Perception of risk and sexual self-protective behavior: a methodological critique.

Although several theories suggest that perceptions of the risk of transmission of sexually transmitted diseases, including HIV, motivate individuals to adopt or maintain self-protective behaviors, the research literature has generally failed to demonstrate this relationship. Because many HIV prevention interventions are based on the presumption of this relationship and because there is support for the effects of risk perception on self-protective behaviors in other health domains, a closer examination of the research concerning HIV risk perception is warranted. Therefore, a critical review of methodological features of research in this area was conducted. Issues considered were measurement; research design; the distinctive characteristics of HIV risk; the sexual and social nature of HIV transmission; and ecological, construct, and statistical conclusion validity. Methodological and design recommendations were made for testing the effects of HIV risk perception more adequately.