Addressing the role of emotion in HIV risk behavior

HIV-preventive behavior has most often been studied in the context of traditional social-cognitive models, which offer a framework for conceptualizing the dynamics of risk behaviors. However, these models do not have an explicit emotion construct in their structures, which may be an important omission, since emotion plays a role in decision-making and in sexual risk behavior. The present line of research aims to explore the role of self-reported emotion in conceptualizing and changing HIV risk behavior. In Study 1, an emotion component was added to a social-cognitive model of HIV-preventive behavior, the Information-Motivation-Behavioral Skills (IMB) model. In the revised IMB plus Emotion (IMB+E) model, emotion had statistically significant paths to IMB model predictors of HIV-preventive behavior as well as to HIV-preventive behavior per se. In Study 2, a single-session IMB+E model-based emotion-based intervention module was developed to facilitate recognition and anticipation of emotions involved in sexual situations (emotional education), and to help individuals to develop strategies to deal with those emotions in ways that result in condom use (emotional competence). The intervention module was pilot-tested and deemed acceptable and potentially efficacious. In Study 3, the emotion-based intervention module was paired with a traditional IMB model-based intervention to form a single-session IMB+E model-based intervention, and then tested against a single-session IMB model-only intervention and a no intervention control condition. Measures of condom use behavior were collected at baseline as well as three- and six-months post-intervention. Generally speaking, the IMB+E model intervention yielded greater condom use and reduced risk than the IMB model and control conditions, in both over time and discrete follow-up analyses. In addition, the IMB+E model arm reported more sustained condom use and reduced risk at second follow-up than did the IMB model arm. Overall, this research highlights the importance of emotion in conceptualizing sexual risk behavior, and introduces a novel intervention module that has the potential to improve the efficacy of social-cognitive interventions and to facilitate sustained risk reduction. Future research may further evaluate the efficacy of the emotional-education emotional-competence intervention in sustaining changes, and may generalize emotion-based intervention development to other health behaviors.