Older Adults Vastly Overestimate Both HIV Acquisition Risk and HIV Prevalence in Rural South Africa.

Content Provider	Europe PMC
Author	van Empel, Eva de Vlieg, Rebecca A. Montana, Livia Gómez-Olivé, F. Xavier Kahn, Kathleen Tollman, Stephen Berkman, Lisa Bärnighausen, Till W. Manne-Goehler, Jennifer
Abstract	Perceptions of HIV acquisition risk and prevalence shape sexual behavior in sub-Saharan Africa (SSA). We used data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa baseline survey. Data were collected through home-based interviews of 5059 people ≥ 40 years old. We elicited information on perceived risk of HIV acquisition and HIV prevalence among adults  ≥ 15 and ≥ 50 years old. We first describe these perceptions in key subgroups and then compared them to actual estimates for this cohort. We then evaluated the relationship between sociodemographic characteristics and accurate perceptions of prevalence in regression models. Finally, we explored differences in behavioral characteristics among those who overestimated risk compared to those who underestimated or accurately estimated risk. Compared to the actual HIV acquisition risk of < 1%, respondents vastly overestimated this risk: 35% (95% CI: 32–37) and 34% (95% CI: 32–36) for men and women, respectively. Respondents overestimated HIV prevalence at 53% (95% CI: 52–53) for those ≥ 15 years old and 48% (95% CI: 48–49) for those ≥ 50 years old. True values were less than half of these estimates. There were few significant associations between demographic characteristics and accuracy. Finally, high overestimators of HIV prevalence tested themselves less for HIV compared to mild overestimators and accurate reporters. More than 30 years into the HIV epidemic, older people in a community with hyperendemic HIV in SSA vastly overestimate both HIV acquisition risk and prevalence. These misperceptions may lead to fatalism and reduced motivation for prevention efforts, possibly explaining the continued high HIV incidence in this community.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8563552&blobtype=pdf
ISSN	00040002
Journal	Archives of Sexual Behavior [Arch Sex Behav]
Volume Number	50
DOI	10.1007/s10508-021-01982-1
PubMed Central reference number	PMC8563552
Issue Number	7
PubMed reference number	34599468
e-ISSN	15732800
Language	English
Publisher	Springer US
Publisher Date	2021-10-01
Publisher Place	New York
Access Restriction	Open
Rights License	Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2021
Subject Keyword	HIV HIV risk perception HIV transmission HAALSI Agincourt South Africa
Content Type	Text
Resource Type	Article
Subject	Arts and Humanities Psychology