摘要：Objectives. To assess the level of HIV-related risk behavior among the general US adult population, we analyzed data from the first sexual behavior questions available for states to use with the Behavioral Risk Factor Surveillance System. Methods. The Behavioral Risk Factor Surveillance System is a state-specific, population-based, random telephone survey. In 1997, 25 states collected sexual behavior data. Annual prevalence estimates for selected behaviors were calculated and examined by sociodemographic characteristics. The correlation between actual and perceived HIV risk also was determined. Results. Most (77.1%) of the respondents reported just 1 sexual partner in the past year; 26.0% reported using a condom at last intercourse. Males, persons who were younger, and Blacks were more likely to report 2 or more partners but also more likely to report using a condom at last intercourse. Only 4.1% of the respondents reported a risk factor for HIV infection; 7.7% reported that they were at medium or high risk for HIV. Actual and perceived HIV risk were positively associated. Conclusions. Most US adults do not engage in HIV-related risk behavior; those that do are more likely to report protective behavior. As we move into the new millennium, it is important to ask what effect the AIDS epidemic has had on the US general adult population. Which adults are at risk for HIV? Do they know they are at risk? Do they make an effort to protect themselves from infection? Although many studies have examined HIVrelated risk behavior among select US populations (e.g., those with HIV infection or at high risk for HIV infection), few studies have investigated these behaviors among the general adult population. 1– 3 Risk behavior data among the general population are an important adjunct to data from AIDS and HIV case reporting. These data can show the effect the epidemic has had on most Americans. They can indicate the level of risk in the population and identify changes in patterns of risk or protective behavior across different subgroups; confirm whether we are targeting appropriate groups in the population for prevention; and provide some indication that large-scale interventions, such as guidelines and policies, might be affecting behavior. Furthermore, these data can enhance understanding of relations among factors found for more select groups. Finally, they can provide an indication of progress in meeting national and state health objectives. This study adds to the small but growing body of work in this area and compares our findings with data from prior surveys of the general population. As the US AIDS epidemic enters its third decade, changing patterns in the epidemiology of the disease have been observed. In the second half of the 1990s, both the incidence of and the mortality due to AIDS decreased. 4 These decreases are no doubt largely attributable to the effect of new treatments, which have improved survival for those with HIV infection and AIDS. As a result, the number of persons living with AIDS has increased. 5 Because of these changes, AIDS incidence and even AIDS prevalence no longer accurately reflect trends in the epidemic. 5 A better measure of the AIDS epidemic is reporting of the full spectrum of HIV infection, which would include AIDS. Not every state currently conducts HIV surveillance, but efforts are under way to establish surveillance systems in all states so that HIV reporting can be conducted on a national level. Even the data collected from such surveillance, however, would not truly represent the epidemic, because only HIV-infected persons who had been tested for the virus would be counted. HIV surveillance data coupled with risk behavior data would best define the epidemic and capture persons in need of preventive intervention as well as treatment and services. Thus, as the epidemic continues to evolve, it is also important to monitor associated risk behavior to help explain the trends in HIV and AIDS. Furthermore, risk behaviors should be monitored among 3 groups: the general population, persons at increased risk, and persons who are infected. 6 The purpose of this study was to describe HIV-related behaviors and perceptions among the general population of US adults aged 18 to 49 years. In addition, we wanted to determine the association between actual HIV risk and perceived HIV risk. Our expectation was that the prevalence of sexual risk behaviors for HIV infection is low among the general US adult population.
