Relationship Between HIV Risk Perception and Condom Use: Evidence from a Population-Based Survey in Mozambique

Abstract

CONTEXT: The relationship between individuals' perception of their risk for acquiring HIV and their use of condoms is poorly understood. Understanding this relationship is crucial to the development of effective strategies to fight HIV and AIDS. METHODS: Data from the Mozambique 2001 Adolescent and Young Adult Reproductive Health and Behavior Risk Survey are used to compare 15-24-year-olds' assessments of their HIV risk with assessments based on current and past sexual behavior. In bivariate and probit regression analyses, the relationship between correct risk assessment and the likelihood of condom use at last intercourse is examined. RESULTS: Twenty-seven percent of women and 80% of men who considered themselves to have no risk or a small risk of contracting HIV were actually at moderate or high risk. For both men and women, the prevalence of condom use at last sex was more than twice as high among those who assessed their risk correctly (30% and 16%, respectively) as among those who did not (14% and 6%). Multivariate analysis showed that correct assessment was positively associated with condom use; the association was driven by use among never-married individuals. Never-married males who assessed their risk correctly were 18% more likely than other males to report condom use; never-married females, 17% more likely than other females. CONCLUSIONS: Educational messages should aim at enabling individuals to correctly assess their own HIV risk and encouraging behavior change based on self-assessment of risk.International Family Planning Perspectives, 2006, 32(4):192-200 dividual's awareness of the consequences of HIV/AIDS and may lead to safer sexual practices.Other studies have reported a lack of association between HIV/AIDS knowledge and sexual behavior. In a survey of almost 1,500 Rwandan women, the vast majority had correct knowledge of HIV transmission, but only a small proportion had adopted any protective behavior in the last year. 10 Sexually active students in Dar-es-Salaam, Tanzania, who knew that condom use prevents HIV infection had a reduced likelihood of always using condoms. 11 In Ethiopia, a cohort study of factory workers with a high prevalence of HIV reported high-risk sexual behavior and low condom use, even though the majority mentioned condom use as the best way to prevent HIV. 12 A study using 1998 Kenyan DHS data reported that the odds of having risky sexual behavior were more than tripled among men and women who perceived their risk of HIV/AIDS as high, and found no association between knowledge of HIV transmission and sexual behavior. 13 The relationship between perception of risk and sexual behavior is complex and poorly understood. Studies conducted in different cultures have associated HIV risk perception with a wide range of variables: number of sexual partners, knowledge of sexual partners' past sexual behavior, fear of AIDS, shame associated with having AIDS, community perception of AIDS risk, knowing someone with AIDS, discussing AIDS at home, closeness of parent-child relation...

HIV/AIDS and Sexual-Risk Behaviors among Adolescents: Factors Influencing the Use of Condoms in Burkina Faso

“…Although we were not able to include social environment, psychological, and cultural factors in our analysis, evidence from other studies suggest that socio-cultural factors are the most common barriers to obtaining male condoms among sexually-experienced adolescents in Burkina Faso. [12][13][14][15][16][17][18][19][20][21][22][23][24] Strong cultural taboos are especially restrictive for sexually active women.…”

Reduction of Health-Related Risks Among Female Commercial Sex Workers: Learning From Their Life and Working Experiences

“…We believe the results regarding the skills of commercial sex workers will be useful to develop strategies and methods of health education to improve the condition of health and promote healthy living in this population living under fragile conditions. A previous study performed in Mozambique indicated that correct self-assessment regarding one's own risk of HIV/AIDS was necessary to change behaviour (Prata et al, 2006). We believe that educational messages to avoid risks should be passed to new as well as experienced commercial sex workers.…”

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“…Numa perspetiva mais alargada de compreensão da exposição das pessoas ao risco de infeção pelo VIH/SIDA, encontramos constructos como a perceção de risco que é tida por muitos autores (e.g., Napper, Fisher, & Reynolds, 2012;Prata, Morris, Mazive, Vahidnia, & Stehr, 2006) como o fator principal para a compreensão do que motiva as pessoas a exporem-se às situações potencialmente perigosas relativas à contaminação pelo vírus. Contudo, a evolução do conhecimento sobre o padrão de transmissão do VIH/SIDA, nomeadamente o aumento significativo da incidência de casos de pessoas consumidoras de substâncias psicoativas, obrigou a que esta nova variável se juntasse à equação.…”