Using an AIDS KABP Survey to Identify Determinants of Condom Use Among Sexually Active Adults From St. Vincent and The Grenadines1

In Fall 1990, a knowledge, attitude, belief, and practices (KABP) survey was administered to a representative sample of residents of St. Vincent and the Grenadines, an island nation in the Eastern Caribbean. The KABP questionnaire contained a large number of questions that could reasonably be expected to be related to whether or not people use condoms. To a certain extent, each of these questions can be viewed as an attempt to assess one of the variables identified by one or more theories of behavior and behavior change. More specifically, questions on the KABP were identified as possible indicants of AIDS knowledge, cues to action, perceived susceptibility, perceived severity, perceived (locus of) control, perceived normative pressure, and condom use outcome expectancies. Statistical analyses indicated that some, but not all, of these variables were related to condom use among sexually active adults. In particular, the analyses indicated that perceived normative pressure to use condoms was the single most important determinant of condom use behaviors on St. Vincent. The implications of this finding for designing mass-media campaigns to increase condom use is discussed, and a campaign that attempts to change condom use by influencing perceived social norms is strongly recommended.     

Knowledge,beliefs, peer norms,and past behaviors as correlates of risky sexual behaviors among college students

Abstract

HIV/AIDS knowledge, age at onset of sexual activity, perceptions of personal risk and peer norms were explored as correlates for risky sexual behaviors among college students. Ninety-nine male and 185 female college students completed a 66-item questionnaire. A majority reported being sexually active with most in mutually monogamous relationships or not currently in a sexual relationship. Multiple regression correlation analyses showed knowledge about HIV/AIDS to be very high but that this knowledge did not independently relate to the extent of risky behaviors. Perceptions of risk were positively related to number of partners and single-time partners but not condom usage. In contrast to previous studies, perceived peer norms did not independently relate to behaviors. Instead, age at first intercourse was found to have substantial overlap with current perceptions, attitudes, and likelihood for engaging in risky behaviors. The necessity for including previous behaviors in analyses of the impact of attitudes and perceived norms on behavioral intentions is discussed.     

The AIDS Risk Reduction Model: Examining Intentions to Use Condoms Among Injection Drug Users1

This paper uses the AIDS Risk Reduction Model (ARRM) to examine psychosocial factors involved in adopting safer sex practices in a sample of Los Angeles injection drug users (IDUs; n= 161) who reported having more than one sex partner in the year preceding the interview. The ARRM hypothesizes that behavior change is a process occurring in three stages: (a) labeling one's behavior as problematic, (b) making a commitment to behavior change, and (c) taking action to accomplish that change. We test the first two stages of the model using a measure of perceived risk of HIV infection (Stage I), and intentions to use condoms always during vaginal or anal sex in the next year (Stage 2). We examine differences in the predictive value of the ARM between IDUs who reported using condoms in the year prior to the interview and those who reported not using them. We identify leverage points in the model-factors which appear to have a major influence on intentions to use condoms and which may be amenable to change through educational or other types of intervention. For both condom users and non-users, susceptibility to AIDS predicted perceived infection risk (Stage I). For condom users, knowledge about AIDS also predicted perceived risk. For both groups, self efficacy, peer norms concerning condom use, and the perceived pleasure of using condoms predicted intentions to use condoms (Stage 2). Our findings do not support either direct or indirect relationships between the Stage 1 and Stage 2 outcome variables for either group.     

HIV risk perceptions and first sexual intercourse among youth in Cape Town South Africa

CONTEXT: HIV prevalence is high among South African youth. Health behavior models posit that the perceived level of risk of HIV infection is associated with the level of HIV risk behavior; however, there has been limited research in Sub-Saharan Africa on factors associated with perceived risk or on the relationship between perceived risk and risk behaviors. METHODS: Longitudinal data collected in 2002 and 2005 from 3,017 black, colored and white youth in Cape Town, South Africa, were analyzed using multivariate regression to examine whether a reciprocal relationship exists between sexual experience and perceived HIV risk. Independent variables taken from the 2002 survey were used to predict dependent variables taken from the 2005 survey. RESULTS: In 2005, most youth (82% of males and 83% of females) viewed themselves as being at no or small risk of HIV infection. A reciprocal relationship in which higher perceived HIV risk was associated with a delay in sexual debut (odds ratio, 0.8) and sexual experience was associated with higher perceived risk (1.4) was found for females, but not for males. Knowing someone who had died of AIDS was associated with sexual debut and with an elevated perceived HIV risk among females (1.7 and 1.3, respectively). The associations between race and perceived risk of HIV infection varied by gender. CONCLUSIONS: HIV/AIDS education and prevention programs should consider more carefully how gender and race may intersect to influence risk perceptions and risk behaviors. In addition, possible reciprocal relationships between risk behaviors and risk perceptions should be considered in education and intervention programs.     

Predictors of Intention to Take Precautions Against AIDS Among Black College Students1

This research explored the relationship between behavioral intentions to engage in AIDS-risky sexual practices and a variety of variables that are theoretically and/or popularly assumed to be important factors in AIDS prevention. These variables included beliefs and knowledge about AIDS, fear of AIDS, perceived vulnerability of self and others, as well as probability that self and others on one's campus would contract AIDS, perceived efficacy to control exposure to AIDS, self-esteem, general locus of control, and past behavioral reaction to the threat of AIDS. General intention to “do something to protect oneself against AIDS,” and specific behavioral intention to use condoms in vaginal sex were measured and considered as possible proxies for future behavior. Data were collected from 124 black respondents in a southeastern university. In a series of multiple regression analyses, each of these measures of behavioral intentions was “predicted” from the other variables. Results showed that situational efficacy (to protect oneself from AIDS) was the best predictor of general intention, followed by reports of past behavioral changes as a result of the AIDS epidemic, and by knowledge. Proximal fear of AIDS was a negative predictor. For specific intentions, a specific belief about inconvenience in condom use was the best predictor, followed by past behavioral change, followed by knowledge. Normative beliefs, a belief that condoms would prevent disease, and distant threat of AIDS were also significant predictors. Theoretical and policy implications of the findings are discussed.     

The role of risk perception and efficacy cognitions in the prediction of HIV-related preventive behavior and condom use

The salience of the Protection Motivation Theory to HIV preventive behavior was investigated in a sample of 468 heterosexual men 20-45 years of age recruited in Germany and at vacation spots in Spain. This theory conceptualizes self-protective behaviors as a function of the severity of the threat, perceived personal vulnerability to this threat, the availability of coping responses, and the effectiveness of these responses. Cognitive variables measured included perceived severity of the threat of AIDS, sexual self-efficacy expectancy, self-efficacy expectations in terms of sexual communication skills, response efficacy, and attitude toward condom use. On a scale of 1 (low) to 6 (high), perceived severity of the AIDS threat averaged 5.3, individual susceptibility ratings averaged 3.5, and susceptibility of peers had a mean of 4.9. Although 33% of respondents had made behavioral changes in response to the AIDS epidemic, only 15% always used condoms while 12% used them occasionally. Self-efficacy expectancy with regard to assertiveness and use of preventive measures emerged as the most significant predictor of HIV-related behaviors. The causal analyses indicated that high communicative self-efficacy expectancy is associated with high-risk sexual behaviors, while self-efficacy expectancy regarding assertiveness and the use of preventive measures promotes risk reduction. These associations were strongest in men over 26 years of age, singles, and tourists. These findings suggest a need for interventions for couples such as assertiveness training and guidance on communicating about sex and AIDS. Also demonstrated was the need for AIDS education programs to identify where participants are in terms of perceiving the threat of and coping with the AIDS epidemic and promote conditions that will help people advance to the next stage.     

Psychological predictors of sexual behaviors related to AIDS transmission

This study was designed to assess the differential value of several psychological variables with regard to predicting safe-sex behavior. A sample of 94 male and 179 female undergraduate students, ranging in age from 16 to 66 years, were surveyed about sexual issues related to safe-sex practices. The survey included scales measuring participants' knowledge of transmission of AIDS, self-perception of safe-sex communication, fear and concern about AIDS, attitudes toward AIDS victims, and self-report of risky behavior. Several interesting relationships among predictor variables were found. For instance, favorable attitudes toward AIDS victims were positively correlated with knowledge about AIDS transmission, perceived communication with partners about safe sex, and fear of acquiring AIDS. However, only two predictor variables were independently predictive of self-reports of risky sexual behavior; specifically, fear about AIDS transmission was positively correlated with risky behavior, while communication was negatively correlated with risky behavior. These data suggest a need for a model that allows for complex, reciprocal relationships between the cognitive, emotional, and behavioral components of safe-sex practice. Implications are applied to research with college populations.     

High school students' perceptions of AIDS risk: realistic appraisal or motivated denial?

We examined perceptions of risk for acquired immunodeficiency syndrome (AIDS) in 296 high school students living in or near a major urban center. We hypothesized that students with a dispositional tendency to deny threat would be more likely to misperceive their risk of contracting AIDS. Results indicated that study participants, overall, used their behaviors as a basis for assessing personal risk in the sense that they perceived higher risk when their behavior was in fact riskier. However, this relation did not hold for those students classified as repressors on a repression-sensitization scale; repressors' perceptions of absolute (but not comparative) risk were negatively correlated with degree of behavioral risk. In a secondary analysis, perceived absolute risk was found to be a significant predictor of intention to change AIDS-risk behaviors. This study provides support for a motivational interpretation of perceived invulnerability and has implications for the development of models of health behavior change.     

Comparison of Marine and College Women's HIV/AIDS-Relevant Sexual Behaviors1

This study compares the heterosexual risk behaviors, perceptions of vulnerability to HIV/AIDS, and predictors of condom use of two groups of women with very different sexual and contraceptive histories and habits–college women and women in Marine Corps recruit training. The Marines' s]exual behaviors put them at greater risk of contracting HIV than the college students; that is, Marines reported more frequent intercourse with more partners, used condoms less frequently, and had less knowledge about HIV/AIDS transmission. Consistent with these differences, college students displayed a larger illusion of unique invulnerability than did the Marines. In general, the women who had more sexual partners and more frequent sexual intercourse were less likely to report regularly using condoms. In addition, the data provide support for Weinstein and Nicholich's (1993) recent suggestion that the relation between risk perception and risk behavior is different for different groups of people.     

Unsafety on two wheels,or social prejudice? Proxying behavioral reports on bicycle and e-scooter riding safety – A mixed-methods study

The use of non-motorized transportation and micro-mobility is increasing in many cities. Bicycle riding and e-scooter use are now more common and affordable than ever. However, users of these devices face certain key issues. These include their own risky behaviors as well as involvement in conflicts with other road users. Self-report data may not adequately capture these behaviors and interactions. Despite this, more objective data (i.e., how third parties perceive these users’ road behaviors) is scarce. Aims: This study aimed to understand whether e-scooter riders have comparable or different riding behaviors than cyclists. This was investigated using a mixed-method study. Methods: This paper is divided into two sub-studies. In Study 1, 950 Spanish non-cyclists and non-e-scooter riders (mean age 31.98 ± 13.27 years; 55.3% female) provided external ratings (proxies) regarding the perceived behaviors of bicycle and e-scooter riders. In Study 2, collective Rapid Assessment Processes (RAPs; n = 23) were used to develop qualitative configurations of some of the key risky behaviors highlighted in Study 1. Results: There were significant differences in the perceived errors and violations rated by proxies for both types of riders (with e-scooter riders perceived as having higher rates of risky behaviors). However, there were also structural differences in the effects of external raters’ risk perceptions, traffic rule knowledge, and traffic incidents with two-wheeled riders on how they rated the behaviors. Conclusion: The results of both studies suggest that external raters’ perceptions provide further understanding of the causes, dynamics, and conflicts related to road behaviors performed by certain groups of road users. This is particularly apparent when there is no clear legislation and information on safe riding in urban areas. In this sense, improving infrastructure could promote safer interactions. Finally, road safety education could focus on promoting safer practices and interactions in order to improve how others perceive riders’ behavior.     

Magnitude and determinants of behavioral risk reduction: Longitudinal analysis of a cohort at risk for AIDS

The magnitude and predictors of longitudinal behavioral change are reported in a cohort of homosexual men at risk for AIDS. Self-reports of sexual behavior were obtained at two points in time separated by an interval of approximately six months. These self-reports were used to construct both dichotomous and continuous measures of changes in behavior consistent with reduction in the transmission of the AIDS virus (HIV). Although there was considerable variability in behavior. mean changes were consistently in the desired direction. Avoidance of anonymous sexual partners, monogamy, and modification of receptive anal sex to reduce exposure to semen by condom use or withdrawal prior to ejaculation appeared to be especially important in this cohort. Both multiple linear regression and multiple logistic regression were used to examine the relationship between a model of health behavior and these outcomes. Variables examined included knowledge of AIDS. perceived risk of AIDS. the perceived efficacy of behavior in reducing AIDS risk, difficulties with sexual impulse control, belief in biomedical technology to provide a prevention or cure, social norms supportive of behavioral change, and gay network affiliation. Of all these factors, only the availability of supportive peer norms was consistently, significantly and positively related to multiple measures of outcome. Differences between these analyses and longitudinal analyses reported elsewhere are discussed. These results suggest the policies regarding HIV antibody testing should be developed cautiously. taking account of the failure of a sense of risk to predict subsequent behavioral change. They also emphasize the important role of gay organizations in developing social norms supportive of behavioral risk reduction.     

An Evaluation of an HIV/AIDS Prevention Program in a Nigerian Setting

The study examined the success of a group based behavioural intervention with Nigerian youths aimed at reducing the risk of contracting and spreading HIV/AIDS and other sexually transmitted illness (STI). Participants were 147 youths (males=75, females=72, age range 5 to 24 years). The study explored the influence of motivational factors (self efficacy), attitudinal factors (perceived personal risk), knowledge (instrumental knowledge of AIDS) and behavioural factors (refusal of high-risk behaviour) in predicting condom use amongst youth participating in a group-based HIV prevention intervention. Findings indicated that the intervention program reliably predicted participants' attitudinal dispositions to high risk heterosexual behaviour. Instrumental knowledge of HIV/AIDS, perceived self-efficacy, perceived personal risk of HIV/AIDS and refusal of risk behaviour were significant predictors of condom use.     

Perceived Peer Norms,Casual Sex,and AIDS Risk Prevention1

To facilitate more effective AIDS education with heterosexual college students, an etiological study of AIDS risk behavior was conducted on a sample of 1,035 students at a large western university. In this study, “AIDS risk behavior” refers to participation in casual sex, failure to use condoms, and resistance to changing casual sex activity. Knowledge regarding AIDS had no significant correlation with AIDS-risk behavior. However, “perceived peer norms” (termed Peer Norm in this study) was a major predictor variable in AIDS risk behavior. Peer Norm was defined as perceived AIDS-risk attitudes and the behavior of one's peers. These findings contrast some what with those of Emmons et al.'s (1986) study of homosexual men. This difference may be due to the focus in the present study upon heterosexual university students as subjects. For this group, our results suggest that programs targeting the peer group in AIDS prevention education are especially needed. These might include peer-based AIDS education, emotion-oriented discussion sessions, encounters with “Peers-with-AIDS” models, and role-playing of assertive responses.     

Health behavior, knowledge and attitudes among Swedish university students

A range of health behaviors was related to beliefs concerning health practices and health knowledge. A questionnaire dealing with health-related practices, health beliefs and knowledge of health risk factors was answered by 166 male and 179 female students aged 18–30 years at Stockholm University. Female students reported engaging in better health behavior than males. Beliefs about the importance of health behaviors were closely related to their frequency of occurrence. There was only a weak relationship between health behaviors and knowledge of specific health matters. It is concluded that health attitudes rather than health knowledge determine health behavior.     

Fatalistic beliefs,risk perception and traffic safe behaviors

IntroductionRoad safety is a major worldwide concern especially for developing countries where a certain feeling of helplessness predominate. Local authorities are seeking ways to change people's behaviors considered as the first causal factor of traffic accidents. Risk perception and fatalistic beliefs have been identified as important socio-cognitive functioning patterns, which can shed light on people's behaviors towards risks, for prevention purpose. But the way fatalistic beliefs are associated with risk perception and safety behaviors remains blurred in literature.ObjectiveThis article examined the relationship between fatalistic beliefs, risk perception and traffic safety-related behaviors.MethodThe study was carried out in Cameroon on a sample of 525 road users with a questionnaire made up of scales measuring fatalistic beliefs, perceived risk for dangerous traffic events and reported safe behaviors.ResultsAs expected, participants with higher levels of fatalistic beliefs perceived dangerous traffic situations as less risky and reported less safe behaviors. Perceived risk partially mediated the association between fatalistic beliefs and reported safe behaviors.ConclusionPerceiving dangerous traffic situations as risky can mitigate the magnitude of one's fatalistic beliefs on the engagement in protective behaviors. The implications for more effective prevention including both beliefs and perceptions are suggested. One can explain to people how to avoid accidents, emphasizing on their capacity to change their behavior and the gains they retrieved from that behavioral change.     

An experimental comparison of two AIDS prevention interventions among young Zimbabweans.

In 1990, psychologists compared data on 42 student teachers at the University of Zimbabwe who underwent an information-based health education session designed to increase condom use with data on 42 other student teachers who underwent a skills-based health education session. They wanted to determine whether skills-based, participative interventions are more effective in changing attitudes toward AIDS and practices than are information interventions. Mean age for all student teachers was 23.1 years. All participants completed a questionnaire before the interventions and the same questionnaire 4 months after the interventions. The 1-hour information-based intervention included a talk about HIV transmission and prevention and a question and answer period after the talk. A condom fitting demonstration, individual practice, group formulation of behavioral self-management approaches, sketches of social and assertiveness skills used to negotiate condom use, pair role plays, group psychodrama about effects of AIDS, and a video about a popular African musician with AIDS comprised the 90-minute skills-based, participative intervention. The skills-based group exhibited more knowledge about condoms and their correct use (p.001), higher self-efficacy (p.05), fewer obstacles to condom use (p,05), and fewer acts of intercourse without condom use in the last 30 days (p.05) than the information-based group. These results were especially encouraging because risk reduction behaviors were maintained over 4 months. Thus more skills-based interventions and skilled AIDS educators are needed in Africa. The few psychologists in Africa can train educators, design training programs and manuals, and develop effective support and supervision systems.     

High risk behaviors in a sample of Mexican-American college students

This study explored different types of high risk behaviors of Mexican-American college students attending a small university in south Texas. High risk behaviors for contracting HIV/AIDS examined in this study included unprotected sex, drug use, and alcohol abuse. In 1995 in the United States, HIV/AIDS is the leading cause of death in people between the ages of 25 and 44. Because use of alcohol and certain recreational drugs lowers inhibitions, their use could increase the possibility of having unprotected and unplanned sex with multiple partners. Thus, it was expected that Mexican-American college students who use drugs and alcohol would be more likely to engage in unprotected sex. Data were from 105 men and 211 women between the ages of 18 and 30 years. Drug use and alcohol abuse were significantly associated with high risk sexual behavior. Individuals in monogamous relationships were more likely to not use condoms than those involved in casual relationships. Self-reported religiosity was not correlated with high risk behaviors, although there were implications that stronger religious affiliation did alter sexual beliefs and practices. Lastly, parental communication was not significantly associated with high risk behaviors, but family unity did seem related to some risky sexual practices.     

AIDS as Threat,AIDS as Stigma correlates of AIDS beliefs among the Dutch general public

Abstract

The central question of this article is whether findings about social and cultural correlates of preventive and public attitudes towards AIDS that were found in other western countries are also valid for the Netherlands. Answering this question contributes to the international accumulation of empirical knowledge about attitudes of the general public and might as well be relevant for the international transfer of knowledge about the public into assumptions of information campaigns. Eight hypotheses derived from international literature were tested on data of the 1987 module of “Cultural changes in the Netherlands,” a general opinion survey of the Dutch population (16-80 years old). In line with international research, younger age and more education are correlated with preventive knowledge and social acceptance; however sex and urbanization do not make a difference in the Netherlands As expected, a negative attitude towards homosexuals is related to a lack of acceptance of people suffering from AIDS, support for mandatory screening for HIV, as well as a lack of preventive knowledge. Also in accordance with earlier research, “authoritarian attitudes” are far more important in explaining the public attitudes than beliefs about AIDS as an individual threat.     

The Association of Gender,Ethnicity, and Length of Residence in the Bay Area to Adolescents' Knowledge and Attitudes about Acquired immune Deficiency Syndrome1

A large-scale survey was conducted in San Francisco to assess adolescents' knowledge, attitudes, and beliefs about AIDS. Data obtained from 1,326 adolescents demonstrate marked variability in knowledge across informational items, particularly about the precautionary measures to be taken during sexual intercourse which may reduce the risk of infection. The findings identified ethnic differences in knowledge about AIDS, with Asians having a lower overall knowledge score than Hispanics, Blacks, and Caucasians. Adolescents who score below the median for total number of correct responses were more than twice as likely to perceive themselves as very susceptible to AIDS. A comparison of surveys from other parts of the country suggests that proximity to an AIDS epicenter has great saliency for adolescents with respect to their knowledge and attitudes about AIDS. The proportion of adolescents reporting correct responses, for questions in common, between the surveys indicates that students in San Francisco score appreciably higher. A framework is also described for providing school-based risk-reduction health education for adolescents.     

Profiles of Chronic Illness Knowledge in a Community Sample of American Adults

The author identified profiles of chronic illness knowledge (i.e., heart disease, cancer, diabetes) in a community sample of American adults and examined the effect of sociodemographic influences on relations of illness knowledge to health practices and well-being. Participants were 181 women and 120 men who completed measures of illness knowledge, sociodemographics, personal health practices (e.g., diet, exercise, substance abuse, adaptive healthcare use), well-being (e.g., self-rated physical health, depression, social support), and perceived illness risk. Two-step cluster analyses performed on random subsets of the sample identified three levels of illness knowledge: low, medium, and high. Knowledge groups were differentiated on most measures of health practices, well-being and perceived illness risk. However, effects were substantially attenuated after controlling for differences in age and SES. Findings indicate that age and other sociodemographic factors are related not only to levels of illness knowledge but also to the application of knowledge in relation to health practices and well-being.