Attitudes toward early detection of infection by the AIDS retrovirus among persons at high and low risk

Abstract

Several months prior to the availability of a now-common blood test, homosexual volunteers, in a longitudinal study of their health, and typical college students were questioned about their attitudes toward early detection of acquired immunodeficiency syndrome (AIDS) and toward receiving information about desirable or fear-worthy hypothetical events. Generally, the homosexual volunteers were more interested in receiving information than were the students. Most homosexual volunteers desired human immunodeficiency virus (HIV) antibody test results, which could indicate infection, and indicated that receiving them would affect their behavior. However, all the subjects showed a preference for information on most questions, especially when the information could be used in guiding behavior change and was not virtually certain to be unfavorable. We are unaware of controlled evidence assessing whether or how knowledge of infection influences the imminent health risk of people who are asymptomatic, but prior to learning their HIV status, the homosexual volunteers who at the time had antibody in their sera were less concerned in knowing the test results of hypothetical future sexual partners than those without antibody.This study assesses attitudes toward the early detection of infection by the retrovirus that causes acquired immunodeficiency syndrome (AIDS) among persons at high and low risk for infection. Although little is known about the impact of human immunodeficiency virus (HIV) antibody test results on subsequent health risk and sexual behavior (but see Coates et al., 1988), a number of studies have explored preferences for information about other personally fearful or unwelcomeevents (Case & Fantino, 1981;Leventhal & Hirschman, 1982). For example, patients have admitted taking longer to seek help after discovering a symptom if they imagined possible severe consequences of their illness (Safer, Tharps, Jackson, & Leventhal, 1979). Children of different ages responded to get information only when the infonnationpredictedtheir receiving rewarding outcomes (Fantino, Case, & Altus, 1983), which is a behavioralso observed in nonhumansubjects (Case & Fantino, 1981). The children preferred a totally uninformative to an informative stimulus about nonrewarding outcomes. " Bad news" was also avoided by collegestudents, unlessit couldbe utilized to improveone's circumstances (Case, Fantino, & Wixted, 1985; The research and preparation of this manuscript were supported by NIMH Grant MH-20752 and NSF Grants BNS 83-02963 and BNS 91-08719 to the Univers ity of California at San Diego (E.F ., principal investigator) and by University of California, San Diego. Project 84-481 and NIH Grant HL-32471 to the Univers ity of California, San Diego (LA .M ., principal investigator) . Portions of these data were presented by D. Case at the First International Conference on AIDS at Atlanta , GA, April 1985. Address correspondence to E. Fantino, Department of Psychology, 0109 , University of California, San Diego, La Jolla , CA 92093-0109 ....

Behavior Analysis and Decision Making

“…For example, patients have admitted taking longer to seek help after discovering a symptom if they imagined possible severe consequences of their illness (Safer, Tharps, Jackson, & Leventhal, 1979). However, Fantino, Case, Stolarz-Fantino, Spechko, and McCutchan (1993) found that most of their gay volunteers desired human immunodeficiency virus (HIV) antibody test results and indicated that receiving them would affect their subsequent behavior. Clearly a complex set of contingencies operates in the natural world when decisions must be made involving aversive consequences.…”