Strategies for Avoiding Unsafe Sex: Sexual Behavior Change Intentions and Actions in the Context of a Randomized Trial of a Conditional Cash Transfer for HIV Prevention in Tanzania

Laura Packel, University of California, San Francisco

Despite isolated successes at lowering HIV transmission rates, behavioral change interventions promoting safer sex have proven remarkably ineffective in curbing the epidemic. This paper addresses this lack of success by exploring consistency between behavior change intentions and actions. In the African context, uncertainty faced in the daily lives of those at risk for HIV infection may influence how intentions are formed and if they are acted upon. Characterizing this uncertainty by identifying reasons for discrepancies between intentions and actions may guide design of HIV prevention interventions. This research makes a unique contribution as the longitudinal nature of the dataset allows analysis of intended sexual behavior change strategies and their corresponding behavior change actions in the context of an economic-based HIV-prevention trial in rural Tanzania. We identify gender, education, and intervention group as significant predictors of consistency between intent and action, and examine potential mediators of these relationships.