Sexual scripts of women: a longitudinal analysis of participants in a gender-specific HIV/STD prevention intervention

Abstract

Project FIO (The Future Is Ours) was a three arm randomized controlled HIV prevention intervention trial carried out with heterosexually-active women in a high seroprevalence area of New York City. The trial was effective and women in the eight-session intervention arm were significantly more likely to report decreased unsafe sex or no unsafe sex compared to controls at one month and one year post-intervention. The current investigation was a qualitative analysis of women's sexual scripts at baseline and one year follow-up for a randomly selected subsample of participants in Project FIO. We examined the domains of sexual initiation, pace setting, sexual decision-making, communication about sexual needs, and the timing of condom introductions in the experimental and control arms at baseline and one year follow-up. At one year follow-up, among both the experimental and control arms, results showed changes away from male-dominated and toward female-dominated sexual initiation and sexual decision-making. Among both the experimental and control arms, results also showed that trial participants shifted from a late condom introduction (right before intercourse) toward much earlier mention of condoms (e.g. during a date). The fact that shifts in sexual scripts at one year follow-up occurred in both groups is likely reflective of the degree to which a lengthy assessment interview facilitated comfort with discussing and imagining new sexual behaviors, even for control group participants who did not receive the intervention. The value of empirically assessing sexual scripts in HIV/AIDS prevention and doing so longitudinally is assessed in light of the goals of HIV prevention interventions.