With high human immunodeficiency virus (HIV) and STD transmission rates among African American young adults, there is a need to study the patterns of risk behaviors among this group for effective HIV prevention strategies. Many studies point to the problem of what is termed the knowledge-behaviour gap, as a contributing factor for high transmission rates. In this phenomenon, the risks for HIV transmission are known, yet this knowledge does not translate into safer sex practices. It is unclear if this phenomenon applies to all young adults. This study examined sexual behaviors, risks for HIV infection, condom use, and HIV testing practices among allied health students. A sample of 614 rcspondents voluntarily completed questionnaires. The respondents were from seven historically black colleges and universities and four predominantly African American physician assistant programs. The significant findings reflect that this sample of mature and informed allied health students engaged in safer sex practices. There was a higher rate of condom use among African Americans compared with other racial and ethnic groups and significant differences for gender, race, and antibody testing. The outcomes of the study have implications for using allied health students as role models in designing effective prevention programs on college campuses and in African American communities to address knowledge-behavior gap issues. J Allied Health. 2003; 32:173-178.
SINCE 1998, MORE AFRICAN AMERICANS have been reported with acquired immunodeficiency syndrome (AIDS) than any other racial/ethnic group. Researchers estimate that 240,000 to 325,000 African Americans, or about 1 in 50 African American men and 1 in 160 African American women, are infected with human immunodeficiency virus (HIV). Globally, 42 million people have been infected with HIV since the beginning of the pandemic, and there are 16,000 new infections documented on a daily basis worldwide."
HIV transmission rates among African Americans are not declining significantly in response to effective interventions compared with whites/ HIV/AIDS continues to be the leading cause of death among African American men age 25 to 44 and the third leading cause of death for African American women of the same age group. The virus has an incubation period of a few weeks to more than 10 years. It is reasonable to assume that increasing numbers of young adult African Americans may be at a higher risk of becoming infected than their majority counterparts.3
Review of the Literature
The literature confirms that college students engage in behaviors that place them at risk for HIV infection. It is estimated that greater than 80% of all college students are sexually active by their freshmen year, and less than half use condoms consistently.4-6 With low condom use, the risk of HIV transmission is increased. Jemmott and Jemmott7 found that only 20% of sexually active, unmarried, African American undergraduates at a commuter university always used condoms. In a study of 408 African American southern college students, 3.18% were diagnosed as HIV positive, higher than the 2% for comparative student populations as reported by the American College Health Association.8,9
Studies have affirmed that knowledge of risks does not deter a person from engaging in high-risk sexual behaviors that facilitate the transmission of HIV and other sexually transmitted diseases (STDs). This phenomenon, known as the knotfiejge-behaviour gap, has been cited as one of the major reasons for increased transmission rates, particularly among heterosexuals. 10-14 In the earlier stages of the HIV epidemic, many universities and colleges focused on providing students with information to dispel myths about HIV/AIDS transmission. These efforts resulted in 80% to 92% of college students possessing correct HIV/AIDS knowledge. These interventional programs that emphasized knowledge about transmission failed to produce significant changes in HIV risk behavior, however. …