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Background Based on theory, COVID-19 transmission-reducing behaviors (TRBs) should become habitual because of their frequent performance. Habits have been hypothesized to develop through reflective processes and, to act in conjunction with them. Purpose We investigated the existence, development, and consequences of TRB habits, for physical distancing, handwashing, and wearing face coverings. Methods A representative sample of the Scottish population (N = 1,003) was interviewed by a commercial polling company in August–October 2020 and half were re-interviewed later. Measures included adherence, habit, personal routine tendency, reflective processes, and action control for three TRBs. Data were analyzed using general linear modeling, regression, and mediation analyses. Results Handwashing was most habitual; only face covering became more habitual over time. Routine tendencies predicted TRB habits, and adherence to handwashing and physical distancing. Those reporting greater habits reported better adherence, for physical distancing and handwashing, and this remained true after controlling for previous adherence. Reflective and habit processes independently predicted adherence for physical distancing and handwashing; only reflective processes were independently predictive for face covering. The relationship between planning and forgetting and adherence was partly direct, and partly mediated by habit. Conclusions The results confirm hypotheses from habit theory including the role of repetition and of personal routine tendency in developing habits. They are consistent with dual processing theory in finding that both reflective and habit processes predict adherence to TRBs. Action planning partly mediated the relation between reflective processes and adherence. The COVID-19 pandemic has enabled the testing and confirmation of several theoretical hypotheses about habit processes in the enactment of TRBs. [ABSTRACT FROM AUTHOR]

Prevention of infectious diseases depends on health-related behavior, which is often influenced by psychological characteristics. However, few studies assessing health-related behavior have examined psychological characteristics to identify risk groups, and this multidimensional approach might improve disease risk assessment. We aimed to characterize subgroups based on psychological characteristics and examine their influence on behavior and disease risk, using chlamydia as a case study. Selected participants (heterosexuals aged 18–24 years and females aged 18–24 years who had sex with both men and women) in a Dutch longitudinal cohort study (the Mathematical Models Incorporating Psychological Determinants: Control of Chlamydia Transmission (iMPaCT) Study) filled out a questionnaire and were tested for chlamydia (2016–2017). Latent class analysis was performed to identify risk classes using psychological predictors of chlamydia diagnosis. Two classes were identified: class 1 (n = 488; 9% chlamydia diagnosis) and class 2 (n = 325; 13% chlamydia diagnosis). The proportion of participants with high shame, high impulsiveness, and lower perceived importance of health was higher in class 2 than in class 1. Furthermore, persons in class 2 were more likely to be male and to report condomless sex compared with class 1, but the number of recent partners was comparable. Thus, risk classes might be distinguished from each other by psychological characteristics beyond sexual behavior. Therefore, the impact of the same intervention could differ, and tailoring interventions based on psychological characteristics might be necessary to reduce chlamydia prevalence most effectively. [ABSTRACT FROM AUTHOR]

Objectives: Men who have sex with men (MSM) who are unaware of their HIV infection are more likely to infect others, and unable to receive treatment. Therefore, we aimed to identify the proportion and characteristics of Dutch MSM who never tested for HIV. Methods: In 2010, the European MSM Internet Survey (EMIS) recruited 174 209 men from 38 countries through an anonymous online questionnaire in 25 languages. We analysed data from participants living in the Netherlands (N=3787). The outcome we investigated was having never (lifetime) been tested for HIV. Results: A total of 770 MSM (20.4%) had never been tested for HIV. In multivariate regression analyses, not being from Amsterdam (adjusted OR, aOR 1.54, CI 1.17 to 2.03), with low education (aOR 1.28, CI 1.04 to 1.57) and low knowledge on HIV-testing (aOR 2.23, CI 1.37 to 3.64) were significantly associated with never having tested. Lower sexual risk (including having fewer sexual partners (aOR 2.19, CI 1.57 to 3.04) and no anal intercourse (aOR 5.99, CI 3.04 to 11.77)), and less social engagement (including being less out (aOR 1.93, CI 1.55 to 2.40)) were also associated with having never been tested. Additionally, 36.1% of MSM who never tested for HIV reported high-risk sexual behaviour that may have put them at HIV risk. Conclusions: MSM make their own risk assessments that inform their choices about HIV-testing. Nevertheless, MSM who were never tested may have been at risk for HIV, and remain important to target for HIV interventions. [ABSTRACT FROM AUTHOR]