# Presentation: 011866

## STD Prevention: The Female as Health Communicator and Risk Manager

- Miriam Y. Vega
- University of California, Berkeley

## Study’s Goals

- To examine how perception of risk-preventive sexual behavior, such as condom use and communication regarding condom use, varies in accordance with:
- (1) specific dyadic relationship forms
- (2) gender roles
- (3) power differentials within relationship

## Social Aspects of STD Research

- STDs socially transmitted
- Sexual behavior is social behavior
- Missing from past models: impact of social context on risky decision making
- Need to incorporate findings about human interaction into STD prevention

## Relational Schemas

- ....are cognitive structures that are representational models of oneself and of others, along with the self as experienced in differing types of relationships (Baldwin, 1992)
- These cognitive structures are interconnected by interpersonal scripts
- Scripts: stereotyped sequences of actions detailing who, what, when, where, and why of appropriate actions (Delameter, 1987)

## Exploratory Study

- Respondents asked how they decided on protective measures
- Most respondents said “By mutual agreement”
- Further explanations never offered
- Lack of explanation for how agreement is reached indicative that script is only vaguely sketched

## The Present Study

- Used a written vignette methodology
- Addressed 4 primary questions
- (1) Are condoms part of relational schemas?
- (2) Is condom use scripted as a contraceptive or as a prophylactic?
- (3) How is communication about protective measures scripted?
- (4) How are power dynamics scripted?

## The Written Vignette

- Hypothetical couple talks for a while, then begin to kiss
- Scene stops immediately following the kiss, forcing respondents to “fill in the gaps”

## Relationship Types:

- (1) One-night stand
- (2) First-date relationship
- (3) Casual, non-exclusive relationship (“just physical”)
- (4) Primary Relationship (“committed”)

## Sociodemographics

- 188 subjects (93 men, 95 women)
- Age range 17-29 years (average: 19.52)
- Racial composition
- 52% Asian
- 32% Caucasian
- 9% Hispanic
- 7% Other
- Sexual experience
- 51.4% Virgin Status
- 48.6% Non-Virgin Status

## Condom Use Communication

- Three central questions investigated:
- (1) Does communication about condom use occur?
- (2) Who initiates the conversation?
- (3) What communication strategies are used?

## Does Condom Use Communication Occur?

- Respondents were first asked as yes/no question (Does condom use occur?)
- Only 23% of all respondents said the couple would talk about condom use
- Respondents perceived communication as very unlikely across _all_ relationships (M=2.78)
- In open-ended probe questions: 46% of respondent mentioned communication unlikely as it would “interrupt the moment”

## How Likely is the Couple to Talk About Condoms Before Sex?

## Who Initiates the Conversation?

- 90% of all respondents reported the female in a heterosexual dyad would initiate the conversation.

## Slide 14

## Introducing the Condom...

- What does the male say in trying to introduce a condom?
- 57.6% of respondents indicated that the male, regardless of relationship type will ask, “Should I get a condom?”

- What does the female say in trying to introduce a condom?
- Casual relationship: “It is best for both of us.”
- Committed relationship: “Time to put the raincoat on.”
- One-night stand: “No condom, no sex.”
- First-date: “Should I get a condom?”

## Power Differentials

- Respondents were asked: (1) Who has the most power overall? (2) Who has the most power over condom use? (3) Who has the most power over sexual intercourse?
- The female, across all relationships, is seen to have more control in all 3 areas.

## Slide 17

## Conclusion

- Cognitive structures organizing how people comprehend heterosexuality are structured around gendered scripts.
- Females are perceived as initiators of communication and in control of condom-use.
- Condom-use communication not part of sexual scripts.