AIDS-related knowledge and behavior among married Kenyan men: a behavioral paradox?

The heterosexual character of HIV/AIDS transmission in sub-Saharan Africa, a context where men are dominant in sexual and reproductive matters, underscores the importance of assessing male behavior in sexual and related health arenas. Despite condom use being the recommended and expected behavioral response to knowledge about the fatal outcome of HIV/AIDS infection, use continues to be extremely low in sub-Saharan Africa. This article explores the relationship between various facets of knowledge about HIV/AIDS and condom use among married Kenyan men. The main finding is one of a significant interaction effect of the recognition that it is impossible to visually identify infected parties and one's perception of self-risk. Although neither is in itself significant, simultaneously recognizing that healthy-looking persons may be infected and perceiving that one is himself not at risk significantly reduces condom use among men. This finding--of an interaction effect--plausibly explains why a perception of self-risk, on its own, does not necessarily translate into safe behavior. After all, those who believe they can identify infected persons may think they are at low risk because they avoid contact with the infected and, in selecting partners they deem free of infection, they may be less inclined to use condoms. This finding has implications for how specific aspects of AIDS-related knowledge are imparted to communities and individuals as well as for our understanding of other health-related behaviors.