Perceived risk of infection, one factor influencing HIV-related behavior decisions, has been the focus of expanding research efforts. A body of research now exists examining factors related to risk perceptions and the relationship between risk perceptions and behavioral decision making. This article examines 60 quantitative studies of HIV-related risk perceptions, identifies methodological and theoretical limitations or gaps in current knowledge, and suggests ways future research might better assess the role of risk perceptions and facilitate the adoption and maintenance of HIV-related health protective behaviors. The authors argue that mixed findings in the quantitative literature are due to (1) cross-sectional study designs that constrain or confound the interpretation of findings, (2) construct confusion and measurement inconsistencies. (3) insufficient consideration of specific subgroup or behavioral differences, and (4) inattention to situational norms and other contextual factors that influence risk perceptions and behavior.
The presence of AIDS within the gay community provides a locus for studying the effects of a new stigma on an already stigmatized group, the gay community. The spread of AIDS through sexual contact among homosexual and bisexual males has reinforced the broader society's stereotype of the promiscuous gay. As a result, singly stigmatized gays distance themselves from the doubly stigmatized by drawing physical and symbolic boundaries around interaction. This exploratory study examines the strategies gay men employ to limit or avoid contact with persons with AIDS. Data were collected through interviews and a focus group with gay men who did not have AIDS.
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 A R M 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.Information regarding the transmission of HIV is a necessary but by no means sufficient element to promote reductions in HIV-related risk behaviors. Rather, research has indicated that a broad array of psychosocial factors impacts the adoption and maintenance of HIV-related behavioral change. Theoretical models such as the Health Belief Model (HBM; Becker, 1974) and the theory of reasoned action (Ajzen
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