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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.155234v1 99/12/2224    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Rimal, R. N. Articles by Creel, A. H. PubMed PubMed Citation Articles by Rimal, R. N. Articles by Creel, A. H. Related Collections Social Science Health Promotion HIV/AIDS Media Prevention Sexual Health

Rajiv N. Rimal, PhD, Jane Brown, MPH, Glory Mkandawire, MPH, Lisa Folda, MHS, Kirsten Böse, MHS and Alisha H. Creel, PhD

Rajiv N. Rimal, Jane Brown, Glory Mkandawire, Lisa Folda, and Kirsten Böse are with the Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Alisha Creel is with the Uniformed Services University of the Health Sciences, Bethesda, MD.

Correspondence: Correspondence should be sent to Rajiv N. Rimal, Department of Health, Behavior & Society, 624 N. Broadway, No. 739, Baltimore, MD 21205 (e-mail: rrimal{at}jhsph.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We sought to determine whether individuals' risk perceptions and efficacy beliefs could be used to meaningfully segment audiences to assist interventions that seek to change HIV-related behaviors.

Methods. A household-level survey of individuals (N = 968) was conducted in 4 districts in Malawi. On the basis of responses about perceptions of risk and beliefs about personal efficacy, we used cluster analysis to create 4 groups within the risk perception attitude framework: responsive (high risk, strong efficacy), avoidance (high risk, weak efficacy), proactive (low risk, strong efficacy), and indifference (low risk, weak efficacy). We ran analysis of covariance models (controlling for known predictors) to determine how membership in the risk perception attitude framework groups would affect knowledge about HIV, HIV-testing uptake, and condom use.

Results. A significant association was found between membership in 1 or more of the 4 risk perception attitude framework groups and the 3 study variables of interest: knowledge about HIV (F_{8, 956} = 20.77; P < .001), HIV testing uptake (F_{8, 952} = 10.91; P < .001), and condom use (F_{8, 885} = 29.59; P < .001).

Conclusions. The risk perception attitude framework can serve as a theoretically sound audience segmentation technique that can be used to determine whether messages should augment perceptions of risk, beliefs about personal efficacy, or both.

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