Credibility of information from official sources on HIV/AIDS transmission.

OBJECTIVE: The authors analyzed data from the 1991 National Planning Survey to (a) assess respondents' awareness of three official sources of information about HIV/AIDS (CDC, the Surgeon General, and state health departments); (b) assess respondents' perceptions of the reliability of these sources; and (c) compare respondents' personal beliefs about HIV transmission with their beliefs regarding the experts' view. METHODS: The authors conducted a secondary analysis of the responses of the 1622 survey participants who gave complete information. RESULTS: People with more years of formal education were more likely to have heard of the CDC and the Surgeon General. The CDC was given the highest overall reliability rating, followed by the Surgeon General and then state health departments. Transmission of HIV/AIDS by various modes of casual contact was perceived more likely among those who gave the CDC lower reliability ratings. However, regardless of their perceptions of the reliability of the CDC as a source of HIV/AIDS information, many respondents believed the probability of transmission by casual contact more likely than they believed experts said it was. CONCLUSIONS: The discrepancy found between what people believe about health risks and what they think experts believe has important implications for the design of effective health information campaigns and for the design of questionnaire items that aim to assess people's "knowledge" and "attitudes" regarding sensitive health topics.

AIDS knowledge gaps: results from the first decade of the epidemic and implications for future public information efforts.

Throughout the first decade of AIDS, certain populations have been disproportionately affected by its spread, particularly men, blacks, Hispanics, and the young. Just as there are population differences in the spread of the disease, there are differences in knowledge about the disease as well. This article applies the knowledge gap framework to examine the nature and magnitude of gaps in knowledge among different populations. The analysis shows that persons of low education lag behind other groups in true-transmission knowledge (i.e., knowledge about ways in which HIV/AIDS actually is transmitted) and false-transmission knowledge (i.e., misconceptions about how the disease is spread).

Addressing the public's concerns about human immunodeficiency virus transmission in health-care settings.

BACKGROUND: The 1990 report of a cluster of patients infected with the human immunodeficiency virus (HIV) associated with a Florida dentist with acquired immunodeficiency syndrome attracted considerable media coverage and legislative attention. A number of polls found that the public favored mandatory HIV-antibody testing of health-care workers. The Centers for Disease Control and Prevention, Atlanta, Ga, conducted a two-phase study to understand how public concerns regarding potential HIV transmission in health-care settings can be addressed by the medical and public health communities. METHODS: Sixteen focus group discussions in nine US cities were conducted to explore the public's perceptions, concerns, and behavioral responses regarding HIV transmission in health-care settings. Using this information, a questionnaire was developed and administered to a nationwide probability telephone sample of 1150 adults. RESULTS: Concern about contracting HIV in health-care settings was highest for emergency department treatment and lowest for treatment by a personal physician. Two factors directly related to patient care, ie, the health-care professional's willingness to discuss acquired immunodeficiency syndrome and the presence of acquired immunodeficiency syndrome educational materials in the waiting room, were considered useful factors for determining potential risk of transmission of HIV in a health-care setting. CONCLUSIONS: Public concern about the potential for HIV transmission in health-care settings remains high. Active steps on the part of health-care professionals, such as providing educational materials and initiating discussions about infection control procedures and about HIV and acquired immunodeficiency syndrome, could likely have positive effects in terms of alleviating these concerns.

Using indices to differentiate dimensions of knowledge regarding modes of HIV transmission in the U.S. population, 1987-1989.

The number of HIV-infected individuals is increasing, making it important for the public to understand not only how HIV is transmitted but also the lack of transmission risk associated with casual contact. Using CDC's National Center for Health Statistics National Health Interview Survey, we divided modes of transmission items into two areas of knowledge: "True Transmission" and "False Transmission." Items were recoded with scores from 3 for the most correct response to 0 for the most incorrect response for each of three items related to true and each of eight items related to false transmission. Item and principal components factor analyses yielded two distinct dimensions (true factor loadings from 0.68 to 0.76, false factor loadings from 0.56 to 0.74). Mean scores of 8.3 (range 0-9) and 15.9 for 1987 (range 0-24) for true and false transmission indices, respectively, provide evidence that the population is highly knowledgeable about true modes of transmission but far less so about false modes. Knowledge levels have increased between 1987 and 1989, most meaningfully in the area of false transmission. Use of these indices will facilitate the monitoring over time of differential knowledge, attitudes, and beliefs related to HIV and AIDS.

A system for evaluating the use of media in CDC's National AIDS Information and Education Program.

The National AIDS Information and Education Program (NAIEP) commissioned the National Academy of Sciences to design a prototypical system of research for use in the evaluation of the agency's media campaign. It consists of four types of evaluation: formative, efficacy, process, and outcome. These types of evaluations are used to answer such questions as the following: What message strategies will work best? Can a campaign under optimal conditions be expected to make a difference? What interventions are actually delivered during the campaign? Has the campaign actually had an impact? How NAIEP has used the system and adapted it during 1 year of research activities is outlined, and examples from a variety of other social marketing programs are described.