1. Lori A. J. Scott-Sheldon, Ph.D. Centers for Behavioral and Preventive Medicine The Miriam Hospital and Department of Psychiatry and Human Behavior Alpert Medical School Brown University Eroticizing Safer Sex Improves Emerging Adults’ Sexual Health: A Meta-Analysis Presented at the XIX International AIDS Conference, Washington, DC

2. Emerging Adults are at Risk for HIV age: 18 – 29 (Arnett, 2000) Emerging adults are vulnerable to HIV: –psychological –developmental –behavioral >50% of all new HIV infections (UNAIDS, 2010)

3. HIV Diagnoses in the U.S., 2010 Centers for Disease Control and Prevention (2012) Emerging adults: ~31% of HIV diagnoses

4. Intervening with Emerging Adults Reducing HIV among emerging adults is a public health priority. Condom use is effective at reducing HIV Behavioral HIV interventions typically focus on prevention rather than pleasure.

5. 5 Condom Use Less sexual pleasure Loss of intimacy Condoms = disease Condoms + pleasure = safer sex?

6. 6 Meta-Analytic Methods (Scott-Sheldon, Johnson, et al., in preparation) Educational, psychosocial, or behavioral interventions eroticizing safer sex Outcomes: –knowledge, attitudes, and intentions –condom use, sexual frequency Cohen’s d

7. 7 Study and Sample Characteristics k = 19 studies and 36 interventions N = 5,049 1983 – 2007 –74% published in journals –79% theory-based –89% located in the U.S. –68% small to medium-sized cities –67% conducted at universities/schools Samples: 50% women, 82% White, 20 yrs old

8. 8 Intervention Characteristics Interventions –47% individual, 53% small groups –median of 1 session, 30 minutes –58% education –58% skills training (43% active, 57% passive) Eroticizing safer sex component: –median = 15 minute (range: 1 to 90 minutes) –median = 50% of content (range: 9 to 100%)

9. 9 Condom Eroticization Condom use was eroticized using several methods: –44% visual erotic component (e.g., videos) –28% erotic instructions/read erotic stories –14% erotic activity (e.g., role-play) 14% used multiple methods

10. Antecedents of Behavioral Change d+ = 0.34 (0.14, 0.55)d+ = 0.23 (0.10, 0.36)d+ = 1.20 (0.42, 1.98)

11. Behavioral Outcomes d+ = 0.13 (0.01, 0.26)d+ = 0.18 (0.03, 0.32)

12. Conclusions Interventions that eroticizing safer sex reduce risky sexual behavior. Many advocates, few implementations Where are the interventions for young MSM?

13. Limitations Eroticization alone or in combination? Missing studies?

14. Future Research At-risk populations Amount and type of eroticization needed Condoms + pleasure = safer sex

15. Many thanks to the NIMH, study authors, and research assistants! Funding NIH grant R01-MH58563 to Blair T. Johnson Contact Lori_Scott-Sheldon@brown.edu