Background: The AIDS epidemic has profoundly affected public health policy and everyday choices of individuals. Understanding the self-protective strategies adopted by the general population is crucial to designing appropriate and more effective primary AIDS prevention strategies.
Methods: A probability sample of the U.S. adult population in 1992, the National Health and Social Life Survey (n = 3,159), addressed detailed aspects of sexual behavior. How respondents changed their sexual behavior due to AIDS was recorded verbatim and categorized for analysis.
Results: Twenty-nine percent of U.S. adults reported some sexual behavior change, primarily, reducing numbers of partners (12%), using condoms more frequently (9%), selecting partners more carefully (7%), changing attitude toward sex (4%), and abstinence (3%). Individuals most at risk show the greatest propensity to change although the actual risk-reduction strategies and the meanings assigned to those strategies vary considerably. Strategies are not all compatible with each other nor equally likely to be adopted by individuals with different lifestyles.
Conclusions: Self-protective strategies to avoid AIDS are widespread, but primary prevention efforts should be targeted to particular circumstances and the self-protective propensities of each individual.