Relationship of optimism, knowledge, attitudes, and beliefs to use of HIV antibody testing by at-risk female adolescents.

This study's purpose was to examine the extent to which optimism, knowledge, attitudes, and beliefs predict use of HIV testing services in a group of at-risk female adolescents. We prospectively interviewed 124 consecutive girls engaging in risky behaviors before regularly scheduled pediatric clinic appointments at a large urban HMO. Subjects completed a self-report questionnaire assessing optimism (Scheier's Life Optimism Test, or LOT), HIV-related knowledge, beliefs, and behaviors before their regular visit. At the visit, they were counseled about risky behaviors and the availability of confidential HIV testing at the clinic. All subjects were next given an opportunity to view an educational video about HIV testing and then decided whether or not to obtain testing. LOT scores were not associated with HIV-related knowledge, perceived risk, self-efficacy, condom expectations, or most risky behaviors, including higher levels of recent unprotected intercourse. LOT scores were higher among those who did not view the video and were also higher among those who did not obtain an HIV test. We conclude that higher optimism is not necessarily associated with HIV protective behaviors among adolescent girls and, depending on the context, may serve as a barrier to HIV prevention in this population.