HIV risk behavior and the health belief model: An empirical test in an African American community sample

The increasing prominence of minority groups, particularly African Americans, in the growing rates of HIV infection and AIDS underscores the urgency for developing ethno-gender specific models for changing behaviors that are placing those groups at risk. To this end, HIV-related knowledge, attitudes, and perceptions reported by an urban community sample of African Americans (N = 364) and formulated as components of the Health Belief Model (HBM) have been tested against HIV avoidance practices, using both structural equation and OLS regression analysis. Both multivariate approaches identified perceived vulnerability as a significant negative predictor and, additionally for women, a positive relationship with generalized sense of personal efficacy. The results suggest an inverted causal sequence from what the HBM assumes: risk behavior leading to or predicting perceptions. Some implications of this critical reversed ordering are suggested.