Background: Strict adherence to personal health recommendations is necessary to improve the clinical control of arterial hypertension. Objective: To identify predictors of the behavior to avoid the "consumption of restricted foods" in a sample of hypertensive patients from Tamaulipas, Mexico. Method: Participants were 183 patients with arterial hypertension diagnosis, who completed two self-administered questionnaires and different questions regarding adherence and self-care behaviors. A trajectory analysis was used for the interpretation of data. Results: Less tolerance to frustration, a major affective social support and a lower body mass index were behavior predictors to avoid the consumption of restricted foods (pBS = 0.294, χ2/gl = 1.417, GFI = 0.993, AGFI = 0.965, NFI = 0.934, IFI = 0.980 y SRMR = 0.040), explaining approximately 20% of the variance in the study behavior. Conclusion: The study of adherence and self-care behaviors demands to identify what and how some personal and interpersonal variables are influencing in their daily practice, which can contribute to improve the interdisciplinary interventions programs in clinical and communitarian settings for attending patients living with arterial hypertension.

Introducción: la adhesión estricta a las recomendaciones del personal de salud es requisito indispensable para coadyuvar en el control clínico de la hipertensión arterial. Objetivo: identificar los predictores de la conducta "consumo de alimentos restringidos" en una muestra de pacientes hipertensos de Tamaulipas, México. Método: participaron 183 pacientes diagnosticados con hipertensión arterial, quienes respondieron a un par de instrumentos y a diferentes preguntas sobre conductas de adhesión y cuidado de la salud. Para la interpretación de los datos se utilizó un análisis de trayectoria. Resultados: una menor tolerancia a la frustración, un mayor apoyo social afectivo y un menor índice de masa corporal predijeron la conducta de evitar el "consumo de alimentos restringidos" (pBS = 0,294, χ²/gl = 1,417, GFI = 0,993, AGFI = 0,965, NFI = 0,934, IFI = 0,980 y SRMR = 0,040), explicando aproximadamente un 20% de la varianza en la conducta de estudio. Conclusión: el estudio de las conductas de adhesión y cuidado de la salud pasa necesariamente por identificar qué y cómo ciertas variables personales e interpersonales están influyendo en su práctica diaria, lo cual puede contribuir a mejorar los programas de intervención interdisciplinaria en los ámbitos clínico y comunitario para la atención de pacientes que viven con hipertensión arterial.

ABSTRACT OBJECTIVE The objective of this study has been to test the ability of variables of a psychological model to predict antiretroviral therapy medication adherence behavior. METHODS We have conducted a cross-sectional study among 172 persons living with HIV/AIDS (PLWHA), who completed four self-administered assessments: 1) the Psychological Variables and Adherence Behaviors Questionnaire, 2) the Stress-Related Situation Scale to assess the variable of Personality, 3) The Zung Depression Scale, and 4) the Duke-UNC Functional Social Support Questionnaire. Structural equation modeling was used to construct a model to predict medication adherence behaviors. RESULTS Out of all the participants, 141 (82%) have been considered 100% adherent to antiretroviral therapy. Structural equation modeling has confirmed the direct effect that personality (decision-making and tolerance of frustration) has on motives to behave, or act accordingly, which was in turn directly related to medication adherence behaviors. In addition, these behaviors have had a direct and significant effect on viral load, as well as an indirect effect on CD4 cell count. The final model demonstrates the congruence between theory and data (x2/df. = 1.480, goodness of fit index = 0.97, adjusted goodness of fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.05), accounting for 55.7% of the variance. CONCLUSIONS The results of this study support our theoretical model as a conceptual framework for the prediction of medication adherence behaviors in persons living with HIV/AIDS. Implications for designing, implementing, and evaluating intervention programs based on the model are to be discussed.

ABSTRACT OBJECTIVE The objective of this study has been to test the ability of variables of a psychological model to predict antiretroviral therapy medication adherence behavior. METHODS We have conducted a cross-sectional study among 172 persons living with HIV/AIDS (PLWHA), who completed four self-administered assessments: 1) the Psychological Variables and Adherence Behaviors Questionnaire, 2) the Stress-Related Situation Scale to assess the variable of Personality, 3) The Zung Depression Scale, and 4) the Duke-UNC Functional Social Support Questionnaire. Structural equation modeling was used to construct a model to predict medication adherence behaviors. RESULTS Out of all the participants, 141 (82%) have been considered 100% adherent to antiretroviral therapy. Structural equation modeling has confirmed the direct effect that personality (decision-making and tolerance of frustration) has on motives to behave, or act accordingly, which was in turn directly related to medication adherence behaviors. In addition, these behaviors have had a direct and significant effect on viral load, as well as an indirect effect on CD4 cell count. The final model demonstrates the congruence between theory and data (x2/df. = 1.480, goodness of fit index = 0.97, adjusted goodness of fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.05), accounting for 55.7% of the variance. CONCLUSIONS The results of this study support our theoretical model as a conceptual framework for the prediction of medication adherence behaviors in persons living with HIV/AIDS. Implications for designing, implementing, and evaluating intervention programs based on the model are to be discussed.

The concept of resilience in the psychology is analyzed, with special emphasis in Ibero-American authors who used it in their research. I argue how, once the authors' part of a logical confusion, this one become in a conceptual confusion, which in turn follows a methodological, concluding with one of interpretation confusions. A successive chain of confusions which allows justifying why resilience is a concept that is neither helpful nor relevant to psychology.

Se analiza el concepto de resiliencia en psicología, poniendo especial énfasis en autores iberoamericanos que lo utilizan en sus investigaciones. Se demuestra cómo, una vez que se parte de una confusión lógica, de ésta se desprende una conceptual, de la que a su vez se desprende una metodológica, para concluir con una de interpretación. Una cadena de confusiones que al final del camino nos permiten justificar por qué el de resiliencia es un concepto que no es ni útil ni pertinente para la psicología.

A mediados de la pasada década se publicó un trabajo en el que se analizaba por qué, a pesar del desarrollo experimentado por la psicología y salud en México, en ese entonces se hadan evidentes dos problemas: la falta de reconocimiento profesional de la psicología y los psicólogos en los marcos normativos sobre la materia, por un lado, así como las dificultades que enfrentaban para su integración en los equipos interdisciplinarios de salud, por el otro. Casi una década después nos encontramos que en general la situación no ha cambiado de manera sustancial, lo que a final de cuentas se traduce en un ejercicio profesional que dista mucho de estar impactando positivamente al diseño, instrumentación y evaluación de programas de investigación e intervención en el seno mismo de las instituciones de salud. Con base en el sentido común y la experiencia de los autores, en este trabajo se discute sobre tres asuntos que consideramos pudieran ayudar a revertir dicha situación, en beneficio de la psicología y los psicólogos que se desempeñan en el ámbito de la salud.

In the middle of the last decade was published a work in which analyzed why, despite the development experienced by the psychology and health in Mexico, then became evident two problems: the lack of professional recognition of psychology and psychologists in the normative frameworks on the subject, on the one hand, as well as the difficulties faced by these for their integration into the interdisciplinary teams of health, on the other. Almost a decade later we find that overall the situation has not changed substantially, which ultimately translates into a professional practice that is far be positively impacting the design, implementation and evaluation of research and intervention programs in the context of health institutions. Based on common sense and the experience of the authors, in this work is discussed on three issues that we believe could help to reverse this situation, for the benefit of psychology and psychologists working in the health field.

Se analiza la relación entre los fenómenos básicos y los fenómenos del desarrollo y la personalidad, en términos de si los primeros deberían concebirse como condición de existencia necesaria y suficiente de los segundos, y, a su vez, si los unos y los otros lo son de los últimos. Se concluye que dependiendo de cómo se plantee dicha relación, es que eventualmente tendrá sentido la construcción de teorías formales sobre el desarrollo y la personalidad, o bien caracterizar ambos fenómenos como categorías tipo interfase con fines de predicción.

The relationship between basic phenomena and development as well as personality is analyzed, in terms of whether the first should be seen as a necessary and sufficient condition for the existence of the second, and in turn the first two as conditions for the last one. We conclude that depending on how this relationship arises is what eventually will make sense to build formal theories of development and personality, or to characterize both phenomena as interface category types with predictive purposes.

Una parte importante del contenido de lo psicológico en la salud y la enfermedad tiene que ver con la conducta de una persona en lo individual, es decir, con el fenómeno de personalidad. Sin una caracterización apropiada de este fenómeno se dificulta el cumplimiento de dos tareas sustantivas en la Psicología y Salud, a saber: 1) identificar y evaluar lo que una persona ha hecho en el pasado, de manera estable y consistente a lo largo del tiempo y entre situaciones, y 2) traducir los hallazgos en programas de prevención primaria, susceptibles de ser replicados bajo distintas condiciones y en diferentes escenarios. Con la finalidad de dar seguimiento a lo expuesto en un artículo previo (Piña, Ybarra, Alcalá y Samaniego, 2010), el presente trabajo se planteó con el objetivo de discutir por qué en el ámbito de la salud es fundamental que los modelos teóricos incluyan un conjunto debidamente articulado de categorías y conceptos que permitan vincular los niveles básico y aplicado, así como lo psicológico con los fenómenos de la salud y la enfermedad, dentro de los que se destaca el de personalidad.

An important part of the psychological aspect in health and sickness has to do with the conduct of a person as an indidual, that is to say, with the phenomenon of personality. Without an appropriate characterization of this phenomenon, compliance with two fundamental tasks in psychology and health is made difficult. These are 1) to identify and evaluate what a person has done in the past in a stable and consistent way over a period of time and between situations, and 2) to translate the findings into programs of primary prevention, able to be reproduced under different conditions and in different scenarios. With the purpose of following up what was stated in a previous article (Piña, Ybarra, Alcalá y Samaniego, 2010), this study was proposed with the objective of discussing why, in the context of health, it is fundamental that theoretical models include a properly coordinated set of categories and concepts which allow basíc and applied levels to be linked, as well as the psychological aspect with the phenomena of health and sickness, among those which highlight personality.

Uma parte importante do conteúdo do psicológico na saúde e a doença têm a ver com a conduta de uma pessoa no individua, é dizer, com o fenômeno da personalidade. Sem uma caracterização apropriada de este fenômeno e difícil o cumprimento de duas tarefas substantivas na psicología e saúde, que são as seguintes: 1) identificar e avaliar o que uma pessoa tem feito no passado de maneira estável e consiste ao longo do tempo e entre situações, e 2) traduzir os descobrimentos em programas de prevenção primaria susceptíveis de serem replicados baixos diferentes condições e distintos cenários. Com a finalidade de dar seguimento ao exposto num artigo prévio (Piña, Ybarra, Alcalá y Samaniego, 2010), o presente trabalho foi planejado com o escopo de discutir por que no âmbito da saúde é fundamental que os modelos teóricos incluam um conjunto devidamente articulado de categorías e conceitos que permitam vincular os níveis básico e aplicado; assim como o psicológico com os fenômenos da saúde e a doença, dentro dos que é destacado o de personalidade.

Con base en un modelo psicológico se condujo un estudio transversal cuyo objetivo fue el evaluar con ecuaciones estructurales la influencia de un conjunto de variables psicológicas y sociales sobre los comportamientos de adhesión en 69 personas con VIH. El modelo estructural final reveló la influencia de las variables motivos y apoyo social sobre los mencionados comportamientos, explicando ambas el 49% de la varianza total; asimismo, se observó una influencia de los comportamientos de adhesión sobre los niveles de carga viral y de este marcador biológico sobre las cuentas de linfocitos T CD4 + . Este estudio contribuye a un mejor entendimiento de las variables que subyacen a la práctica eficiente de los comportamientos de adhesión en personas con VIH, por lo que los programas de intervención tenientes a promover y/o mantener esos comportamientos deben considerar el peso específico de algunas variables psicológicas y sociales, a lo largo del continuo de interacción.

A cross-sectional study was carried out in order to assess the influence of a set of psychological and social variables on adherence behaviors in a sample of 69 persons with HIV, using a structural equations model. The final model revealed a strong influence of motives and social support on adherence behaviors, both explaining 49% of the total variance; also, an effect of adherence behaviors on viral load levels and of this one on T CD4+ cell counts were observed. The current study contributes to understand variables underlying adherence behaviors in a sample of persons with HIV, and therefore intervention programs directed to promote and/or to maintain these behaviors must to consider the specific weight of some psychological and social variables along the behavioral continuum.

Se realizó un estudio transversal que contó con la participación de 51 personas VIH+ 100% adherentes, cuyo objetivo fue evaluar los efectos de un conjunto de variables psicológicas sobre la calidad de vida, en función del estadio clínico de infección. Para la dimensión salud física los resultados fueron: en el estadio clínico A se encontró un efecto de las competencias conductuales presentes (F [1, 13] = 13,372; p < 0,001); en el B, de bajos niveles de estrés vinculados con tolerancia a la ambigüedad y tolerancia a la frustración (F [2, 17] = 19,648; p < 0,001), y en el C no se encontraron predictores. Para la dimensión salud psicológica los resultados fueron: en el estadio A hubo un efecto de las competencias conductuales presentes (F [1, 13] = 4,899; p < 0,05), en el B no hubo efecto de ninguna variable, mientras que en el C se presentó como respuesta de bajos niveles de estrés, vinculado con tolerancia a la ambigüedad (F [1, 14] = 4,906; p < 0,05). El presente estudio sugiere que los efectos de diversas variables psicológicas sobre la calidad de vida en sus dimensiones de salud física y psicológica, ejercen un efecto diferenciado en función del estadio clínico de infección. Se discuten algunas implicaciones de los hallazgos para el diseño de programas de intervención interdisciplinaria dirigidos a mejorar tanto la adhesión a la terapéutica médica, como la calidad de vida en personas VIH+.

A cross-sectional study was carried out with the main objective to assess the effects of psychological variables on quality of life in terms on the clinical stage of the infection among 51 HIV+ persons, whom were 100% adherent. The physical health dimension yielded results as follows: in clinical stage A an effect of current behavioral competencies was observed (F [1, 13] = 13,372; p < 0,001); in stage B, effects included low stress-related factors with of tolerance to ambiguity and tolerance to frustration (F [2, 17] = 19,648; p < 0,001), and in stage C no effect was apparent. For the dimension of psychological health, results revealed: in clinical stage A, an effect of current behavioral competencies (F [1, 13] = 4,899; p < 0,05); in B, stage no effect was found, whereas in stage C low stress-related tolerance to ambiguity had an effect (F [1, 14] = 4,906; p < 0,05). The study suggests definitely effects of psychological variables on quality of life, including both physical and psychological dimensions, with differential role in function of the clinical stage of the infection. Some implications are discussed for the development of intervention programs, aimed at improving adherence to medical treatment and quality of life among HIV+ persons.

Introduction HIV infection is a disease that demands a consistent and efficient practice of adherence behaviors related to antiretroviral treatment. However, research findings in the last few years have shown that psychological and social variables (e.g., depression, stress, low motivation, as well as little or no social support) interfere with the practice of those behaviors. This facilitates the clinical progression of the disease, and reduces the quality of life and survival time in people living with HIV. The intersection area between psychology and health involves widely diverse theoretical models, including self-regulation, health beliefs, and the one linking information-motivation-behavior. Such models have sought to account for the way in which the addressed variables affect adherence behavior. While analyzing psychological factors, these models usually emphasize either cognitive concepts or adopt a more traditional stance such as relating adherence behavior to personality, motivation, behavioral skills and stress management. Although this diversity seems inclusive, it fails to integrate explanations on therapeutic adherence under a more comprehensive theoretical umbrella. Thus, the present study was conducted within the scope of an interactive-functional model which attempts to articulate the interaction of sets of biological and psychological variables along four phases. The first involves psychological processes and results variables; the second comprises the diagnostic of HIV infection and later development of other opportunistic diseases; the third contains two types of behavior: therapeutic adherence and disease-related behaviors; the fourth involves conventional biological indicators and health outcomes. This model contrasts with others not only in the sense of proposing an inter-behavioral approach derived from Kantor's work, including articulated behavioral and personality theories, but it also proposes an interactive and functional emphasis on analyzing those variables assumed to determine therapeutic adherence behaviors. Such variables subsume personality phenomena, behavioral competencies and motives to behave. Thus, the approach includes those consistent ways in which HIV-positive persons interact with stress-related situations which contain unpredictable, ambiguous or uncertain stimulus signals and behavior consequences. The behavioral competencies category synthesizes what the patient knows on HIV, including those self-care actions that need to be taken efficiently. For instance, what is HIV-AIDS, what are the clinical stages of the infection, what medications help, how should they be used and, above all, why is so important to take medications in a consistent and efficient manner on the basis of the indications of the healthcare personnel. On the other hand, motives or motivation refer, in the traditional conception, to variables related to willing to act. It is said that a person is motivated to engage in therapeutic adherence behaviors when he/she is willing to behave accordingly, after having understood the relation between such behavior and some specific consequences. Such consequences may vary widely, ranging from interpersonal in nature, such as verbal praise or support from others, and intrinsic, such as self-perceived physical and psychological well-being. Materials and method A cross-sectional study was carried out in order to identify predictors of adherence behaviors related to antiretroviral treatment in a group of 68 persons living with HIV. Participants answered two self-administered questionnaires: i) psychological factors and adherence behaviors, and ii) stress-related situations in three modalities: decision-making, tolerance to ambiguity, and tolerance to frustration. Data analysis included univariate statistics, the Pearson's x² test, the T-test for independent samples, as well as a linear multiple regression analysis. Results Of the total of participants, 58 (85.3%) reported that they self-administered their antiretroviral medication everyday of the last week, and 10 (14.7%) did it with some inconsistence. Differences were significant (x² [1] =33.882; p<0.001); the T-test showed a significant difference among adherents and non-adherents in the motivation variable (t [66] = -27.954; p<0.001). Finally, the linear multiple regression analysis contributed as predictor of the adherence behaviors at variables like motivation (β =O.8O2; p<0.001), as well as low stress-related situations in the modalities of decision-making ( β = -0.268; p<0.01) and tolerance to frustration ( β = -0.280; p<0.01), with the adjusted determination coefficient [adjusted R²] = 0.629, thus explaining 62.9% of the total variance. Discussion The results of this study show that persons with HIV who are 100% adherent to antiretroviral medication are those who are clearly more motivated and are experiencing less stress-related to decision-making, as well as higher levels of tolerance to frustration. These findings suggest that interventions aimed at improving the treatment of HIV-positive patients should expressly include components related to these factors. It seems especially relevant to consider two additional aspects: first, once psychological factors are identified and explained through research, they need to be translated into viable intervention strategies subject to systematic methodological evaluation. Second, interventions must be consistent with the theoretical assumptions underlying the model used so that those techniques designed or selected to establish adequate medication use and other adherence and well-being-inducing behaviors will actually result effective. Given the context of the institutional treatment of this condition, it seems especially relevant to insure that such programs actually have an interdisciplinary character in order to facilitate and maintain therapeutic adherence. Such inter-professional collaboration is especially important in a public healthcare context in which resources, ranging all the way from facilities, equipment and caregiver salaries to the schooling of the patients, pose special challenges in places like Latin American countries, where real optimization can occur mainly through the quality of integrated professional performance. After all, the key healthcare ingredient in public health problems affecting ever-growing portions of the population, such as the HIV infection, remains the human being, i.e., actual persons with biological, psychological, and social functional components.

Introducción La infección por VIH es un padecimiento que demanda la práctica consistente y eficiente de los comportamientos de adhesión al tratamiento antirretroviral en sí y a otras actividades de apoyo al mismo. Sin embargo, en años recientes se ha identificado una diversidad de variables psicológicas y sociales (i.e., depresión, estrés, bajos niveles de motivación y carencia de apoyo social, principalmente) que dificultan la práctica de esos comportamientos, favoreciendo así el progreso clínico de la enfermedad y una reducción en la calidad y tiempo de sobrevida en las personas con VIH. En el subcampo de conocimiento conocido como psicología y salud existen diversos modelos teóricos con los que se ha buscado dar cuenta de cómo es que esas variables influyen sobre los comportamientos de adhesión; destacan, principalmente, el autorregulatorio, el de creencias en salud y el de información-motivación-habilidades conductuales. En general, se trata de modelos que, o bien privilegian el análisis de lo psicológico a partir de conceptos de naturaleza cognoscitiva, o bien carecen de análisis de fenómenos como los de estrés y personalidad, así como de los comportamientos asociados a la enfermedad. El presente estudio se realizó con base en un modelo psicológico para la investigación de los comportamientos de adhesión terapéutica; se trata de un modelo interactivo y funcional en el sentido de consignar la interacción de un conjunto de variables psicológicas y biológicas a lo largo de cuatro fases comportamentales en el proceso del desarrollo de padecimientos crónicos. En la primera se incluyen variables psicológicas de procesos y resultados; en la segunda el diagnóstico de la infección por VIH y el posterior desarrollo de otras enfermedades oportunistas; la tercera, psicológica, contempla la práctica de dos tipos de comportamientos, los de adhesión terapéutica y los asociados a la enfermedad; finalmente, en la cuarta se contemplan los indicadores biológicos convencionales y los resultados de salud. Materiales y método Se condujo un estudio transversal que tuvo como objetivo identificar predictores de los comportamientos de adhesión al tratamiento antirretroviral en 68 personas con VIH. Los participantes respondieron a dos instrumentos: i) factores psicológicos y comportamientos de adhesión, y ii) situaciones vinculadas con estrés. Para el análisis de los datos se utilizaron estadísticas univariadas, la x² de Pearson, la prueba T para muestras independientes y un análisis de regresión lineal múltiple. Resultados Del total de participantes, 58 (85.3%) respondieron que se habían administrado sus medicamentos todos los días de la última semana y los restantes 10 (14.7%) lo habían hecho con inconsistencia, diferencia que resultó significativa (x² [1] =33.882; p<0.001). La prueba T para muestras independientes arrojó una sola diferencia significativa entre las personas con VIH adherentes y no-adherentes en la variable motivos ( t [66] = -27.954; p<0.001); finalmente, el análisis de regresión lineal múltiple aportó como predictores de los comportamientos de adhesión a las variables motivos (β = 0.802; p<0.001) y bajos niveles de estrés vinculados con toma de decisiones ( β = -0.268; p<0.01) y con tolerancia a la frustración (β = -0.280; p<0.01), con un coeficiente de determinación [R² ajustado] = 0.629, es decir, que las tres variables explican 62.9% de la varianza total. Discusión Los resultados muestran que las personas con VIH 100% adherentes son aquellas que se encuentran claramente motivadas y que en general experimentan bajos niveles de estrés relacionados con la toma de decisiones y tolerancia a la frustración. Estos hallazgos sugieren que en el diseño e instrumentación de programas de intervención orientados a mejorar la adhesión de estos pacientes es indispensable incorporar módulos o componentes basados directamente en dichos factores, poniendo especial énfasis en programas interdisciplinarios.

Se revisa el uso del concepto de motivación en Psicología y salud. Se concluye que algunas teorías hacen un uso incorrecto del concepto, pues incurren en lo que Ryle llamó errores categoriales, lo cual compromete la interpretación que se hace de los resultados obtenidos en la práctica de la investigación

It's review the motivation concept uses in health psychology. It's conclude that some theories make an incorrect concept uses, to commiting which Ryle's name as categorial mistakes, compromising the interpretation of the results gained in the research practice.

Se realizó un estudio transversal cuyo objetivo fue el de identificar predictores del comportamiento sexual con múltiples parejas en una muestra de 423 estudiantes de una institución de educación superior que se localiza en Hermosillo, en el noroeste de México. Para el tratamiento de los datos se utilizaron de manera sucesiva la prueba T, la prueba U de Mann-Whitney, el coeficiente de correlación de Pearson (r) y un análisis de regresión lineal múltiple. El análisis de regresión para el grupo de hombres identificó como predictores del comportamiento a las variables edad biológica, edad de inicio de relaciones y una situación social -encontrarme en un lugar para adultos-,según lo cual las tres variables explican el 42.4% de la varianza total. Por otra parte, en el grupo de mujeres, los predictores fueron las variables edad biológica, edad de inicio de relaciones y un estado biológico -me encontraba excitada físicamente-,según lo cual éstas explican el 70.3% de la varianza total. Los resultados del presente estudio aportan información valiosa con respecto a las variables que facilitan que las personas de ambos géneros se relacionen sexualmente con múltiples parejas, aspecto que debe ser tenido en cuenta en el momento de diseñar e instrumentar programas para prevenir la infección por el VIH en ese sector de la población.

A cross-sectional study aimed at identifying predictors of sexual behavior with multiple partners in a sample of 423 higher-education students took place at Hermosillo city, Northwest of Mexico. For data processing, the T-test, the Mann-Whitney U-test, the Pearson’s (r) correlation coefficient, as well as a multiple regression analysis were used in consecutive order. Regression analysis by gender showed that biological age, age of sexual initiation, and a social situation -Finding myself in a place for adults- were predictors of the behavior in men, thus explaining 42.4% of the total variance. On the other hand, predictors of this behavior in women were biological age, age of sexual initiation, and one type of biological state -I was physically excited-, with these variables explaining 70.3% of the total variance. The results of this study contribute with valuable information to identifying the variables that facilitate both in men and women the practice of having multiple partners when performing sexual behavior, an aspect that must be considered at the time of designing and implementing HIV prevention programs in this population sector.

Levou-se a cabo um estudo transversal cujo objetivo foi identificar preditores do comportamento sexual com diversos casais em uma amostra de 423 estudantes de uma instituição de educação superior localizada em Hermosillo, noroeste de México. Para o tratamento dos dados foram utilizados sucessivamente a prova T, a prova U de Mann-Whitney, o coeficiente de correlação de Pearson (r), e uma análise de regressão lineal múltiple. A análise de regressão para o grupo de homes mostrou como preditores do comportamento as variáveis idade biológica, idade de início das relações e uma situação social (achar-se em um lugar para adultos), que explicam 42.4% da variância total. No grupo das mulheres, os preditores foram as variáveis idade biológica, idade de início de relações e um estado biológico (achar-se excitada fisicamente), que explicam 70.3% da variância total. Os resultados deste estudo provem informação valiosa das variáveis que facilitam as relações sexuais de pessoas de ambos os gêneros com diversos casais. Este aspecto deve ser tido em conta ao desenhar e implantar programas de prevenção de infecção pelo VIH em esse sector da população.

Con base en la propuesta interconductual de Kantor, en este trabajo se presentan algunas variaciones sobre el modelo psicológico de salud biológica de Ribes. Tanto por la lógica que le subyace como por las características de los elementos que lo conforman, se trata de un modelo de campo y multifactorial que pone especial énfasis en la interacción de un conjunto de variables psicológicas de tipo histórico y situacional, que probabilizan la práctica de los comportamientos instrumentales de prevención o de riesgo.

Based on Kantor's interbehavioral approach, in this paper we present some variations on Ribes's psychological model of biological health. Because of both the underlying logic, and the characteristics of the elements that shape it, it is a field and multifactorial model which places a special emphasis on the interaction among a set of historical and situational variables that set probabilities for instrumental behaviors of prevention and risk.

Se realizó un estudio transversal cuyo objetivo principal fue el de identificar predictores psicológicos del uso de preservativo en una muestra de 381 mujeres en edad reproductiva de la ciudad de Tunja, Colombia. Se administró un instrumento que evalúa conocimientos, motivos, situaciones sociales y estados biológicos relacionados con el uso del preservativo en la primera relación sexual y a lo largo de la vida sexual activa. Para el tratamiento de los datos se obtuvieron estadísticas descriptivas y se utilizaron el x² de Pearson y un análisis de regresión logística multivariado (método hacia atrás con Wald). El análisis con el x² de Pearson arrojó diferencias entre quienes utilizaron y no utilizaron preservativo en su primera relación (x² [1] = 25.000; p = 0.000), así como entre quienes lo utilizaron consistente e inconsistentemente a lo largo de su vida sexual activa (x² [3] = 21.907; p = 0.000). El análisis de regresión logística multivariado aportó como predictor del uso del preservativo a lo largo de la vida sexual activa al motivo "porque yo no sabía utilizarlo" (x² [2] = 6.786; p = 0.034). Se discute sobre la importancia de diseñar programas para la prevención de la infección por VIH que pongan especial atención en la variable motivos que subyacen al uso de preservativo, así como en la necesidad de entrenar a las mujeres en edad reproductiva en competencias relacionadas con la negociación y el uso consistente y eficiente del preservativo.

A cross-sectional study was performed with the purpose of identifying psychological predictors of condom use behaviors in a sample of 381 women in reproductive age from Tunja, Colombia. An instrument that evaluates knowledge, motives, social situations, and biological states related to condom use behaviors in the first sexual encounter, and throughout active sexual life was administered. For data processing descriptive statistics were obtained. Additionally, Pearson’s x² test and a multivariate logistic regression analysis were used. Pearson’s x² test showed differences between women who used and did not use condom in their first sexual intercourse (x² [1] = 25.000; p = 0.000), and also showed differences between those who consistently or inconsistently used it throughout their active sexual life (x² [3] = 21.907; p = 0.000). A multivariate logistic regression analysis showed that condom use behavior throughout these women’s active sexual life was predicted by the motive "Because I didn’t know how to use it" (x² [2] = 6.786; p = 0.034). A discussion is presented about the importance of designing prevention programs for VHI infection that pay special attention to the motives underlying the use of condom, as well as the need to educate women in developing skills both for negotiation and for a consistent and effective use of condom.

Se presenta un modelo psicológico para la investigación de los comportamientos de adhesión al tratamiento en personas con VIH, cuyos elementos se agrupan en cuatro fases, dos psicológicas y dos biológicas. La primera incluye variables disposicionales -situaciones interactivas vinculadas con estrés, competencias funcionales y motivos- y comportamientos instrumentales de riesgo y prevención; la segunda contempla, en una primera instancia, la enfermedad por VIH y otras resultantes en diferentes patologías; la tercera, el papel que juegan dos tipos de comportamientos, los de adhesión al tratamiento y los asociados a la enfermedad; la cuarta y última, comprende los efectos potenciales que ambos comportamientos tienen sobre la modulación y vulnerabilidad biológicas, y su posterior impacto sobre el desarrollo de otras patologías relacionadas con el VIH, consideradas en la segunda fase.

The present paper proposes a psychological model for research on treatment adherence behavior in persons with HIV. The elements of the model are grouped in four stages, two psychological and two biological. The first includes dispositional variables such as interactive situations related to stress, functional competencies and motives, as well instrumental risk and preventive behaviors. The second includes the disease generated by HIV and others resulting in diverse pathologies. In the third phase, once pathology sets its course, the model involves the role of two types of behaviors, treatment adherence and those typically associated to the disease itself. The fourth includes the potential effects of the psychological components as modulators of both biological vulnerability and the development of further HIV-related pathology.