Interview: Feelings Matter in Curbing HIV

Addressing youths' mental stress and the coping mechanisms needed to negotiate safe sex are just as important as practical condom-use instruction, a new report suggests. The report by Celia Lescano of Bradley Hasbro Children's Research Center and colleagues studied HIV transmission among adolescents and young adults.

Asked how mental health issues affect HIV prevention, Lescano said that, in general, psychiatric issues or stress can increase youths' HIV risk. These issues can make it more difficult to manage the sexual experience, including whether condoms are used, used properly, or discussed, she said. For instance, sexual abuse survivors are at a higher HIV risk through risky behaviors stemming from their post-traumatic stress.

Sexual situations can bring up positive feelings, but they can also bring stress or uncertainty, Lescano noted. Some mental health professionals think that addressing what people believe they can or cannot do around the issue of sex, their self-efficacy, is integral for HIV prevention, she said.

Teaching accurate information and skills certainly help STD prevention, said Lescano. But condom use efficacy may be tightly bound with emotional skills needed to cope with difficult situations. That may require a general mental health approach or even professional advice.

"It's not as simple as, 'You need to use a condom, here's one, go use it,'" said Lescano. "It is, 'Here's a condom and let's talk about how you might feel bringing up using this condom with your partner.'" Emotions, self-efficacy, how to be assertive rather than passive - but not aggressive - all come into play, she said.

The full study, "Unsafe Sex: Do Feelings Matter?" was published in the Journal of Prevention & Intervention in the Community (2007;33(1/2):51-62).

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