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J Adolesc Health. 1996 Mar;18(3):177-81.

Adolescents' perceived risk for STDs and HIV infection.

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Department of Pediatrics, University of California, San Francisco 94143, USA.



(1) To determine whether adolescents systematically underestimate their relative risk for STDs and HIV; and (2) to determine to what extent anxiety about STDs and HIV, past condom use, number of lifetime partners and STD/HIV-related beliefs predict perceived relative risk.


Two hundred and thirty-one sexually experienced, racially diverse, urban high school teenagers (mean age = 15.5 years; 53% male) were surveyed regarding their STD/HIV-related attitudes, beliefs, and behaviors.


The subjects did not perceive themselves to be at lower risk compared to their perceptions of the risk of other people their age for STDs or HIV. Using hierarchical multiple linear regression analysis, perceptions of lower relative risk for STDs and for HIV were predicted by higher levels of anxiety (p < .001) but not by past condom use, number of lifetime partners or STD/HIV-related beliefs (p > .05).


Adolescents' perceptions of risk appear to be related to anxiety about STDs and HIV and their behaviors may be related to peer influences and attitudes toward using condoms.


In 1991, 881 urban US high school students participated in a survey designed to determine their perceptions of risk for acquiring sexually transmitted diseases (STDs) and to test whether results of a previously reported clinic-based study on perceptions of risk are generalizable. Of the students, 278 had engaged in sexual intercourse, and 231 of these returned questionnaires with usable answers to each question. The analysis was based on this latter cohort. The mean age of this group was 15.5 years. 53% were male, 34% Black, 27% Hispanic, 14% Asian, 9% White, and 16% other. The perceived relative risks for STDs and HIV (dependent measures) were submitted to separate analysis using the 5-point Likert scales. Independent measures included demographic variables, STD and HIV anxiety, condom use, number of partners, and STD and HIV beliefs. It was found that 24% never used a condom and 43% always used condoms. The subjects showed no optimistic bias in their perceptions of the relative risk of STDs or HIV (they believed their risks to be the same as those of other people their age). The only variance found was that the White subjects believed themselves at less relative risk than the other subjects. These findings contrast those of the clinic-based study and suggest that perceptions of risk may vary among different cohorts. Higher levels of anxiety were also found to be associated with higher levels of perceived risk whereas other factors were not. A possible limitation of this study was that the group to which the study population was asked to compare itself was not clearly defined. However, this study indicates that sexually active adolescents are well aware of their STD and HIV risks and that their decision to engage in risky behavior may be due to factors other than a heightened sense of invulnerability (such as perception of social norms or alcohol use).

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