range: 1 to 90 minutes) • median = 50% of content (range: 9 to 100%)
Condom Eroticization • Condom use was eroticized using several methods: • 44% visual erotic component (e.g., videos) • 28% erotic instructions/read erotic stories • 14% erotic activity (e.g., role-play) • 14% used multiple methods
Antecedents of Behavioral Change d+ = 0.34 (0.14, 0.55) d+ = 0.23 (0.10, 0.36) d+ = 1.20 (0.42, 1.98)
Behavioral Outcomes d+ = 0.13 (0.01, 0.26) d+ = 0.18 (0.03, 0.32)
Conclusions • Interventions that eroticizing safer sex reduce risky sexual behavior. • Many advocates, few implementations • Where are the interventions for young MSM?
Limitations • Eroticization alone or in combination? • Missing studies?
Future Research • At-risk populations • Amount and type of eroticization needed • Condoms + pleasure = safer sex
Many thanks to the NIMH, study authors, and research assistants! Funding NIH grant R01-MH58563 to Blair T. Johnson Contact Lori_Scott-Sheldon@brown.edu