Preventing unprotected anal intercourse in gay men: a comparison of two intervention techniques

This study compared the effectiveness of getting gay men to evaluate the self-justifications they use when breaking their safe sex rules to that of a standard approach to AIDS education. Men (n = 109) who had 'slipped up' (broken their safe sex rules by having unprotected anal intercourse) kept diaries of their sexual behaviour for 16 weeks. After 4 weeks they were allocated to one of 3 conditions, 2 involving brief interventions--Self-justifications (evaluation of self-justifications) and Standard (examination of posters used in AIDS education)--and a Control (diary only). At the time of the intervention, more members of the Self-justifications than the Standard group thought that it would help them not to slip up. In the post-intervention period, the 3 groups did not differ in the incidence of sexual activity or in the proportion who slipped up at least once, but the Self-justifications group were less likely to have had multiple slip-ups. Three possible explanations are offered for the effectiveness of the Self-justifications intervention. This approach may provide a useful alternative to standard techniques of AIDS education.