Low Risk Perception Research Articles

Risk perception and psychological state of healthcare workers in referral hospitals during the early phase of the COVID-19 pandemic, Uganda

BackgroundSafeguarding the psychological well-being of healthcare workers (HCWs) is crucial to ensuring sustainability and quality of healthcare services. During the COVID-19 pandemic, HCWs may be subject to excessive mental stress. We assessed the risk perception and immediate psychological state of HCWs early in the pandemic in referral hospitals involved in the management of COVID-19 patients in Uganda.MethodsWe conducted a cross-sectional survey in five referral hospitals from April 20–May 22, 2020. During this time, we distributed paper-based, self-administered questionnaires to all consenting HCWs on day shifts. The questionnaire included questions on socio-demographics, occupational behaviors, potential perceived risks, and psychological distress. We assessed risk perception towards COVID-19 using 27 concern statements with a four-point Likert scale. We defined psychological distress as a total score > 12 from the 12-item Goldberg’s General Health Questionnaire (GHQ-12). We used modified Poisson regression to identify factors associated with psychological distress.ResultsAmong 335 HCWs who received questionnaires, 328 (98%) responded. Respondents’ mean age was 36 (range 18–59) years; 172 (52%) were male. The median duration of professional experience was eight (range 1–35) years; 208 (63%) worked more than 40 h per week; 116 (35%) were nurses, 52 (14%) doctors, 30 (9%) clinical officers, and 86 (26%) support staff. One hundred and forty-four (44%) had a GHQ-12 score > 12. The most common concerns reported included fear of infection at the workplace (81%), stigma from colleagues (79%), lack of workplace support (63%), and inadequate availability of personal protective equipment (PPE) (56%). In multivariable analysis, moderate (adjusted prevalence ratio, [aPR] = 2.2, 95% confidence interval [CI] 1.2–4.0) and high (aPR = 3.8, 95% CI 2.0–7.0) risk perception towards COVID-19 (compared with low-risk perception) were associated with psychological distress.ConclusionsForty-four percent of HCWs surveyed in hospitals treating COVID-19 patients during the early COVID-19 epidemic in Uganda reported psychological distress related to fear of infection, stigma, and inadequate PPE. Higher perceived personal risk towards COVID-19 was associated with increased psychological distress. To optimize patient care during the pandemic and future outbreaks, workplace management may consider identifying and addressing HCW concerns, ensuring sufficient PPE and training, and reducing infection-associated stigma.

Predictors of Covid-19 vaccination acceptance in IBD patients: a prospective study.

BackgroundAdherence to vaccinations is unsatisfactory in the inflammatory diseases (IBD) population because of concerns regarding adverse events or low perception of infectious risk. The aim of this study was to maximise adherence to anti-Covid-19 vaccination in IBD patients.MethodsIn the third trimester of 2020, all IBD patients were informed concerning the need for anti-Covid-19 vaccination and family physicians were advised to proceed with anti-Influenza and anti-pneumococcus vaccinations. Demographic data, disease-related data together with acceptance of vaccinations were recorded. From May 2021, vaccinations of IBD patients were directly arranged at our hospital. We registered performance, procrastination or denial of anti-Covid-19 vaccination, type of vaccine and adverse events.ResultsFive hundred and twenty-three patients were included (Crohn’s: 266, ulcerative colitis: 257; M/F 289/234; mean age 48 ± 17 years); 53 patients were excluded from analysis as they became infected with SARS-CoV-2 during the study period; overall adherence to vaccination was 400/470 (85%), procrastinators 44 (9%) and 27 patients (6%) refused. Compared with influenza (58%) and pneumococcus (65%) vaccinations, acceptance was higher for anti-Covid-19 vaccination (P < 0.0001, both). Mild adverse events occurred in 31% and two (0.5%) needed precautionary but uneventful hospitalization. On multiple stepwise regression analysis, factors positively associated with adherence to vaccination were age (P < 0.039; OR, 1.016, 95% CI: 1.001–1.031) and previous anti-influenza vaccination (P < 0.008; OR, 2.071, 95% CI: 1.210–3.545).ConclusionsDirect counselling and on-site administration were associated with a satisfactory acceptance of anti-Covid-19 vaccination, whereas vaccinations against influenza and pneumococcus remained below expected levels. Increased risk perception may account for the observed differences.

Determining the Knowledge, Attitude and Perception towards COVID-19 among Newly Recruited Surveillance Team in Ikeja, Lagos State, Nigeria: How justified are we in the Recruitment?

&#x0D; Background: In the current pandemic, real-time analyses of epidemiological data generated from a reliable source are required for increasing awareness about COVID-19. Therefore, it is important to assess the perception of risk of the surveillance team that would be deployed, as this will contribute to their commitment towards rapid surveillance of COVID-19.&#x0D; Objective: This study assessed the knowledge, attitude and perception towards COVID-19 among newly recruited surveillance team in Ikeja, Lagos State, Nigeria.&#x0D; Methods: A descriptive cross-sectional study, with the respondents being active surveillance volunteers recruited by the World Health Organization. One hundred respondents were purposively recruited and data collection was done using a pretested self-administered, semi-structured questionnaire. Data were analyzed using IBM SPSS version 25; bivariate and multivariate analyses were done using Chi-square and binary logistic regression respectively at 5% level of significance.&#x0D; Results: The mean age of the study participants was 37.1 ±11.9 years. Of all the respondents, 58.6% had poor knowledge of COVID-19. Less than half of the respondents (44.8%) had negative attitude towards COVID-19 while majority (90.8%) of them had low risk perception about COVID-19. The binary logistic regression analysis revealed that married respondents had significantly lesser odds (67%) of having poor knowledge about COVID-19 compared with the respondents who were single/Widowed/Widower. (aOR; 0.33, CI; 0.04 - 0.88).&#x0D; Conclusion: The study highlights the poor knowledge, negative attitude, as well as low risk perception about COVID19 among newly recruited active surveillance workers. Hence, targeted health educational interventions are urgently needed for the surveillance team, most especially in this second wave of COVID-19.&#x0D; &#x0D; Keywords: Attitude; COVID-19; knowledge; perception; surveillance; team.

Risk perception and preparedness of backcountry visitors in Australia’s Snowy Mountains

ABSTRACT Effective management of National Parks requires an understanding of visitors to provide safe and enjoyable visitor experiences. Risk and preparedness of snow-based recreation is not well understood outside of the context of avalanches. This study investigated the risk perception and preparedness of snow-based backcountry visitors in the Snowy Mountains of Australia through the theoretical lens of recreation specialisation. The recreation specialisation index was an appropriate tool for segmenting snow-based backcountry visitors into intermediates and experts along behavioural, cognitive and affective dimensions. We identified an overall low perception of risk and discuss the reasons and implications of this. In contrast, level of preparedness was of a high standard among both intermediate and expert snow-based backcountry visitors. This pertained to pre-trip planning and the carrying/use of safety equipment and trip notification behaviour. The findings provide insights for land managers to enhance visitor safety and risk management for snow-based backcountry visitors.

Key Informant Perspectives on Somali Adolescent Tobacco Use: Contextualizing Influences and Prevention Opportunities.

Somali American adolescent tobacco use has increased over the past decade amid a high prevalence of tobacco use among Somali American adults. While established adolescent tobacco use determinants may apply for Somali youth, a deeper understanding of these influences is imperative to the development of effective prevention strategies for this population. This study aimed to identify risk and protective factors influencing Somali American adolescent tobacco use decision making and potential family and community roles in tobacco prevention. We conducted 15 semistructured, in-depth interviews with 12 Somali and 3 non-Somali professionals serving Minnesotan metropolitan Somali communities in clinical, educational, religious, and other community organizations. Grounded Theory informed our data collection and analysis. Key informants cited three major influences on Somali adolescent tobacco use: evolving norms and increasing exposure to tobacco products in the United States, low risks perception, especially for waterpipes, and conflicting interpretations of faith. Informants highlighted the important roles of families in Somali youth tobacco prevention while acknowledging areas where families would benefit from greater support. Proposed sources of support included faith communities and nonparental, ethnically similar adult mentors. Informants acknowledged challenges to addressing youth tobacco prevention in clinics and underscored the importance of youth involvement in developing prevention strategies. Our results indicate Somali adolescent tobacco prevention efforts should address the evolving tobacco use exposures and norms, low risk perceptions, and clarify faith messaging. Effective strategies may include strengthening family-based tobacco prevention approaches that also engage faith and other community leaders along with youth themselves.

Risk Perception and Aberrant Driving Behavior Among Autorickshaw in Palakkad

The study examines the relationship between risk perception and aberrant driving behavior among Autorikshaw drivers. The sample consists of 200 Autorikshaw drivers from various locations in the district of Palakkad. The statistics techniques used in this study are Karl Pearson’s coefficient of correlation, Arithmetic Mean and Standard Deviation. The results showed that there exists a relationship between variables and hence the hypothesis is accepted. The result indicates that the Autorikshaw drivers who have high risk perception are showing more aberrant driving behavior. The study concluded that some drivers who showed high score on Driver Behavior Questionnaire is found to have low risk perception.

HIV Serostatus Disclosure Among Men Who Have Sex with Men in China in the Era of U=U and PrEP

Given the recent evidence on “Undetectable = Untransmittable” (U=U) and pre-exposure prophylaxis (PrEP), the present study aimed to investigate HIV disclosure behaviors and their associations with sexual risk behaviors and U=U and PrEP awareness among men who have sex with men (MSM) in China. A cross-sectional survey was conducted among 689 MSM recruited through a gay-friendly non-governmental organization located in Chengdu, China in 2018–2019. Information was collected by a structured self-administrated questionnaire. The enrolled sample included 554 (80.4%) participants who were HIV-negative and 135 (19.6%) participants with an unknown HIV status. In terms of disclosure, 41.4% of participants informed all partners about their HIV status all the time (informing behavior), while 30.4% asked all partners about their HIV status all the time (asking behavior). Only one-fifth knew about U=U, but this was not statistically associated with either informing or asking behavior. Half (50.5%) had heard of PrEP but this was not statistically associated with either informing or asking behavior. Common barriers to informing and asking behaviors were lower risk perception of HIV infection, a history of sexually transmitted infections, engagement in receptive sex, and a history of sex with casual partners. We found that both U=U and PrEP awareness and HIV serostatus disclosure were infrequent and not associated in this study of Chinese MSM. These data indicate huge information gaps among MSM in China.

Caregivers’ Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi

Background: Vaccines are among the most effective and cost-efficient public health interventions for promoting child health. However, uptake is considerably affected by vaccine hesitancy. An example is Malawi, with a decline in second vaccine doses and the highest cervical cancer incidence and mortality rate in Sub-Saharan Africa. Understanding vaccine hesitancy is especially important when new vaccines are introduced. This study explores factors contributing to vaccine hesitancy for routine childhood immunization and the human papillomavirus vaccine in Malawi. Methods: The study used a cross-sectional survey design targeting caregivers of children under five years old and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (n = 600). The measures were based on 5C scale for measuring vaccine hesitancy. Multiple regression analyses were performed to explore vaccination intention predictors. Results: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. Caregivers had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband’s positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and risks of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but the need to attain a husband’s approval did. Being a young adult and unemployed increased belief in rumors, while trust in healthcare workers reduced the belief. Conclusions: This study provides good insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.

Predictive Model of Preventive Behaviors against COVID-19 in the Older Adult: The PREASOC-COVID-19 Study.

Background: The purpose of this study was to analyze the relationship between COVID-19 preventive behaviors, as the dependent variable, with risk perception, coping style and sense of coherence, as independent variables, in older people living in the community. Methods: An observational design for predictive model development. This study was reported following the STROBE statement. The subjects were people over 65 years of age living in the community. Data collection included sociodemographic variables related to COVID-19, risk perception and types, coping styles in the face of contagion, sense of coherence, and preventive behaviors in the face of COVID-19. The data collection period was from November 2020 to January 2021. Results: A total of 305 people participated in this study (71.5% women, mean age 71.34 years; 6.9% suffered from COVID-19 and 44.3% knew someone close to them who suffered from the virus). The coping style variables problem-focused, emotion-focused, and sense of coherence subscales Significance and manageability explained 17% of the variable preventive behaviors against COVID-19. There were statistically significant differences by gender in all subscales, with women scoring higher in all of them; Conclusions: Men with low risk perception, extrinsic risk perception, and low sense of coherence presented worse COVID-19 preventive behaviors. It would be interesting to develop specific prevention and health education campaigns for this population.

Differences in Perceived Risk of Contracting SARS-CoV-2 during and after the Lockdown in Sub-Saharan African Countries.

This study investigated risk perception of contracting and dying of SARS-CoV-2 in sub-Sahara Africa during and after the lockdown periods. Two online surveys were conducted one year apart, with participants 18 years and above living in sub-Sahara Africa or the diaspora. Each survey took four weeks. The first survey was taken from 18 April to 16 May 2020, i.e., during the lockdown. The second survey was taken from 14 April to 14 May 2021, i.e., after the lockdown. A cross-sectional study using adopted and modified questionnaires for both surveys were distributed through online platforms. Question about risks perception of contracting and dying of SARS-CoV-2 were asked. The Helsinki declaration was applied, and ethical approvals were obtained. Total responses for both surveys, i.e., both during and after the lockdown, was 4605. The mean age was similar in both surveys (18–28 years). The mean risk perception scores were higher after lockdown by 3.59%. Factors associated with risk perception of COVID-19 were survey period, age group, region of residence, and occupation. Non-health care workers had a lower risk perception of COVID-19. This first comparative study on the level of risk perception of Africans during and after the lockdown shows that one in every three and every four persons in sub-Sahara Africa felt at high risk of contracting COVID-19 and thought they could die from contracting the same, respectively.

Factors associated with motivation to avoid meeting family and friends during the COVID-19 pandemic

BackgroundThe widespread adherence to behaviours that prevent the transmission of the SARS-CoV-2 virus depends on human will. There is a paucity of research on the factors that influence adherence to social distancing. Available research suggests that it varies with the specific behaviour and that reducing contact with family and friends is the hardest one. This study aims to identify factors associated with motivation to avoid meeting with family and friends during the second lockdown of the COVID-19 pandemic in Portugal.MethodsWe used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes sociodemographics, psychosocial variables, and subjective health and wellbeing indicators from 20th February to 19th March 2021. We included 1336 participants who answered the question “To what extent is it easy for you to avoid visiting family and friends?”. Logistic regression analysis was used to identify factors associated with difficulty to avoid visiting family and friends.ResultsPreliminary data shows that 38.4% (513) had difficulties avoiding meeting with family and friends. Those with greater difficulty were the ones who have less education, higher negative emotionality, do not work remotely, have more difficulties to stay home and practice physical distancing and consider the Government's measures inadequate. Contrarily, those who have less difficulty avoiding visiting friends and family are older and have low risk perception of COVID-19 infection.ConclusionsThis study suggests higher difficulty in avoiding visiting friends and family for those whose routines demand not staying at home, with low agreement with Government measures, and struggle with higher negative emotionality, confirming the personal costs of these behaviours and the importance of habits. Older people had less difficulty, suggesting that these measures may be closer to their usual routines. Interventions should consider the specificities of social interaction.Key messages Social distancing comes at an enormous cost to people's livelihoods and it also depends on people living circumstances.Interventions to improve adherence to social distancing should consider the specificity of social interaction and the potential dissonance created by the overall routines.

Differences in Sources of Information, Risk Perception, and Cognitive Appraisals between People with Various Latent Classes of Motivation to Get Vaccinated against COVID-19 and Previous Seasonal Influenza Vaccination: Facebook Survey Study with Latent Profile Analysis in Taiwan.

The present study aimed (1) to identify distinct latent classes of motivation to get vaccinated against coronavirus disease 2019 (COVID-19) and previous seasonal influenza vaccination among people in Taiwan and (2) to examine the roles of sources of information, risk perception, and cognitive appraisals of vaccination against COVID-19 in these classes. We recruited 1047 participants through a Facebook advertisement. The participants’ motivation to get vaccinated against COVID-19, previous seasonal influenza vaccination, sources of information about COVID-19 vaccination, risk perception of COVID-19, and cognitive appraisals of vaccination against COVID-19 were determined. We examined the participants’ motivation for COVID-19 vaccination and previous seasonal influenza vaccination through latent profile analysis. Four latent classes of motivation were identified: participants with high motivation for COVID-19 vaccination and high seasonal influenza vaccination, those with high motivation for COVID-19 vaccination but low seasonal influenza vaccination, those with low motivation for COVID-19 vaccination but high seasonal influenza vaccination, and those with low motivation for COVID-19 vaccination and low seasonal influenza vaccination. Compared with participants in the latent class of high motivation for COVID-19 vaccination and high seasonal influenza vaccination, those in the other three latent classes had lower levels of positive appraisals of COVID-19 vaccination; participants in the latent class of low motivation for COVID-19 vaccination and low seasonal influenza vaccination had lower risk perception of COVID-19 and were also less likely to obtain information about COVID-19 vaccination from the internet, friends, and family members. The various motivations and behaviors for vaccination, sources of information, risk perception, and cognitive appraisals of vaccination against COVID-19 should be considered in intervention programs aiming to increase people’s motivation to get vaccinated against COVID-19.

Compliance with mass marketing solicitation: The role of verbatim and gist processing.

IntroductionMass marketing scams threaten financial and personal well‐being. Grounded in fuzzy‐trace theory, we examined whether verbatim and gist‐based risk processing predicts susceptibility to scams and whether such processing can be altered.MethodsSeven hundred and one participants read a solicitation letter online and indicated willingness to call an “activation number” to claim an alleged $500,000 sweepstakes prize. Participants focused on the solicitation's verbatim details (hypothesized to increase risk‐taking) or its broad gist (hypothesized to decrease risk‐taking).ResultsAs expected, measures of verbatim‐based processing positively predicted contact intentions, whereas measures of gist‐based processing negatively predicted contact intentions. Contrary to hypotheses, experimental conditions did not influence intentions (43% across conditions). Contact intentions were associated with perceptions of low risk, high benefit, and the offer's apparent genuineness, as well as self‐reported decision regret, subjective vulnerability to scams, and prior experience falling for scams.ConclusionsOverall, message perceptions and prior susceptibility, rather than experimental manipulations, mattered in predicting scam susceptibility.

Parental health risk perceptions and preventive measures related to Children\u2019s second-hand cigarette smoke exposure in Malaysia

BackgroundSecondhand smoke (SHS) exposure can affect physical development in children. An understanding of parental risk perception of SHS could guide efforts to develop measures for prevention of SHS exposure among children. This study aimed to assess parental risk perceptions of SHS and action taken by parents to minimise SHS exposure in their children.MethodsThis cross-sectional nationwide study conducted in 2018 recruited convenience sample of 289 parents with children up to age 12 at public areas. Parents were asked to rate the risk level from 1 (no risk) to 5 (extremely high risk) by looking at photographs of an adult smoking in the presence of a child in 8 different situations. The implementation of smoking restriction rules was assessed. Mean scores were calculated with higher scores representing higher risk perception of SHS to child’s health. Linear regression analysis was used to determine factors associated with the level of parental risk perception of SHS exposure to their children’s health.ResultsA total of 246 parents responded. Their mean age was 35 years (SD 6.4). The majority were mothers (75.6%), Malays (72.0%) and had tertiary education level (82.5%), and non-smoker (87.1%). The mean age of respondents’ youngest child was 3 years (SD 3.1). The risk perception level was high [mean scores: 4.11 (SD: 0.82)]. Most parents implemented household (65.0%) and car (68.3%) smoking restriction rules. Lower levels of risk perception were observed among participants who were current smokers (p < 0.001), lived with a smoker (p < 0.001), allowed household smoking with an open window (p = 0.027).ConclusionMost parents perceived that risks of SHS exposure to their children were high but only two-thirds of them had set rules prohibiting smoking. Health policymakers should pay attention to factors associated with lower risk perception among parents.Trial registrationThis study was approved by the Medical Research Ethics Committee, Ministry of Health Malaysia (Registration Number: NMRR-18-3299-44967).

Facilitators and barriers to implementing occupational safety interventions in the fishing industry: A scoping review

BackgroundHigh fatality rates among fishermen have characterized the fishing industry for decades. Several safety interventions have been implemented, with considerable decline in fatalities in some countries. However, statistics suggest that global rates are still high. In addition, little is known regarding factors that support or hinder the implementation of these interventions. ObjectiveTo explore, synthesize and analyze factors influencing the implementation of safety interventions in the fishing industry. MethodsIn accordance with the scoping review methodology, an extensive search of articles reporting on factors influencing implementation of safety interventions was conducted in PubMed, CINAHL, Embase, Scopus and grey literature. The Social Ecological Model was used as a guiding framework for mapping and analysis of results. ResultsThe search identified 618 articles with 12 meeting the inclusion criteria. The key facilitators included knowledge, management commitment, collaborative practices, supportive policies and enforcement of regulation. The key barriers included low risk perception, lack of time, inadequate skills, cultural and social norms, lack of support, high compliance cost, lack of harmonization of regulations, inadequate enforcement guidelines, lack of funding and weak coordination. ConclusionThe review highlighted that there is limited literature on factors affecting the implementation of safety interventions on most of the levels of the Social Ecological Model. There is need for extensive global research to fully understand what enables and impedes the implementation of safety interventions, as lack of attention to exploring these factors will result in non-reduction of fatalities. An effort to meet the UN's 17 global goals for sustainable development in fishing will be impossible. Furthermore, future knowledge translation should focus on the identified facilitators and barriers.

The Impact on HIV Testing Over 6 Months When Free Oral HIV Self-Test Kits Were Available to Truck Drivers in Kenya: A Randomized Controlled Trial.

Background: Studies suggest that offering HIV self-testing (HIVST) increases short-term HIV testing rates, but few have looked at long-term outcomes.Methods: We conducted a randomized controlled trial (RIDIE 55847d64a454f) on the impact of offering free oral HIVST to 305 truck drivers recruited from two clinics in Kenya. We previously reported that those offered HIVST were more likely to accept testing. Here we report on the 6-month follow-up during which intervention participants could pick-up HIVST kits from eight clinics.Results: There was no difference in HIV testing during 6-month follow-up between participants in the intervention and the standard of care (SOC) arms (OR = 1.0, p = 0.877). The most common reasons given for not testing were lack of time (69.6%), low risk (27.2%), fear of knowing HIV status (20.8%), and had tested recently (8.0%). The null association was not modified by having tested at baseline (interaction p = 0.613), baseline risk behaviors (number of partners in past 6 months, interaction p = 0.881, had transactional sex in past 6 months, interaction p = 0.599), nor having spent at least half of the past 30 nights away from home for work (interaction p = 0.304). Most participants indicated a preference for the characteristics associated with the SOC [preference for blood-based tests (69.4%), provider-administered testing (74.6%) testing in a clinic (70.1%)]. However, those in the intervention arm were more likely to prefer an oral swab test than those in the SOC (36.6 vs. 24.6%, p = 0.029).Conclusions: Offering HIVST kits to truck drivers through a clinic network had little impact on testing rates over the 6-month follow-up when participants had to return to the clinic to access HIVST. Clinic-based distribution of HIVST kits may not address some major barriers to testing, such as lack of time to go to a clinic, fear of knowing one’s status and low risk perception. Preferred HIV testing attributes were consistent with the SOC for most participants, but oral swab preference was higher among those in the intervention arm, who had seen the oral HIVST and had the opportunity to try it. This suggests that preferences may change with exposure to different testing modalities.

Knowledge, Attitudes and Practices, and Personality Predictors of Risk Taking towards COVİD-19 among University Students in Kenya

The purpose of this study was to examine the knowledge, attitudes, and practices (KAP) of university students towards COVID-19, and further, some personality characteristics that exacerbate the risk of infection. Out of the 300 university students based in Mombasa, Kenya, targeted in the online study, 219 submitted their filled questionnaires. Data was analyzed quantitatively using SPSS (v.25). Two-way ANOVA and regression models were used to analyze the data. Findings show high knowledge levels and low-risk behaviors towards COVID-19 but unhealthy attitudes especially among women aged 20-29 who also reported higher extroversion, and positive attitudes towards social interactions during COVID-19. Basic knowledge was predicted by age, gender, extroversion, public self-consciousness, and high-risk perception while advanced knowledge was predicted by basic knowledge. Low-risk perception was predicted by age, basic knowledge, and positive attitudes towards social interaction during COVID-19. Age, extroversion and risk perception predicted attitudes about social interactions. Preventive practices were in turn predicted by gender, risk perception, attitudes towards social interactions, extroversion and lack of premeditation. Findings of the study raise interest about university students’ KAP, underlying personality dynamics that predict risk taking towards COVID-19, and appropriate COVID-19 messaging to affect attitudes.

DRIVERS AND CONSEQUENCES OF BUSINESS-REFERENCE-CONTENT (BRC): THE ROLE OF NARRATIVE TRANSPORTATION IN B2B COMMUNICATION

COVID-19 is bringing changes in B2B sales and marketing strategies. Digital interaction with potential customers has become more critical. Business-reference content (BRC) is the most shared content, mainly using narrative format, available to potential customers through digital touchpoints. Reducing perceived purchasing risk has been recognized as the primary benefit of using BRC, but empirical research on this has been insufficient. Therefore, this research investigated the underlying mechanisms of BRC and related processes that lower risk perception based on narrative transportation theory. For empirical analysis, a serial-parallel mediating model was established in which BRC type (narrative versus non-narrative) influences purchase intention through the mediation of narrative transportation and perceived purchase risks – functional risk and financial risk. In this experimental study, an online survey was conducted in which 233 purchasing managers in Korean companies participated. The analysis confirmed that the BRC type had a significant effect on the level of receivers’ narrative transportation. In addition, serial-parallel mediating effects through narrative transportation (primary mediator) and perceived functional risk and perceived financial risk (secondary mediators) were all significant. This research provides meaningful implications in that it broadens the theoretical understanding of BRC by presenting the integrated BRC effect model. Also, it clarifies the importance of narrative BRC in B2B marketing practices.

Sexual Behaviors and HIV/STI Prevention Strategies Among Sexual Minority Men in Ecuador Who Use Geosocial Networking Apps

Around the world, geosocial networking apps have become widely popular among sexual minority men (SMM). This research analyzed the sexual behaviors and HIV and STI prevention strategies (HIV/STI testing, HIV/STI inquiry, and HIV/STI disclosure) of an online-recruited sample of 284 SMM living in Ecuador. Sexting and oral sex were the most common sexual behaviors among SMM in the sample. Most participants had low perceptions of HIV and STI risk; 85% reported being tested for HIV and 70% for STIs. Being older predicted higher odds of being tested for either HIV or STIs at least once. Being single also predicted HIV testing. Future interventions in the country should explore apps’ utility as intervention tools to spread information about sexual health and HIV prevention strategies, such as condom use and event-driven PrEP. Apps can also facilitate connections to sexual health services, including programs for PrEP initiation and linkage to HIV treatment. They should also focus on promoting sexual harm reduction conversations among potential app-met sexual partners.

Effect of perceived HIV risk on initiation of antiretroviral therapy during the universal test and treat era in South Africa

BackgroundSouth Africa has not achieved the 90–90–90 goals, in part due to low rates of antiretroviral therapy (ART) initiation among those aware of their HIV status. Perceived risk of HIV at the time of testing may affect likelihood of rapid ART initiation. The purpose of this study was to evaluate factors associated with perceived risk of HIV and the relationship between perceived HIV risk and rapid ART initiation during the universal test and treat era which was adapted in October 2016.MethodsWe conducted a prospective study of adults undergoing HIV testing from October 2016–February 2019 at Ithembalabantu Clinic in Durban. Eligible participants reported not previously being diagnosed with HIV. Before HIV testing, participants were asked to assess their perceived HIV risk on a four-level scale. We categorized “definitely not” and “probably not going to acquire HIV” as a low perceived risk, and “probably will” and “definitely will become HIV-infected” as a high perceived risk of HIV infection. Participants were followed for up to 14 months following HIV testing to assess ART initiation.ResultsAmong 1519 people newly diagnosed with HIV, 55% were female and mean age was 33 years. Among those, 1382 (90.9%) had a high HIV risk perception and 137 (9.1%) reported low HIV risk perception. In the low risk group individuals were more likely to be female (58% vs 55%), unemployed (62% vs 59%), have a partner with unknown HIV status (61% vs 55%) compared to the high risk group. 83.2% of those with low HIV risk perception reported previously HIV testing compared 91.5% of those with high HIV risk perception. In the multivariate model, males were associated with a higher chances of initiating ART compared to females (adjusted hazard ratio (aHR): 1.187, CI 1.187 (1.060–1.329) and being unemployed (aHR 0.767 CI (0.650–0.905). Those with a low HIV risk perception were less likely to initiate ART 125 (91%) vs 1310 (95%) p = 0.022), and took longer to initiate on ART after HIV diagnosis (11 days’ vs 4 days, p = 0.042).ConclusionFactors associated with high HIV risk perception included being unemployed, single, and having a partner of unknown HIV status. People living with HIV (PLHIV) in South Africa who had a low self-perceived risk to HIV infection were less likely to initiate ART. Assessing self-perceived risk of HIV infection may help direct counselling and improve ART initiation to achieve universal 90–90–90 goal.