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Interventions to assist persons in reducing risk for HIV infection have drawn on a number of behavioral science theories such as the Theory of Planned Behavior (Ajzen, 1991), social cognitive and self-efficacy theory (Bandura, 1988), the Information-Motivation-Behavior model (Fisher & Fisher, 1992), and the AIDS Risk Reduction Model (Catania, Kegeles, & Coates, 1990). Although these theories approach the issue of HIV risk behavior changes from different perspectives, they all posit that behavioral skills including the ability to communicate condom use requests with sexual partners--are important determinants of success in risk-reduction behavior change. State-of-the-art skills building interventions aimed at promoting HIV risk-reduction behavior change have often emphasized the acquisition of sexual assertiveness, communication, and negotiation skills to be used with sexual partners. Methods often used to teach these skills include the modeling, role-playing, and practice of negotiation tactics, and emphasis of communication with sexual partners as an important precursor of condom use. Negotiation skills training has been incorporated into HIV risk-reduction intervention programs for many at-risk populations including adolescents (DiNoia & Schinke, 2007; Fisher, Fisher, Bryan, & Misovich, 2002; Hovell et al., 2001), inner-city men (Calsyn et al., 2009; Kalichman, Cherry, & Browne-Sperling, 1999) and women (Carey et al., 2000; DiClemente & Wingood, 1995), gay men (Bowen, Williams, Daniel, & Clayton, 2008; Kelly et al., 1997), and adults with serious mental illness (Otto-Salaj, Kelly, Hoffmann, Stevenson, & Kalichman, 2001; Sikkema et al., 2007; Susser et al., 1998). In several meta-analyses of HIV risk-reduction interventions, negotiation skills training has been cited as a common component of many HIV interventions that have been deemed efficacious in changing HIV risk behaviors (e.g., meta-analyses by Albarracin et al., 2005; Crepaz et al., 2006; Darbes, Crepaz, Lyles, Kennedy, & Rutherford, 2008; Herbst et al., 2007). Further, a synthesis of the results of HIV intervention meta-analyses suggests that increased condom use, in particular, may account for the greatest effect sizes in HIV prevention intervention results (Noar, 2008). In support of this finding, results of a meta-analysis examining the impact of sexual communication on condom use (Noar, Carlyle, & Cole, 2006) showed that communications about condom use had the largest effect size of all the variables they examined, indicating that discussion of condom use in some fashion may play a key role in facilitating use.

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