AIDS Education and the Perception of Risk
The research for this book grew out of the concern that Cleveland's Maternity and Infant Health Care Program (M&I) clinic clients were not heeding the M&I safer sex message. There was nothing unique about the relative failure of the M&I AIDS education mission, which focused on the dissemination of factual information. Most studies conclude that no significant relation exists between safer sex and the degree of AIDS or HIV knowledge people have (e.g., Farmer and Kim 1991; Geringer et al. 1993; Johnson 1993; Linden et al. 1990; Mays and Cochran 1988; Prohaska et al. 1990); behavioral changes made by homosexual men ( Turner et al. 1989, 136) living in areas with firmly established gay social and political structures are the exception (see Winkelstein et al. 1987). But even among this group patterns of relapse have been documented ( Miller et al. 1990, 109; Stall et al. 1990). Factual information is necessary, but it is certainly not sufficient to drive and sustain behavioral change. This chapter asks why not, and investigates the key role risk perception plays in motivating (or obstructing) health-protecting behavior such as condom use.
Findings from the 1992 National Health Interview Survey ( Schoenborn et al. 1994) indicate that 96 percent of U.S. adults know that HIV can be transmitted through sexual intercourse and 94 percent know that it can pass from pregnant women to their babies perinatally; 96 percent know that it is "very likely"1 that an individual will contract HIV if sharing needles with an infected person. Among Black Americans the respective percentages are lower, but only by one to two percentage points (regarding AIDS knowledge levels of Blacks in particular, see also Flaskerud and