Literature Review: Self-affirmation Theory and Health Behavior
unhealthy behaviors
APPENDIX
According to self-affirmation theory, people are motivated to maintain a global sense of self-integrity [Self-affirmation theory’s key insight is that these defensive responses can be reduced by encouraging people to affirm a positive aspect of themselves that is unrelated to the threat [Two findings are particularly relevant for our investigation. The first is that self-affirmation can increase people’s openness to accepting “difficult truths” [The second key finding is that self-affirmation can help people cope with stigma [In short, prior research suggests that, by bolstering a global sense of self-worth, self-affirmation interventions can diminish people’s reluctance to acknowledge the health risks they face and improve people’s ability to deal with stigma. Earlier, we suggested that such reluctance and stigma are potent psychological barriers in the Senegalese context that they may prevent FSWs from using condoms or getting tested. Thus, we reasoned that self-affirmation has the potential to improve these women’s HIV-prevention behaviors.There are, however, reasons to doubt whether the salutary effects of self-affirmation found in prior research would emerge among FSWs in Senegal.First, most research has been conducted in the US and UK (see Appendix S1 for examples), two of the most individualistic countries in the world [Second, Senegalese FSWs face greater health risks and are more stigmatized than most of the populations previously studied in the literature. Most research in this literature was conducted with undergraduates whose unhealthy behaviors were associated with little or mild stigma, such as consuming alcohol [Despite these doubts, we hypothesized that self-affirmation would improve HIV-prevention behaviors among FSWs in Senegal. We next describe our specific hypotheses and how we tested them.