Protection Motivation Variables in HIV Testing: The Function of Motivational Factors

Abstract

Most previous studies on HIV/AIDS using Rogers' protection motivation theory (PMT) have focused on primary prevention. This study examined the utility of PMT for predicting HIV testing, a form of secondary prevention. Cross-sectional survey data from 243 young adults was assessed. It was hypothesized that motivational factors, notably fear and maladaptive coping, reliably predict testing over and beyond variation attributable to cognitive appraisals. Hierarchical logistic regression analysis showed that testing was not influenced by cognitive appraisals. As expected maladaptive coping produced a significant improvement in model fit after accounting for threat- and coping appraisals. Interestingly, fear was not significant. Controlling for past risk behavior and demographic variables at an earlier step failed to negate the salience of maladaptive coping, which again significantly improved model fit. Use of rationalizations (to discount personal risk) was the key maladaptive response that reliably distinguished between testers and nontesters. Testing was associated with less use of rationalizations and higher levels of prior risk behavior. However, overall less than 20% of testers were correctly classified, suggesting that PMT components overall have limited explanatory value in this context. Implications for promoting HIV testing are considered.