Examining models of HIV prevention among African-American gay/bisexual men

In 1998 more minority gay/bisexual men, especially African Americans, were diagnosed with AIDS than European-American gay men. This project used structural equation modeling to examine three models of sexual health behavior among 151 African-American gay/bisexual men: The Health Belief Model, Theory of Reasoned Action, and Information Motivation Behavioral Skills Model. These models show conceptual overlaps and have neglected to integrate variables that may be important predictors of safer sex behavior (e.g., gay socialization) among minority gay/bisexual men. Adding such measures should improve each model. An integrative model that includes all key variables will show the best model fit. The results of this study suggest that traditional models of safer sex should be consolidated to include the most relevant variables across models and expanded to include constructs relevant to African-American gay/bisexual men. The Theory of Reasoned Action can be used as a basis for an integrated model of safer sex practices. An integrated model should include social norm perceptions for safer sex, specific types of attitudes toward safer sex (e.g., condom attitude, expected partner reactions to safer sex), sexual assertiveness, gay socialization, self efficacy as a mediator, and safer sex intentions and behavior (e.g., reported condom use) as outcome variables.