The objective of this study was to determine the factors associated with HIV testing behaviors among Guatemalan women using data from the Centers for Disease Control and Prevention (CDC) 2008 – 2009 National Health Survey in Guatemala. A total of 16,819 women from the larger sample of 23,905 participants (men and women), aged 15 – 49 years were surveyed using a household, interviewer-administered questionnaire. The survey collected self-reported data on fertility, family planning use, young adult reproductive health and practices, HIV/AIDS knowledge and risk behaviors, history of sexually transmitted infections, nutrition, infant health and mortality, and domestic violence. In the current study, I reported HIV testing behavior, and determined association with demographic factors, risk perception, and HIV knowledge. Significant associations were found between age, HIV knowledge, education, risk perception, marital status, ethnicity, employment, and HIV testing behaviors. The study findings suggest that there has been a shift in HIV testing policy to prioritize indigenous women. It is recommended that HIV prevention campaigns in Guatemala continue to prioritize this group and expand efforts to promote testing among older women. Sustained HIV risk monitoring and access to testing services in indigenous communities are needed.

Substantial empirical research has documented that HIV prevention and decision-making are heavily influenced by the knowledge and practice of values and beliefs regarding infection and behavior. Most HIV research is still concentrated among high-risk populations (IDU and FSW), leaving out women in long-term heterosexual marriage who have been considered "safe" and less at risk of infection. In addition, researchers have called for more comparative and cross-cultural studies focused on the interplay of health education, behaviors, context, and HIV risk perception. The objective of this dissertation is to advance understanding of the factors sexually experienced women in Postsocialist Georgia consider important when they assess HIV perceived risk of which they are made aware by messages emanating from the social environment. A conceptual framework that integrates concepts from traditional social psychological theory and the constructs of context-specific factors to guide research intervention is applied. Combined quantitative and qualitative approaches are used to achieve a better understanding of perceived HIV risk and its association with different factors. The testing of relationships from two national Reproductive Health Survey samples (1999 and 2005) demonstrate strong positive associations among increased HIV transmission knowledge, belief in accidental transmission, HIV testing practice, and HIV perceived risk, while controlling for sociodemographic factors. Characteristics associated with social norms and economic factors (including stigmatizing attitudes about the rights of PWAs, constrained attitudes concerning sexual control, and experienced migration) demonstrate a strong significant link with assessment of HIV risk perception. Qualitative research with women strengthens the argument of superficial health education and helps to explain variations in perceived risk assessment. Through the interviews, HIV prevention practice is examined in relation to a myriad of cognitive components. This study finds health knowledge, misconceptions, stigmatizing attitudes, and beliefs in sexual and gender norms among the major factors constraining successful HIV/AIDS prevention practices. An effective strategy for HIV/AIDS prevention will require enhancement of research, more emphasis on an integrated approach to target education efforts, training providers in information diffusion approaches, and promoting a general communication campaign.

My main focus of interest in this dissertation is to evaluate the relationship between known risk factor for HIV and HIV testing behavior, with a particular interest in women. Utilizing data from the National Survey of Family Growth, I conduct both descriptive and logistic regression analysis to evaluate this relationship. In addition to examining this relationship for women overall, I also evaluate the differences between White and Minority women, and compare and contrast this relationship for men versus women. In this dissertation, I did find some evidence to indicate that women with factors that put them at risk for HIV are more likely to be tested than are women without risk, however the strength of this relationship differed across types of risk factors. Drug use was consistently stronger in predicting the likelihood of testing than were sexual risk factors, indicating a "lag" in public health perception of risk due to heterosexual risk factors. I also found that African-American women had significantly higher prevalence of risk than did White women, although no difference was found in the relationship between risk and testing. Finally, sexual risk factors were a substantially stronger predictor of testing for men than it was for women. The findings reported in this dissertation have the potential for significant public health implications and indicate the need for further policies that target the populations identified in this research. While the evidence in this dissertation and elsewhere does suggest that these efforts have been successful for homosexual men and drug users, and marginally successful for women at risk due to heterosexual behavior, it is important that efforts that target women, especially African-American women, are increased.

The purpose of this study was to determine if there was a relationship between HIV knowledge, perception of HIV risk and severity, prior sexuality education, and HIV risk behaviors among college students. The participants of this study consisted of a convenience sample of students who attended a large Midwestern urban university during the fall quarter of the 2006-2007 academic year. Most students were female, white, and heterosexual. It was concluded that sexual risk behaviors were affected by both HIV knowledge levels and whether or not sexuality education was received. Furthermore, it was concluded that a relationship existed between several factors: condom use frequency, HIV knowledge, number of partners in the past year, personal beliefs regarding HIV transmission, sex while under the influence of drugs or alcohol, and the type of sexuality education received.

The risk for contracting HIV/AIDS among women living sub-Saharan Africa continues to remain high. Research has identified a link between perception of HIV risk and health-behavior change. Many studies also demonstrate a discrepancy between an individual's perceived risk and actual risk for contracting HIV/AIDS. The purpose of this study is to understand the relationship between HIV risk perception and psychosocial factors including: depressive symptoms, anxiety symptoms, and self-esteem among Malawian women. Participants included 60 Malawian women who were queried about perception of risk of HIV infection, depression and anxiety symptoms, and self-esteem as part of the Malawi Health Behavior Survey. The mean age of women in the study was 30.1 (SD=7.9). The majority of the women in the study had completed Primary (Elementary) education (58%) and reported being in a civil or common law monogamous marriage (76.5%). Contrary to the predicted outcome, symptoms of depression and anxiety were positively correlated with HIV/AIDS risk perception (r=.23 and r=.25). Consistent with the expected outcome, self-esteem was negatively correlated with HIV risk perception (r=-.26). Multivariate logistic regression was conducted to examine the relative contribution of each variable (depressive symptoms, anxiety symptoms, self-esteem) to predict HIV-risk perception. The model was not found to be statistically significant.