Dissertations, Theses, and Capstone Projects

Date of Degree

9-2023

Document Type

Dissertation

Degree Name

Ph.D.

Program

Psychology

Advisor

Sarit A. Golub

Committee Members

Ana P. Gantman

Cheryl L. Carmichael

Sarah K. Calabrese

Subject Categories

Health Psychology | Social Psychology

Keywords

blame, moral outrage, contraception, PrEP, HIV, pregnancy

Abstract

Unintended pregnancy and HIV are both possible but preventable outcomes of vaginal sex, and both can be prevented in similar ways (condoms, daily oral medication, etc.). Despite these similarities, providers more readily prescribe contraception to cisgender women, compared to PrEP (Guttmacher Institute, 2021; Raifman et al., 2019). Providers’ differential willingness to prescribe each medication cannot be attributed merely to differences in women’s need for pregnancy prevention vs. HIV prevention, as women account for nearly 20% of new HIV infections (CDC, 2021). Through three studies, I examined whether perceivers’ support for harm reduction (i.e., prescribing PrEP/contraception) and behavior reduction (i.e., discouraging condomless sex) result from an interplay of their ideological and/or prejudicial beliefs, attributions of blame, and feelings of moral outrage. In Study 1, health care providers in New York City (n = 132) read a description of a fictional patient with HIV or an unintended pregnancy, and answered survey questions assessing their reaction to this patient. Study 2 was designed to be a replication and extension of Study 1 in a larger sample of NYC residents (n = 276). Finally, Study 3 explored the impact of trait-level differences on moral outrage and agent blame among NYC residents (n = 275). Results indicated greater moral outrage is associated with greater agent blame, and that both are associated with greater support for retributive behavior reduction strategies to prevent HIV and unintended pregnancy. This research also provided preliminary evidence that perceivers’ biases differentially impact blame judgments in the context of each health outcome.

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