BACKGROUND The frequently asymptomatic nature and high incidence of severe complications of sexually transmitted diseases (STD) calls for targeted efforts to identify those at greatest risk. Earlier studies have shown inconsistencies regarding STD evaluation by primary care clinicians and physicians. However, the literature regarding the consistency of practice patterns regarding elicitation of sexual history is limited. We examined practice patterns for the elicitation of sexual history among providers across seven sites nationwide. METHODS As part of a multisite study to encourage health seeking for populations specifically at risk for gonorrhea (GC) and other STDs, semistructured interviews that included questions regarding sexual history elicitation were conducted with 208 service providers in a total of 121 publicly and privately funded clinics, managed care organizations (MCOs), hospital clinics, community- and school-based clinics in Denver, New York, Los Angeles, Birmingham, St. Louis, Indianapolis, and Prince Georges County, MD. RESULTS Among the providers interviewed, practice patterns for the elicitation of sexual history were inconsistent. Sexual histories were described as routine (i.e., solicited from every client regardless of reason for visit) in 57% of sites. Providers most frequently asked clients their number of sex partners (57%), their contraceptive history (55%), and STD history (34%). Client discomfort among 46% and provider discomfort among 13% was cited as barriers to the elicitation of sexual history. A quarter (26%) of providers agreed that the elicitation of sexual history can be fostered by improved provider communication skills and 16% agreed increasing training and experience for providers is needed. CONCLUSIONS These findings suggest that interventions with providers to standardize sexual history elicitation can help to reduce barriers to prevention, diagnosis, and treatment of STD.

Are design arguments just a matter of taste, or does layout affect how readers understand news stories? The question applies broadly to all media. This experiment measured whether respondents found horizontal layout more tranquil and whether their responses depended on the content. Horizontal layouts did relate to measures of comfort and human interest. Presented with a horizontal layout, respondents rated an article more comforting, pleasant, light, and so forth. The effects depended on the content, interacting with form in complex ways. The results show that design decisions matter and should be taken with care. In the media, form is content.

THROUGH ONE OF ITS MANY HIV prevention programs, the Prevention Marketing Initiative, the Centers for Disease Control and Prevention promotes a multifaceted strategy for preventing the sexual transmission of HIV/AIDS among people less than 25 years of age,The Prevention Marketing Initiative is an application of marketing and consumer-oriented technologies that rely heavily on behavioral research and behavior change theories to bring the behavioral and social sciences to bear on practical program planning decisions. One objective of the Prevention Marketing Initiative is to encourage consistent and correct condom use among sexually active young adults.Qualitative formative research is being conducted in several segments of the population of heterosexually active, unmarried young adults between 18 and 25 using a semistructured elicitation procedure to identify and understand underlying behavioral determinants of consistent condom use. The purpose of this paper is to illustrate the use of this type of qualitative research methodology in designing effective theory-based behavior change interventions. Issues of research design and data collection and analysis are discussed. To illustrate the methodology, results of content analyses of selected responses to open-ended questions on consistent condom use are presented by gender (male, female), ethnic group (white,African American), and consistency of condom use (always, sometimes). This type of formative research can be applied immediately to designing programs and is invaluable for valid and relevant larger-scale quantitative research.

In Fall 1990, a knowledge, attitude, belief, and practices (KABP) survey was administered to a representative sample of residents of St. Vincent and the Grenadines, an island nation in the Eastern Caribbean. The KABP questionnaire contained a large number of questions that could reasonably be expected to be related to whether or not people use condoms. To a certain extent, each of these questions can be viewed as an attempt to assess one of the variables identified by one or more theories of behavior and behavior change. More specifically, questions on the KABP were identified as possible indicants of AIDS knowledge, cues to action, perceived susceptibility, perceived severity, perceived (locus of) control, perceived normative pressure, and condom use outcome expectancies. Statistical analyses indicated that some, but not all, of these variables were related to condom use among sexually active adults. In particular, the analyses indicated that perceived normative pressure to use condoms was the single most important determinant of condom use behaviors on St. Vincent. The implications of this finding for designing mass‐media campaigns to increase condom use is discussed, and a campaign that attempts to change condom use by influencing perceived social norms is strongly recommended.

Based on extensive formative research in the three Eastern Caribbean countries of St. Lucia, St. Vincent and the Grenadines, and Grenada (Fishbein, Middlestadt, & Trafimow, 1993; Fishbein, Trafimow, et al., 1993), a three‐nation, mass media, condom use campaign was developed. In order to assess the impact of the campaign, a follow‐up survey was conducted in St. Vincent and the Grenadines. This paper examines the effectiveness of the campaign by comparing responses on this survey by respondents who were or were not exposed to the campaign. A statistically significant impact of exposure to the campaign was obtained, indicating that a well‐designed, empirically based, mass media campaign can be an effective tool in the battle to prevent the spread of AIDS.

A knowledge, attitude, belief, and practices survey was given to a sample of 591 residents of St. Lucia in the fall of 1990. The survey posed a host of questions relating to whether respondents were inclined to use condoms when having sex. Respondents were sexually experienced, aged 15-60 years, and interviewed in their homes. Questions were posed and viewed as possible indicators of AIDS knowledge, cues to action, perceived susceptibility, perceived severity, perceived locus of control, normative pressure, and condom use outcome expectancies. Statistical analysis suggests that each variable is related to condom use. Analysis also indicates that perceived normative pressure to use condoms was by far the single most important determinant of condom use among the sample. The author closes by discussing the implications of these findings for designing mass media campaigns to increase condom use and strongly recommends a normative campaign.

The present paper presents the results of AIDS Knowledge, Attitudes, Beliefs, and Practices (KABP) surveys conducted in two Caribbean countries: St. Vincent and St. Lucia. Despite religious, socioeconomic, and literacy differences between the two countries, their citizens are remarkably similar with respect to AIDS knowledge, attitudes, beliefs, and practices. The major differences between the two countries concern the perception of AIDS risk and the relative position of AIDS as a serious problem facing the country. These differences, however, appear unrelated to AIDS knowledge, sexual practices, or the likelihood of engaging in AIDS‐protective behaviors. These findings question the role of perceived risk of AIDS as a determinant of AIDS‐protective behaviors, and, more important, they question the utility of increasing perceived risk as a strategy in AIDS prevention programs.

The authors examined the relationship between perceived occupational stress and the prevalence of a number of psychologic and physical ailments in a sample of professional symphony orchestra musicians and related musicians' self-reports of stress to demographic and occupational characteristics. Results of a survey of 2,212 musicians from 47 symphony orchestras revealed a significant relationship between perceived occupational stress and prevalence of a number of psychologic as well as physical medical problems. Age and occupational factors, such as the orchestra in which the musician plays, the instrument played, and status as a soloist, were also found to be significant correlates of perceived stress.

This study examined the use of oral contraceptives in a sample of sexually active college women. The analytic approach employed was based on Fishbein's model for the prediction of behavior, which emphasizes perceived consequences and normative influences. It was found that each of these factors was significantly related to use of oral contraception, and that a stronger relationship was obtained when both components were combined. Results suggested that nonusers are more Likely to associate oral contraception with unhealthful consequences than are users, and that users believe employment of this method enhances their sexual satisfaction. It was also suggested that the opinions of these young women's partners and close friends, but not of their parents, are reflected in respondents' use of the pill. These results were compared with earlier findings on the correlates of intentions to use oral contraceptives, and applied implications were discussed.