AIDS education for gay men: towards a more cognitive approach

An approach to AIDS education is presented that focuses on the thinking processes which accompany gay men's decisions to engage in high-risk sex. It is proposed that: (1) at the time they are deciding to have high-risk sex, gay men generally engage in an 'internal dialogue' that justifies this decision to themselves; (2) the AIDS-related thinking underpinning such self-justifications can differ appreciably from the AIDS-related thinking that takes place outside the sexual context; and (3) AIDS education can profitably exploit this difference between 'heat of the moment' and 'cold light of day' thinking. Evidence supporting these proposals is drawn from studies in which gay men who had engaged in unprotected anal intercourse recalled the occasion concerned in detail, including any self-justifications they had used; and from controlled intervention studies, in which gay men who had engaged in unprotected anal intercourse were confronted with the thinking they had employed in the heat of the moment.