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Heterosexual adult men have been a neglected population that is at risk for HIV infection. In an era burdened by the devastation caused by HIV, it is alarming that risky sexual behavior continues to be a problem among heterosexuals. Heterosexual sexual behavior has contributed to a growing trend of HIV transmission in the Caribbean where the average prevalence in the adult population is 5%. Despite the availability of condoms and HIV prevention efforts of many Caribbean public health departments to reduce the spread of the disease, there appears to be barriers to safer sex practices. Guided by the theory of planned behavior, a descriptive correlational design was used with 185 Bahamian men ages 18 years and older to (a) examine the relationships among select demographics, masculine ideology, condom attitudes, self-efficacy for condom use, and safer sex behaviors; and (b) identify select predictors of condom use among Bahamian men. Data were collected using four standardized instruments and a demographic questionnaire. The results of this study suggest that masculine ideology, condom attitudes, and condom use self-efficacy are important in explaining 33% variance in safer sex behaviors among Bahamian men. Income (β = -.15, p < .01), masculine ideology (β = -.24, p < .01), condom attitudes, (β = .36, p < .01), and condom use self-efficacy (β = .1, p < .01) were significantly associated with safer sex behaviors. The empirical knowledge obtained from this study will be used to provide a rationale for nurses and policy makers to design and conduct culturally sensitive interventions with an aim of achieving an increase in safer sex behaviors among Bahamian men.

Since the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) was first reported in Sierra Leone in 1987, its prevalence rate has stabilized at 1.5% in the nation's general population. However, concerns exist regarding the potential increase in high-risk populations, particularly among mineworkers and commercial sex workers. The potential spread of HIV/AIDS as a result of labor migration may threaten the mining sector, which has been identified as a critical driver of recent economic growth and development. A gap remains in the literature regarding the contextual factors in mining communities that lead to high rates of HIV/AIDS. Therefore, the purpose of this study was to quantitatively examine the association between labor migration and of sexual risk behaviors among mineworkers in the Marampa Mines in Lunsar, Sierra Leone. Grounded in the ecological model and using a cross-sectional design, 296 mineworkers from the Marampa mining communities were surveyed using a standardized survey questionnaire. Research questions were answered using simple linear and binary logistic regression analyses. Analyses of the results indicated a significant relationship between labor migration and condom self-efficacy, where migrants were predicted to have condom self-efficacy scores 7 times higher than nonmigrants. However, the results showed no statistically significant relationship between labor migration and engagement in multiple sexual partnerships and commercial sex among the mineworkers. These findings will provide important implications for positive social change in the development of multilevel HIV intervention programs to reduce sexual risk behaviors that transmit HIV, thereby improving the health and wellbeing of miners and that of their partners and families in the mining communities.

Older African American (AA) women are at increased risk for HIV and STDs. The purpose of this quantitative study was to examine the influence of provider-initiated condom use education on condom use among unmarried, heterosexually active AA women aged 50 and over using the constructs of self-efficacy and attitudes of the health belief theoretical model. The relationships between provider education on condom use, condom use self-efficacy, condom use attitudes, and actual condom use were tested individually, and provider education on actual condom use was tested after controlling for condom use self-efficacy and attitudes among 95 study participants recruited primarily from Raleigh-Durham, NC. A 2-tailed sample t test or analysis of covariance was used for analysis. Provider education on condom usage failed to show a benefit with regard to condom usage, condom use self-efficacy, and attitudes toward condom usage. Additionally, women who received provider education on condom use were less likely to use condoms. Possibly these women had a low perception of risk and vulnerability to HIV and STDs, which correlated with lower condom use. The counter intuitive findings could also be related to another variable that was not tested and should spur more research. Results could be used to contribute to the design of an intervention model that specifically addresses the sexual behaviors of older AA women. Results of this study, combined with previous research, can help emphasize the need for improved patient-provider communication so that provider communication produces a more positive outcome and helps limit the spread of HIV and STDs, a limitation that would benefit individuals, whole communities, and the nation.