Saturday, 14 January 2006 - 8:00 AM

Self-Perception of Risk Is Not Enough: Developing Effective HIV/STD Prevention in Adolescents

Ranjana Banerjea, MA/MBA, Rutgers University and Judith Baer, PhD, Rutgers University.

According to the Center for Disease Control (CDC, CDNR, 2001) fifty percent of all adolescents in the U.S. are sexually active. Of these at least three million are infected with a sexually transmitted disease (STD) each year, and another 3,897 are diagnosed with HIV/AIDS (CDC Surveillance 2003). Many young adults diagnosed with the HIV are most likely to have been infected in their teens. Individuals in the 13-to-24 age group comprise an important study pool because this time in the life span is where the initiation of high-risk behavior most often begins. Despite school and community based programs and widespread dissemination of information about HIV and STD's, problems remain because information does not necessarily translate into actual risk reduction behavior. With the onset of puberty adolescents become increasingly more vulnerable, yet they are one subgroup likely to underestimate their personal susceptibility to HIV and AIDS (Ben-Zur, 2003; Graber, et al., 1999; James, et al., 1991). Analyses were conducted using the National Longitudinal Study of Adolescent Health data, Wave 1 (N=13,570). Bivariate subgroup differences in STD/HIV testing among youth engaged in different kinds of sexual activity and condom usage were tested with chi-square statistics. To observe the effects of the sexually risky behavior, and the self-perception of risk on the odds of getting tested for STD/HIV (controlling for other variables that may affect the relationship) logistic regression techniques were used to test elements of the Health Belief Model. Results: Of those who were sexually active (N= 6,541), only 5% had been tested; those who used condoms infrequently (less than equal 50% of the time) only 14% were tested. The bivariate analysis also revealed that a large percentage of those who professed high or very high self-perception of risk remained untested (89%). The results using odds ratios (95% confidence intervals) indicated that although females had a lower perception of risk than males (OR 0.78) they were tested almost three times more (OR 2.92) as males. Thus self-perception of risk was not a sufficient condition for change in the adolescents' risky sexual behavior and gender differences need to be further investigated. A large number of youth were sexually active despite a high self-perception of risk for acquiring STDs and HIV. Implications: Unless interventions are designed to take into account developmental and relational forces, mere sex education is not enough to change behavior. References: 1. Ben-Zur, H. (2003). Peer risk behavior and denial of HIV/AIDS among adolescents, Sex Education, 3(1), 75-86. 2. CDC (2003). Cases of HIV infection and AIDS in the United States, 2002: HIV/AIDS Surveillance Report, Vol.14. 3. CDC, CDNR (2001).Reducing the Burden of Chronic Disease, Chronic Disease Notes & Reports, 14(1). 4. Graber, J.A., Brooks-Gunn, J., Galen, B.R. (1999). Betwixt and between: sexuality in the context of adolescent transitions. In R. Jessor (Ed.), New perspectives on Adolescent Risk Behavior (pp. 270-316),Cambridge University Press. 5. James, N.J., Gillies, R.A., & Bignell, C.G. (1991). AIDS-related perception of risk and self-reported sexual behavior. Paper presented at the 7th International Conference on AIDS, Florence, Italy


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