A Multilevel Path Analysis of Risk Perception and Risky Sexual Behavior Under the Framework of the Health Belief Model

Abstract

The Health Belief Model is a path analytical framework that identifies risk perception among other variables as very crucial to safer sexual behaviors. Yet, very few studies have examined what influences risk perception itself and the simultaneity of the relationship between risk perception and sexual behaviors. Using data from the Cape Area Panel Survey and applying multilevel path models, this study examined what influences risk perception and sexual behaviors, focusing on the complexities of the relationship between the two variables. The study also examined the effects of poverty at the community level on risk perception and sexual behaviors. Results indicate a negative relationship between risk perception and sexual risk-taking. At the community level, poverty impacts sexual risk-taking positively but risk perception negatively.

KEYWORDS:

• South Africa
• risk perception
• Health Belief Model
• HIV/AIDS
• sexual behavior
• multilevel path analysis

Notes

Note. ***p < .01; **p < .05; *p < .1.

All of the paths are significant for p < .05.

N = 1319.

χ² = 37.58.

p for 27 df = .09.

RMSEA = 0.017.

The second wave of the survey is not used because it did not follow the whole sample from Wave 1. In addition, Wave 2 did not collect some information as found in Wave 1.

The attrition has been shown to be entirely unrelated to sexual activity (see Mateleto et al., 2008). Thus, attrition is unlikely to affect our estimates.

The 2001 Census of Statistics South Africa defined a sub-place as a suburb, ward, village, farm, or informal settlement. A main place, on the other hand, is defined as a city, town, or tribal area.

The last category, “undecided,” is made up respondents who reported they did not know their risk perceptions.