Background:
The Protect and Respect Project is a prevention research project that aims to help HIV-positive women decrease their sexual risk behaviors. Women in the intervention arm of the program (n=135) receive sexual risk reduction messages from a skills-based group-level-intervention (GLI) and Peer-led support groups. Women's relationships with men are a predominant topic of discussion in these groups.

Objective:
Using safer sex skills requires respectful relationships. Therefore, this study examines what women said about their relationships with men to define future research questions and to determine how to address relationships in prevention programs for heterosexual men and women.

Method:
The researchers taped and transcribed the GLIs and peer groups (n = 35 transcripts, 23 women) and conducted theme analysis using ATLAS.ti.5.0. Focusing on women's relationships with men, coders reviewed a portion of the transcripts and developed a codebook outlining key themes. Then, researchers employed the codebook to analyze transcripts.

Result:
Study participants were mostly African American and low-income. The transcript analysis revealed that women define their relationships with men negatively. Specifically, women talked about: their lack of trust of men; men's suspicions of women; an inability to be friends with men; poor communication in their relationships with men; men not taking care of them; and men being “bad news” in general. Further, men often refused to use condoms with women, despite knowing that women were HIV-positive.

Conclusion:
Until men and women engage in healthier relationships, they cannot successfully use the skills commonly taught in HIV and STD prevention programs.

Implications:
Future research efforts must be directed at learning more about the relationships between men and women and how these relationships effect safer sex practices. Safer sex interventions that help both male and female participants define and engage in healthier relationships where safer sex can happen need to be developed.