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Complacency, risk perception and the problem of HIV education.

Many public surveys on the issue of HIV and AIDS have concentrated on the relationship between attitudes and knowledge. Often this relationship has been found wanting or at most tenuous. A recent survey of 1,002 people in Wales has supported these earlier findings, but found additionally that discriminatory and complacent attitudes on AIDS or towards people with the 'AIDS virus' are held by a significant proportion of the population. The survey also discovered that people correctly perceive the risk of HIV infection as being minimal. Depending on the question 17%-65% of the sample expressed discriminatory attitudes towards people that have the 'AIDS virus'. There was also no marked change over previous surveys in the degree of complacency surrounding AIDS. Younger people (aged (15-34) considered themselves to be more at risk of infection with the 'AIDS virus' but overall the perceived risk of infection was low. A sustained low key education programme in a variety of settings and independent of perceived risk is necessary to combat prejudice and complacency.

Adolescent↗

Risk perception, federal spending, and the Savannah River Site: attitudes of hunters and fishermen.

This paper examines the attitudes of 285 hunters and fishermen from South Carolina about hunting and fishing, risk, environmental issues, and future land use of the Savannah River Site, We test the null hypothesis that there is no difference in hunting and fishing rates, attitudes toward the safety of fish and deer obtained from SRS, attitudes toward future land use at SRS, and perceptions of the severity of environmental problems as a function of how far respondents lived from the site. Respondents hunted or fished an average of over 40 days a year, and only half felt that the fish and deer from SRS were safe to eat. Willingness to expend federal funds was correlated with perceptions of the severity of the problem. Preferences for future land use at SRS fell into three categories: high (environmental research park, hunting, fishing, camping), medium (nuclear production, factories, preserve only), and low (nuclear waste storage, residential). There were no differences in hunting and fishing rates, ranking of the severity of environmental problems, and willingness to expend federal funds as a function of distance of residence from SRS, but attitudes toward future land use differed significantly as a function of location of residence. Those living close to SRS were more willing to have the site used for factories, residential, nuclear material production and to store nuclear wastes than those living farther from the site. Our data on recreational rates, attitudes toward future land use, and willingness to expend federal funds to solve environmental problems reiterate the importance of assessing stakeholder attitudes toward decisions regarding future land use at DOE sites.

Adult↗

The optimism bias and traffic accident risk perception.

Research suggests that people are excessively and unrealistically optimistic when judging their driving competency and accident risk. In this study, college-age drivers compared their risk of being involved in a variety of described traffic accidents relative to their peers. They also rated each of the accidents along a number of dimensions hypothesized as being related to optimism. In addition, subjects provided global estimates of their driving safety, skill, and accident likelihood. Significant optimism was evident for both the accidents and the global ratings. Optimism increased with driving experience and marginally with age. Those with more driving experience considered human factors to be more important in accident causation; those assigning more importance to human factors also rated themselves as more skillful drivers. For the specific accidents, perceived controllability was a strong predictor of optimism. The findings for controllability are interpreted in terms of other recent data and hypothesized explanations of the optimism bias. In general, it appears that optimism arises because people persistently overestimate the degree of control that they have over events.

Accidents, Traffic↗

[Cesarean sections: risk perception and indication by attending obstetricians in a public maternity hospital in Rio de Janeiro].

The cesarean section rate in municipal public maternity hospitals in the city of Rio de Janeiro in the year of 2000 was 30.1%. With such a high rate, our hypothesis is that attending obstetricians in these units are indicating cesarean sections for reasons not restricted to clinical factors. The article aims to analyze physicians' representations of the inherent risks in cesarean sections that influence the medical decision for their indication. In this qualitative study, conducted through participant observation during ward duty and interviews with obstetricians, we observed that C-section indications by obstetricians are influenced by various non-obstetric factors, including insecurity about performing obstetric maneuvers, fragmented care, and fear of legal liability. The paper suggests that the widespread use of this intervention in private maternity services has fostered a practice in public obstetric services that compromises the quality of public health care and may jeopardize the health of women and infants.

Adult↗

Public communication, risk perception, and the viability of preventive vaccination against communicable diseases.

Because of the nature of preventive vaccination programs, the viability of these public health interventions is particularly susceptible to public perceptions. This is because vaccination relies on a concept of 'herd immunity', achievement of which requires rational public behavior that can only be obtained through full and accurate communication about risks and benefits. This paper describes how irrational behavior that threatens the effectiveness of vaccination programs--both in crisis and non-crisis situations--can be tied to public perceptions created by media portrayals of health risks. I concentrate on childhood vaccination as an exemplar of 'non-crisis' preventive vaccination, and on the recent flu vaccine shortage as a 'crisis' situation. The paper concludes with an examination of the steps necessary to resolve these threats through better public communication.

Child↗

Deciding about the unknown: perceptions of risk of women who have prenatal diagnosis.

This paper examines the risk perceptions of women who undergo two prenatal diagnostic procedures, amniocentesis and CVS (chorionic villus sampling). Data were collected from a survey of clinic patients in suburban Washington, D.C. and in San Diego (N = 120). The survey was supplemented by in-depth interviews with prenatal diagnosis users and genetic counselors. Women with more education, as well as those who had CVS rather than amniocentesis, were more likely to view their risk as low. This contradicts the accepted view that users are aware of the higher risks of CVS. Rather, it seems that risk perceptions are socially constructed to achieve cognitive consistency with the action undertaken. Qualitative data suggest that perceptions of risk appear to be influenced not only by the users' demographic characteristics but by the salience and severity of the event in question and by the user's perceived control over it.

Amniocentesis↗

Drug and risk perception on ninth-grade students: sex differences and similarities.

Sixty-two secondary school students were observed in their classrooms over 5 weeks of intensive drug information for within-group changes in their perceptions. "Peer pressure" and "kicks" were cited as reasons for starting and using drugs; but peer pressure had relatively greater strength for girls than for boys, and curiosity increased for girls. Boys and girls differed in reasons for stopping drugs (peer and professional help for girls, and punishment for boys). In rating the relative dangers and pleasures of marijuana and heroin, most students did not discriminate effectively between the two drugs, although ratings of marijuana dangers decreased. Unexpectedly, responses concerning the health hazards of heroin did not increase. In a situation simulating risk under peer pressure, boys chose targets as appropriate for their skill as did the girls.

Adolescent↗

Cardiovascular risks: perception versus reality.

The high estrogen doses in the original oral contraceptive (OC) formulations were associated with an increased risk of cardiovascular events. Since then the steroid doses in OC have been reduced steadily, so that current low-estrogen-dose (< or = 35 micrograms) combination OC are associated with a lower risk of arterial and venous events than occurs with higher-estrogen-dose formulations. Based on the currently available epidemiologic evidence, the following conclusions can be made regarding the cardiovascular disease risks associated with use of low-dose OC by healthy, nonsmoking women: there is no increased risk of myocardial infarction (MI) or hemorrhagic or ischemic stroke; and there is a three- to fourfold increased risk of venous thrombosis and embolism (VTE). This risk is about half that associated with pregnancy. Smoking is the most important independent risk factor for MI, and is synergistic with OC use. Women smokers should be advised strongly to stop smoking, but those aged < 35 years may use any OC containing < or = 35 micrograms of estrogen. Women smokers aged > or = 35 years should be advised to use a nonestrogen or nonhormonal contraceptive method.

Adolescent↗

Risk perception, family history, and use of breast cancer screening tests.

A family history of breast cancer is an established risk factor for the disease, but there are few published studies on the use of breast cancer screening tests among family-history-positive women. Among 1015 respondents to telephone surveys of random samples of women 50 to 75 years old residing on Long Island (New York), the frequency of ever having had a mammogram or having a mammogram during the past year was significantly higher in respondents with a self-reported family history of breast cancer than in other women 50 to 64 (but not 65 to 75) years old. The association between family history and mammography during the past year held only among 50 to 64-year-old women with a lower perceived risk of breast cancer. Among women 50 to 64 years old, strong agreement with the ability of mammography to detect nonpalpable lumps was positively associated with mammography during the past year, especially among women with lower perceived risk of breast cancer. Implications are discussed with regard to breast cancer screening programs.

Adult↗

Gender differences in risk perception: effects differ in stressed vs. non-stressed environments.

Contrary to previous reports that women are more concerned about environmental risks than men, we hypothesized that men and women residing in neighborhoods stressed by multiple hazards would demonstrate similar concerns about local environmental conditions. Analysis of a national data base and an aggregate of ten local data bases found greater female than male concern about local technological, behavioral, and land use hazards in good neighborhoods, but, as expected, not in stressed ones. We urge analysts to conduct more studies in stressed neighborhoods in order to better understand the perspective of those who live with environmental risks.

Adult↗

Differential risk perceptions for unintended pregnancy, STDs, and HIV/AIDS among urban adolescents: some preliminary findings.

Two pilot studies tested the hypothesis that adolescents perceive differential risks for unintended pregnancy (UP), sexually transmitted diseases (STDs), and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). The 1st study used a college sample consisting of 14 adolescents (21 years or younger) and 64 adults (over 21) who rated the likelihood that they and others would experience 15 health problems. The 2nd study used a community sample of 48 adolescents between 16 and 21 years of age who rated 11 health problems in a similar manner. Optimistic bias and uniqueness of risk in adolescents' perceived susceptibility to adverse sexual outcomes were examined. Optimistic bias is the difference between ratings of risk to self and risk to others, reflecting lower risk to self. Uniqueness of risk is the difference between ratings of risk and a baseline risk estimate (i.e., the mean rating for all non-sex-related health problems). Consistent with the hypothesis, adolescents perceived differential risks for UP, STDs, and HIV/AIDS. Implications for adolescent prevention programs are discussed.

Adolescent↗