more effective prevention strategies, as well as to provide baseline data to evaluate their effectiveness. Specific sexual practices—dry sex, oral sex, and anal sex being but a few examples—may impede the success of particular interventions, yet information about such practices is necessary for encouraging behavioral change.

Recommendation 4-5. Research on coercive sex, especially among adolescents, is critical.

The magnitude of the problem of coercive sex is all but unknown, as are the circumstances under which forced sex or rape takes place. How frequently does it happen and why? Do the aggressors or the victims share characteristics that might suggest a path for preventive or protective interventions? Research on community attitudes, mores, and gender expectations that may serve to encourage or inhibit coercive sex is urgently needed in order to determine how to enlist community support for the curtailment of such practices.

Recommendation 4-6. Research aimed at achieving a better understanding of perceptions about the dual roles of condoms is required.

Condoms help prevent the spread of HIV/AIDS; they also prevent pregnancy. How aware are people of these dual roles, and what weight do they give each when deciding whether to use condoms? How often are these roles in concord and how often in conflict? Do partners discuss this issue, and if so, what are the negotiating mechanisms used?

Recommendation 4-7. Research on attitudes and beliefs about and behavioral responses to sexually transmitted diseases is required.

To develop effective strategies for the treatment of STDs, understanding is needed about social and cultural responses to STDs, including stigmatization. Much more knowledge about the health-seeking behaviors of people infected with STDs, and whether their sexual habits are altered by knowledge of infection, is also needed.

Recommendation 4-8. Research on acceptance of and behavioral responses to HIV vaccination is urgently needed.

Because vaccine trials are likely to begin with vaccines of limited efficacy, there is an urgent need to learn whether individuals who are vaccinated increase their exposure to HIV through riskier behavior, and if so, to determine how to mitigate this response.



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