Date of Award
Doctor of Philosophy in Psychology
HIV-risk was assessed, and staged by the Transtheoretical Model, among 239 adolescents, ages 13-19 (mean age 15), with a 163-item self-administered questionnaire, supplemented with qualitative data from 28 focus groups. Thirteen psychometrically reliable scales were isolated and validated with 457 youth pooled from previous samples: factual, transmission, and perceived AIDS knowledge, misconceptions, perceived susceptibility, self-efficacy, homophobia, substance use and abuse, communication assertiveness, condom use assertiveness, and risk histories for self and partner(s). AIDS risk was defined by frequency of unprotected occasions and number of intercourse partners. Sexual activity was indicated by 54 percent of the sample. Young men reported significantly lower sexual onset age than women (13 and 14, respectively), and significantly more lifetime partners (5 and 3, respectively). Utilizing a multivariate approach, gender-specific risk profiles were identified, and interaction effects noted between gender and sexual activity for risk variables. Sexually active women had higher AIDS knowledge with fewer misconceptions than men, and men had higher perceived susceptibility, homophobia, substance use and abuse, self-risk histories, and assertiveness than women. High misconceptions, perceived susceptibility, substance use and abuse, partner- and self-risk histories, and low condom assertiveness were significant risk factors for sexually active men. High perceived susceptibility, partner- and self-risk histories, and low self-efficacy, assertiveness for communication and condom use were significant risk factors for sexually active women. High homophobia was predictive of risk for the group. Youth typically did not view their sexual activities as risky. Among sexually-active youth, three-quarters reported substance use prior to sex; 95 percent reported "unsafe" activity, with inconsistent or no condom use; and, 39 percent of those "unsafe" considered themselves to be at "no risk" for HIV contagion. Self-estimates of behavior change state for current and predicted condom use were inaccurate. Based on adjustments, less than half of sexually active youth would be in advanced stages of behavior change in six months. Focus group participants discussed AIDS awareness, assertiveness complexities, informational resources, risk perceptions, gender roles, societal repercussions of the AIDS pandemic, and intervention suggestions. Prediction of adolescent risk and implications for effectiveness of HIV educational intervention and prevention programs are discussed.
Lang, Michelle A., "A Quantitative and Qualitative Assessment of Adolescent HIV-Risk Predictors" (1997). Open Access Dissertations. Paper 984.