The Deterrent Effect of the Fear of HIV Disease: Influences on Young Adult Risk-Taking Behaviors

Abstract

Young adults account for over one in five new HIV diagnoses each year in the United States, and although the total incidence has been decreasing among most groups in recent years, diagnoses among young adults are increasing. To better understand the decision-making processes of young adults 18-24 years old at risk of contracting HIV, as well as the deterrent effect of the fear of HIV on their decision-making, a two-phase study was conducted. Qualitative interviews and focus groups were conducted with young adults (n=31) to gain a comprehensive understanding of their current HIV risk perceptions, decision-making processes, and risky behaviors to inform the second phase of study. The themes and ideas from Phase I, derived through thematic synthesis, were incorporated into a perceptual mapping survey to visually depict young adults’ HIV perceptions and related risk-taking behaviors. The Phase II survey was conducted online via Mechanical Turk to access a diverse sample of young adults (n=226) still at risk of contracting HIV. Both study phases were informed by Social Cognitive Theory and the psychometric paradigm. Results of descriptive analyses and perceptual mapping suggest that HIV is not a factor in young adults’ decision-making and resulting behaviors. Their lack of perceived risk of HIV is exhibited in their continued engagement in unprotected sex, casual sex, lack of sexual history discussion, and infrequent HIV testing. Perceived value of condoms, concerns of pregnancy, and perceptions of the sexual encounter itself, as well as sociodemographic and personality factors, were important factors in their decision-making instead.