Acquired Immunodeficiency Syndrome and Adolescents: Knowledge, Attitudes, Beliefs, and Behaviors in a New York City Adolescent Minority Population

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Abstract
In this survey, the knowledge, attitudes, beliefs, and behaviors concerning acquired immunodeficiency syndrome (AIDS) in a group (N = 196) of innercity adolescents in New York City were assessed. Sexual activity was the major risk factor for AIDS in this population; 58% of the adolscents had engaged in sexual intercourse; 12% of these had never used contraception. There were small reported rates of homosexuality, anal intercourse, and prostitution. Of respondents, 22% reported alcohol use and 22% had tried recreational drugs. None had ever taken drugs intravenously. Knowledge of human immunodeficiency virus (HIV) transmission was generally good, although there were prominent misconceptions. For example, 52% of the adolescents believed that donating blood could transmit HIV. Of respondents, 47% "never" or "rarely" worried about the disease. Of the total group, 39% reported behavior changes because of concern about AIDS in the previous 6 months. Those who changed behaviors tended to have a greater perceived risk, worry more frequently about the disease, and have a better knowledge of means of HIV transmission. Of those reporting behavior changes, 66% (25% of the total study group) claimed to be using condoms currently, and 16% (6% of the total study group) claimed to be abstemious. More black adolescents than Hispanic adolescents instituted behavior changes. Of black female adolscents, 71% were sexually active, as compared with 30% of Hispanic female adolescents. Assessment of beliefs in method of risk reduction indicated that although female adolsecents were more likely to believe that condoms were a good way to decrease their risk of acquiring HIV, those who were sexually active were less likely than men to institute the behavior change of insisting on condom use or of having their partners use condoms the last time they had sexual intercourse. Of sexually active female adolescents, 73% did not insist on condom use the last time they had sexual relations, whereas 51% of sexually active male adolescents did use a condom. These adolescent women were not using their knowledge concerning HIV transmission and protection to alter behavior effectively and thereby decrease their risk. Also 21% of respondents spontaneously clamined that they would commit suicide if they tested positive for the HIV antibody. Other motivational and educational strategies besides education, targeting female adolescents, must be used and the consequences of the use of the HIV antibody test must be carefully considered in this age group.