Page 263 - Encyclopedia of Nursing Research

230 n HIV rISK BeHAVIOr

AIDS epidemic is spreading gravely, these Action (Ajzen & Fishbein, 1980), have suggested
terms in most studies specifically refer to possible mechanisms and have been popularly
H HIV/AIDS-related sexual behavior. used in the understanding and prevention of
Many psychosocial, biological, and HIV-related risk behaviors. Most of the cogni-
sociologic circumstances or cofactors have tive-behavioral interventions that stem from
been recognized as impacting the likelihood these theories report effectiveness in reduc-
of HIV risks. The personal factors, includ- ing risk of HIV infection. Strong evidence has
ing age, gender, race, developmental stage, shown that cognitive functions, such as self-
early age of initiation of intercourse, HIV/ efficacy, uniquely contribute to the rationale of
AIDS-related sexual knowledge, mental the safer sexual behaviors and especially in the
health, sexual identity, self-esteem, self- domain of condom use. The robust association
efficacy, alcohol uses, and the use of illicit between self-efficacy and practices of safer sex-
drugs, are found to be associated with ual behaviors had been revealed among people
increase or decrease risks of HIV infection. with different cultural background and across
Interpersonal factors such as discussing countries. In addition to the findings revealed
safe sex with sexual partners and asking in research participants from Western cultures,
sexual partners about his or her sexual his- African cultures, and Hispanic culture, higher
tory and being ethnic minorities may also level of HIV/AIDS preventive self-efficacy
be correlated with the risk of HIV infection. was also found to be significantly related to
environmental factors, including social eco- less HIV/AIDS-related risky sexual behaviors
nomic status, peers, schools, families, gender among people in Asian countries (lee, Salman,
roles, cultural norms, religious beliefs, polit- & Fitzpatrick, 2010).
ical and health policies, and social isolation, Numerous experts have contributed to
were also found to influence the likelihood of research in this field since the beginning of
becoming HIV infected. The variety of social the HIV epidemic. research has indicated that
and structural factors, including gender some behavioral preventive efforts have slowly
inequality, human rights violations, stigma but effectively reduced HIV prevalence across
and discrimination, poverty, and lack of HIV the world. An extensive body of research has
awareness and access to education, health, provided noteworthy information on strate-
and other services, increase people’s vulner- gies to facilitate or sustain behavioral changes
ability to HIV infection and dive the HIV epi- for HIV preventions. However, to effectively
demics (UNAIDS, 2010). oppose health disparities in HIV prevention
Many behavioral contributors that and care, many researchers have suggested
increase or decrease the risk of HIV infection that it is critical to address cultural issues in
have been explored and identified. These delivering HIV/AIDS intervention programs
contextual factors combine in dynamic ways to achieve maximum effectiveness (Faryna
to increase behavioral risk. However, the con- & Morales, 2000; Jemmott, Maula, & Bush,
textual risk factors and their casual relation- 1999). Because of their vulnerability of access-
ships with HIV risk behaviors are still not ing health services and specific cultural back-
well understood. This limited understanding grounds, ethnic minority and immigrants are
is an obstacle for developing effective behav- one of the target populations for conducting
ioral interventions to prevent or reduce HIV HIV prevention research and interventional
risk–associated behaviors. program. recruiting participants with dif-
Several health behavior theories, such as ferent ethnic or cultural backgrounds in HIV
the Social cognitive Theory (Bandura, 1994), research to enhance our understanding and
the Health Belief Model (rosenstock, 1974), the capability against HIV epidemic is essential;
AIDS risk reduction Model (catania, Kegeles, however, it is challenging. The existing num-
& coates, 1990), and the Theory of reasoned ber of research conducted to understand HIV