The Effect of Psychosocial Domains on AIDS Risk Behaviors

SUMMARY

The psychosocial domains of emotional well-being, cognitive functioning, and motivation to change can affect AIDS risk behaviors in two ways. First, psychosocial domains can act as causal determinants of risk behaviors. When people feel bad (low emotional well-being), when they are not thinking clearly (low cognitive functioning), and when they fail to recognize the costs of behaviors (low motivation to change), then they are led to choose rewarding yet risky behaviors. Second, once risk behaviors have begun, psychosocial domains can act as resources for behavioral change. When people feel good, they want to improve; they care about risks. When people are thinking clearly, they make good decisions; they can perceive and implement ways to avoid risks. When people perceive the seriousness of risks, they see a profit in change and are motivated to change. The results of this study confirm other studies that suggest that drug users at greatest risk for AIDS are those with the lowest levels of psychosocial variables. The results of this study suggest, furthermore, that psychosocial domains may have a more important role as root causes of HIV risk behaviors than as resources for behavioral change. The psychosocial domains did not appear to operate as resources for behavioral change in this sample. Among causal mechanisms, feeling good and thinking clearly were predictive of AIDS risk behaviors, while motivation to change did not predict risk behaviors. Interventions that can successfully induce changes in the psychosocial domains of emotional well-being and cognitive functioning show the greatest promise to produce changes in AIDS risk behaviors.