Structure of HIV knowledge, attitudes, and behaviors among American Indian young adults.

Although present incidence and prevalence rates are still low, dramatic increases have been noted in the percentages of American Indians (AIs) diagnosed with HIV and AIDS, perhaps indicating groups that are increasing in their risk for the infection. High rates of sexually transmitted diseases among AIs who are 20-24 years old also raise concern about the vulnerability of these young adults. In a community-based group of 706 AI young adults, knowledge about sexuality and HIV transmission was rather low; efficacy and outcome expectations were high. Levels of some risk behaviors (e.g., exchanging sex for drugs or money) were low, while others (e.g., inconsistent condom use) were considerably higher. Knowledge and attitudes were modestly related; neither was related to risk behaviors. Suggestions are made about interventions focusing on specific high-risk groups and broad-based knowledge and skill-based interventions.