摘要：Objectives. We sought to determine whether individuals' risk perceptions and efficacy beliefs could be used to meaningfully segment audiences to assist interventions that seek to change HIV-related behaviors. Methods. A household-level survey of individuals (N = 968) was conducted in 4 districts in Malawi. On the basis of responses about perceptions of risk and beliefs about personal efficacy, we used cluster analysis to create 4 groups within the risk perception attitude framework: responsive (high risk, strong efficacy), avoidance (high risk, weak efficacy), proactive (low risk, strong efficacy), and indifference (low risk, weak efficacy). We ran analysis of covariance models (controlling for known predictors) to determine how membership in the risk perception attitude framework groups would affect knowledge about HIV, HIV-testing uptake, and condom use. Results. A significant association was found between membership in 1 or more of the 4 risk perception attitude framework groups and the 3 study variables of interest: knowledge about HIV ( F 8, 956 = 20.77; P < .001), HIV testing uptake ( F 8, 952 = 10.91; P < .001), and condom use ( F 8, 885 = 29.59; P < .001). Conclusions. The risk perception attitude framework can serve as a theoretically sound audience segmentation technique that can be used to determine whether messages should augment perceptions of risk, beliefs about personal efficacy, or both. Malawi has been greatly affected by AIDS. In 2007, approximately 68 000 deaths in Malawi were attributable to this pandemic, 1 and AIDS prevalence is currently estimated at 11.9% among Malawian adults, a figure that has changed little since 2004. 2 Prevalence of HIV infection in the southern region of the country is 17.6%. As of 2005, life expectancy for women in Malawi was 42 years, and life expectancy for men was 41 years. 3 The number of orphans in the country who have lost either parent to AIDS almost tripled in 6 years, from 201 000 in 2001 to 560 000 in 2007. 1 Approximately 840 000 adults in Malawi are currently living with HIV. There is an urgent need for long-term strategies to promote behaviors that protect Malawians from HIV infection. A number of efforts to address the growing problem are currently under way, including provision of antiretroviral treatments and promotion of HIV testing and counseling. It is only recently that comprehensive programs to prevent AIDS transmission have been undertaken, one of which is the Malawi BRIDGE project, described here.
