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 (F8, 956=20.77; P<.001), HIV testing
uptake (F8, 952=10.91; P<.001), and condom use (F8, 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. (Am J Public Health. 2009;99:2224–2229. doi:10.2105/AJPH.
2008.155234)