SEXUAL BEHAVIOR CHANGE ASSOCIATED WHIT A COLLEGE HIV COURSE.

This is an study that MacNair-Semands, Cody, et al., do in a three credit semester long course
called “The HIV pandemic and AIDS”, piblishing the results, discussion and conclusions on
December 1997, They targeted knowledge, attitudes and behaviors of students, trough a quasi-
experimental design trial whic implemented using pre and post questionnaires.
In a brief literaute review, the authors show some HIV interventions whit young people within
the United Stetes of America from 1989 to 1995. They conclude, whit Keeling (1992) that “HIV
education on college campuses must address affective as well as cognitive dimensions and must
include experiential as well as informational learning to be effective in HIV prevention”. They
use the Transtheoretical model with its 5 stages of change (pre.contemplation, contemplation,
preparation, action and maintenance) to analyze their results.
The semester course was based on 1) some dimensions of HIV/AIDS cannot be understood
trough cognitive reasoning alone and must be experienced in other ways, 2) information is
necessary, but not sufficient for behavior change, 3) the most effective HIV educators are peers,
and 4) sustained, open and frank communication is crucial for effective prevention of HIV
transmission and compassionate and competent care for those livving whit HIV infection. The
purposes of the course were a) to support and enhance HIV prevention among students, their sex
partners, social networks and future clients, and b) tocontribute to a compassionate and
competent response to the HIV/AIDS pandemic. A key component of the course was the use of
multimedia teaching strategies.
They applied the College Student Behavior Questionnaire (CSBQ) to the course students (n:131
whit a mean age of 24.12 years) and to 2 control groups similar in age, gender, degree
programme and class. The participation was voluntary and the students were tol they could
cease participation at any time if they wanted to.
The results were “strong findings at post.test that students in the HIV course reported mor
behavioral changes althougs there was no significat difference in behavioral change at pre-test”.
Post-hoc analyses were conducted using several chi square tests to further explore types of
behavioral changes between the course and the control groups, and they suggested significant
differences by post-test groups in the number of students who reportste that they had become
more selective about their partners; a significant difference in students reporting that they had
begun using condoms, and also a significant difference regarding students reporting that they
had learned more about HIV/AIDS. They found that “HIV courses have the potential to shift
some students to a new stage in the change process: for pre-contemplation to contemplation;
from contemplation to preparation, for instance... the study indicates taht an HIV course on a
college campus may increase preventive behaviors, help students talk abaout safer sex whit
potential partners, increase the tendency to become more selective of sexual partner and
increase learning about HIV/AIDS... one must be aware that such changes may be short-term in
nature and prone to relapse, in line with the transtheoretical model”.

I think the article is complete and their trial is successful in some fields, as they have
mentionated. Their literature review gives them enough background to offer a more integral
course, taking into account not only the necessity of knowledge, but to work with affective
areas, choosing the appropiate themes for the course: pathophysiology of HIV, transmission,
condom use, for instance, but at the same time they assess cultural and gender realted
differences in negotiating safer sex behaviors, the effect of alcohol and drugs, how to increase
comfort whit sexual language, as well as issues of homophobia, presumed monogamy, sexism
and class issues.

Their knowledge about the Transtheoretical Model helps them in the analysis to give a wide
view what stage of change the students could be in reference to their safe behavior towards
HIV/AIDS infections.
I I find the study consistent and coherent whit the theory used. It convinced me to use it as a
successful intervention model and I would be willing to apply it to other populations in other
cultures such as the mexican one.
In several instances the authors comment that the changes registered in the trial could be “short-
term”, and they recognize it in the limitations part, but they don`t do any thing about it. I think
that a better intervention could incluide a follow up for 2 or 3 semesters to see how long the
changes lasted, or this could be another trial.
I liked this intervention, based on safer sex , a holistic approach and theory-based.

Juan Cralos Hernandez Mueijueiro.