The aim of interpretative phenomenological analysis (IPA) is to explore in detail how participants are making sense of their personal and social world, and the main currency for an IPA study is the meanings particular experiences, events, states hold for participants. The approach is phenomenological (see Chapter 3) in that it involves detailed examination of the participant’s lifeworld; it attempts to explore personal experience and is concerned with an individual’s personal perception or account of an object or event, as opposed to an attempt to produce an objective statement of the object or event itself. At the same time, IPA also emphasizes that the research exercise is a dynamic process with an active role for the researcher in that process. One is trying to get close to the participant’s personal world, to take, in Conrad’s (1987) words, an ‘insider’s perspective’, but one cannot do this directly or completely. Access depends on, and is complicated by, the researcher’s own conceptions; indeed, these are required in order to make sense of that other personal world through a process of interpretative activity. Thus, a two-stage interpretation process, or a double hermeneutic, is involved. The participants are trying to make sense of their world; the researcher is trying to make sense of the participants trying to make sense of their world. IPA is therefore intellectually connected to hermeneutics and theories of interpretation (Packer and Addison, 1989; Palmer, 1969; Smith, in press; see also Chapter 2 this volume). Different interpretative stances are possible, and IPA combines an empathic hermeneutics with a questioning hermeneutics. Thus, consistent with its phenomenological origins, IPA is concerned with trying to understand what it is like, from the point of view of the participants, to take their side. At the same time, a detailed IPA analysis can also involve asking critical questions of the texts from participants, such as the following: What is the person trying to achieve here? Is something leaking out here that wasn’t intended? Do I have a sense of something going on here that maybe the participants themselves are less aware of?

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Interpretative Phenomenological Analysis

Numerous theories in social and health psychology assume that intentions cause behaviors. However, most tests of the intention- behavior relation involve correlational studies that preclude causal inferences. In order to determine whether changes in behavioral intention engender behavior change, participants should be assigned randomly to a treatment that significantly increases the strength of respective intentions relative to a control condition, and differences in subsequent behavior should be compared. The present research obtained 47 experimental tests of intention-behavior relations that satisfied these criteria. Meta-analysis showed that a medium-to-large change in intention (d = 0.66) leads to a small-to-medium change in behavior (d = 0.36). The review also identified several conceptual factors, methodological features, and intervention characteristics that moderate intention-behavior consistency.

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Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence.

Criticism and the Growth of Knowledge. Edited by I. Lakatos and A. Musgrave. Pp. viii, 282. £3·50, paperback £1. 1970. (Cambridge University Press.)

Male circumcision for HIV prevention in young men in Kisumu, Kenya : a randomised controlled trial. Commentary

This article examines the role of attention and automaticity in auditory processing as revealed by event-related potential (ERP) research. An ERP component called the mismatch negativity , generated by the brain's automatic response to changes in repetitive auditory input, reveals that physical features of auditory stimuli are fully processed whether or not they are attended. It also suggests that there exist precise neuronal representations of the physical features of recent auditory stimuli, perhaps the traces underlying acoustic sensory (“echoic”) memory. A mechanism of passive attention switching in response to changes in repetitive input is also implicated. Conscious perception of discrete acoustic stimuli might be mediated by some of the mechanisms underlying another ERP component (NI), one sensitive to stimulus onset and offset. Frequent passive attentional shifts might accountforthe effect cognitive psychologists describe as “the breakthrough of the unattended” (Broadbent 1982), that is, that even unattended stimuli may be semantically processed, without assuming automatic semantic processing or late selection in selective attention. The processing negativity supports the early-selection theory and may arise from a mechanism for selectively attending to stimuli defined by certain features. This stimulus selection occurs in the form ofa matching process in which each input is compared with the “attentional trace,” a voluntarily maintained representation of the task-relevant features of the stimulus to be attended. The attentional mechanism described might underlie the stimulus-set mode of attention proposed by Broadbent. Finally, a model of automatic and attentional processing in audition is proposed that is based mainly on the aforementioned ERP components and some other physiological measures.

The role of attention in auditory information processing as revealed by event-related potentials and other brain measures of cognitive function

Objective: To test the safety of the 'negotiated safety' strategy - the strategy of dispensing with condoms within HIV-seronegative concordant regular sexual relationships under certain conditions. Method: Data from a recently recruited cohort of homosexually active men (Sydney Men and Sexual Health cohort, n = 1037) are used to revisit negotiated safety. The men were surveyed using a structured questionnaire and questions addressing their sexual relationships and practice, their own and their regular partner's serostatus, agreements entered into by the men concerning sexual practice within and outside their regular relationship, and contextual and demographic variables. Results: The findings indicate that a significant number of men used negotiated safety as an HIV prevention strategy. In the 6 months prior to interview, of the 181 men in seroconcordant HIV-negative regular relationships, 62% had engaged in unprotected anal intercourse within their relationship, and 91% (165 men) had not engaged in unprotected anal intercourse outside their relationship. Of these 165 men, 82% had negotiated agreements about sex outside their relationship. The safety of negotiation was dependent not only on seroconcordance but also on the presence of an agreement; 82% of the men who had not engaged in unprotected anal intercourse outside their regular relationship had entered into an agreement with their partner, whereas only 56% of those who had engaged in unprotected anal intercourse had an agreement. The safety of negotiation was also related to the nature of the safety agreement reached between the men and on the acceptability of condoms. Agreements between HIV-negative seroconcordant regular partners prohibiting anal intercourse with casual partners or any form of sex with a casual partner were typically complied with, and men who had such negotiated agreements were at low risk of HIV infection. Conclusions: The adoption of the strategy of negotiated safety among men in HIV-seronegative regular relationships may help such men sustain the safety of their sexual practice.

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Sexual negotiation in the AIDS era: negotiated safety revisited.

Understanding emotion memory-work - theory and method saying sorry and being sorry happiness fear and danger emotions and agency - the construction of self holidays - emotion in childhood and adulthood compared remembering and forgetting anger the gendering of emotion.

Emotion and Gender: Constructing Meaning from Memory

Objective To assess the maintenance of safe sexual practice. (We use the term ‘safe’ sex throughout the paper, since ‘safe’ is the term adopted by the Australian National Committee on AIDS.) Design Maintenance was assessed by comparing sexual behaviour with both regular and casual partners reported in a 1986/1987 survey (time 1) with behaviour reported in a second survey in 1991 (time 2). Method The 145 homosexually active participants were a non-clinical sample recruited in 1986/1987 by advertisement and followed-up in 1991. A structured questionnaire was administered at both times. Items included questions about the nature of the men's sexual relationships and their sexual practices. Results Our findings indicate that the majority of men had sustained safe sex practices. HIV prevention strategies adopted included condom use, avoidance of anal intercourse and negotiated safety (i.e., the negotiated practice of unprotected anal intercourse within regular partnerships of concordant serostatus). Conclusions Negotiated safety is not the same as relapse.

Sustaining safe sex: a longitudinal study of a sample of homosexual men.

Objective
A range of risk reduction behaviours in which homosexual men practise unprotected anal intercourse (UAI) has been described. We aimed to assess the extent of any reduction in HIV risk associated with these behaviours.

Unprotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men.

The aim of this analysis was to examine gay men's sexual risk practice to determine patterns of risk management Ten cross-sectional surveys of gay men were conducted six-monthly from February 1996 to August 2000 at Sydney gay community social, sex-on-premises and sexual health sites (average n = 827) Every February during this period, five identical surveys were conducted at the annual Gay and Lesbian Mardi Gras Fair Day (average n = 1178) Among the minority of men who had unprotected anal intercourse which involved ejaculation inside with a serodiscordant regular partner, there was a clear pattern of sexual positioning Few regular couples were both receptive and insertive Most HIV-positive men were receptive and most HIV-negative men were insertive Among the minority of men who had unprotected anal intercourse which involved ejaculation inside with casual partners, there was also a pattern of sexual positioning Whereas many casual couples were both receptive and insertive (especially those involving HIV-positive respondents), among the remainder HIV-positive men tended to be receptive and HIV-negative men tended to be insertive These patterns of HIV-positive/receptive and HIV-negative/insertive suggest strategic risk reduction positionings rather than mere sexual preferences among a minority of gay men If so, they point not to complacency but to an ever more complex domain of HIV prevention

June Crawford

Papers

Sexual negotiation in the AIDS era: negotiated safety revisited.

Emotion and Gender: Constructing Meaning from Memory

Sustaining safe sex: a longitudinal study of a sample of homosexual men.

Unprotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men.

In a minority of gay men, sexual risk practice indicates strategic positioning for perceived risk reduction rather than unbridled sex.