Social factors and the process of risk construction in HIV sexual transmission

Abstract

This paper reviews different approaches used to analyse the process of risk construction as concerns the sexual transmission of HIV. Individualistic approaches focus on understanding how individual risk representation is constructed. Constructivist approaches consider that the process of risk construction occurs in relation with other people and is affected by social context. The specificities of these procedures are considered from theoretical and methodological points of view, and by using examples taken from quantitative and qualitative research in different countries. Zero exposure to HIV risk does not exist in reality, and people tend to reduce their risk through condom use and other prevention strategies. Prevention campaigns should thus aim for risk reduction instead of risk elimination. Constructivist research elucidates why some people do not protect themselves, notably because of marginalization processes and social normalization of gender roles. It also elucidates why preventive behaviour differs according to type of partner by showing how preventive behaviour depends on power role relationships and social, sexual or confidential relationships, and feelings of