Educational Status and Risk of HIV in Young Gay Men.

Lower socioeconomic status (SES) has been associated with higher rates of HIV infection as well as higher rates of unsafe sex. The behavioral determinants that might mediate the effect of SES on risky sex have not been studied thus far. We investigated the involvement of social cognitions in the link between educational status and unprotected anal sex in 292 participants of the Amsterdam Young Gay Men Study. We found that poorly educated men had poorer knowledge about HIV and preventive behavior, perceived social norms to be less favorable towards condom usage with casual partners, and had lower perceived control over that behavior than the better educated men. Poorly educated men were also more likely to have engaged in unprotected anal sex with casual partners in the six-month period that followed the assessment of the social cognitions. However, the education-related behavioral difference could not be explained by social cognitions. We concluded that cognitive models of behavior might not explain all of the risk behavior in gay men with lower SES. These men's risk-taking behavior might result from specific psychological characteristics of men with lower SES that interfere with traditional cognition-behavior correlations as posited in prevailing models of behavior.