AIDS-related health behavior: coping, protection motivation, and previous behavior

Abstract

The purpose of this study was to examine Rogers' protection motivation theory and aspects of Janis and Mann's conflict theory in the context of AIDS-related health behavior. Subjects were 84 heterosexual men and women and 147 homosexual men with multiple sexual partners; LISREL's path-analysis techniques were used to evaluate the goodness of fit of the structural equation models. Protection motivation theory did fit the data but had considerably more explanatory power for heterosexual than for homosexual subjects (49 vs. 22%, respectively). When coping styles were added, different patterns of findings were found among both groups. Adding variables such as social norms and previous behavior increased the explained variance to 73% for heterosexual subjects and to 44% for homosexual subjects. It was concluded that although protection motivation theory did fit the data fairly adequately, expanding the theory with other variables--especially those related to previous behavior--could improve our understanding of AIDS-related health behavior.

PIP: In this AIDS related health behavior study, the conceptual framework is similar to Rogers' protection motivation theory with elements from Janis and Mann's conflict theory. The purpose of the study is to examine the effects of cognitive mediators on behavioral intentions, to examine the relationship between the mediators and adaptive and maladaptive coping styles, and to test the predictive validity of mediators with additional variables. The adaptive style is included as vigilance, which refers to accurate information searching, and problem solving to reduce and minimize the threat. 2 maladaptive styles are included as defense avoidance (denying threatening information or evading the thread actively) and hypervigilance (panic-like searching for appropriate responses without reaching well balanced decisions). Additional variables included that ordinarily are not found in the general framework of protection motivation and conflict theory are fear, disadvantages of the adaptive response, pleasantness of the maladaptive response, social norms and previous behavior, knowledge about a threatening situation, perceived constraints, and regrets about previous maladaptive behavior. 147 homosexual and 84 heterosexual subjects, who were analyzed separately, aged 18-30 and not HIV positive were recruited in Amsterdam. Self administered questionnaires were given which assessed sexual behavior and intentions, threat and coping appraisal, coping styles, and additional variables. The program, LISREL, was used to provide maximum likelihood estimates and Chi square tests. Differences between groups were pronounced. Homosexuals perceived themselves more at risk and social norms more positive, felt more fear, had lower levels of self response efficacy, and greater tendency for previous adaptive behavior and higher behavioral intentions. There was confirmation of other findings that coping appraisal processes independently affect behavioral intentions to adopt the recommended response. Severity, for example, was significantly related to behavior only when fear as worry was removed from the equation, and risk reduction motivation varied with worry, even when threat appraisal processes are held constant. Hypervigilance had neither adaptive nor maladaptive influences. For planning purposes, it is suggested that information programs need to emphasize how to handle constraining situations. Population specific messages which can be sensitive to severity or experience with the threat need consideration. Immediate positive effects of recommended behavior is suggested. Motivational factors are important at higher fear levels, where anxiety reduction is the focus instead of danger avoidance. Prevention needs to minimize fear arousal. Limitations included the lack of reciprocal models and a limited behavioral intentions scale.