HIV risk perceptions and first sexual intercourse among youth in Cape Town, South Africa

CONTEXT: HIV prevalence is high among South African youth. Health behavior models posit that perceived risk of HIV/AIDS is associated with HIV/AIDS risk behaviors, but research in sub-Saharan Africa that has considered the predictors of HIV/AIDS risk perceptions and behaviors or the relationship between them has been limited.

METHODS: Longitudinal data collected in 2002 and 2005 from 3,025 black, coloured, and white youth aged 14-22 (in 2002) in Cape Town, South Africa were analyzed using multivariate regression to examine correlates of perceived HIV/AIDS risk and one HIV/AIDS risk behavior, transition to first sex. Independent variables taken from the 2002 survey were used to predict dependent variables taken from the 2005 survey.

RESULTS: Most respondents viewed themselves at no risk or small risk of HIV infection. Perceived risk of HIV/AIDS was positively associated with having had sex and knowing somebody with HIV/AIDS. Among those who were virgins in 2002, perceived HIV/AIDS risk and knowing somebody with HIV/AIDS predicted entry into first sex by 2005 for females only. The effects of race on risk perceptions also varied by gender.

CONCLUSIONS: HIV/AIDS education and prevention programs should consider more carefully how gender and race may intersect to influence risk perceptions and risk behaviors. The reciprocal relationship between risk perceptions and risk behaviors should also be considered in education and intervention programs.