Maintenance of behavioral change in a cohort of homosexually active men.

OBJECTIVES

To assess associations of perceptions of sexual behavior change with actual risk behaviors and psychosocial variables, and to determine whether perceptions of behavior change predict subsequent behavior.

DESIGN

Cohort study of homosexually active men.

SETTING

Community health center in Boston, Massachusetts, USA.

PATIENTS,

PARTICIPANTS

Two hundred and sixty-two cohort members who participated in follow-up in 1989 and who had at least one subsequent visit.

INTERVENTIONS: None.

MAIN OUTCOME MEASURE: Composite risk behavior variable, based on unprotected anogenital contact and number of partners.

RESULTS

Of the 96% who had effected behavior change, 47% perceived that they were able to maintain those changes consistently and 58% wanted to make more changes. Perceptions of consistent maintenance were associated with lower risk behavior, lower perceived riskiness of behaviors and susceptibility to AIDS, and fewer barriers to behavior change. Desire for more change was associated with increased behavioral effort, fewer barriers to condom use, and greater perceived riskiness of current behavior. Among those with lower risk behaviors, perceived inconsistent maintenance predicted relapse to more risky behavior at the following visit.

CONCLUSIONS

Perceived maintenance of behavior change is potentially useful in identifying individuals at risk of relapse from safer sex.