An 18-year follow-up of HIV knowledge, risk perception, and practices in young adults

To evaluate trends over the last 18 years in HIV-related knowledge, risk perceptions, and sexual behaviors in young adults.

Data were obtained from six KABP (knowledge, attitudes, beliefs, and practices) surveys (1992, 1994, 1998, 2001, 2004, and 2010) from representative samples of the French population. Surveys were similar in terms of data collection and target populations: 2362 men and 2774 women aged 18-29 were interviewed by telephone.

Young people were very familiar with the true routes of HIV transmission throughout the full period. However, in 2010, approximately 30% erroneously believed that mosquito bites could transmit HIV versus only 12% in 1994. They were less convinced about the efficacy of condoms in protecting against HIV: approximately 50% in 2010 versus 70-80% in 1992-1994. The proportion of respondents very afraid of AIDS significantly decreased from a maximum of 44% in 1994 to approximately 20% in 2010. Condom use at first intercourse was widespread after 1995 and sex without condoms in the previous year was far less frequently reported in 2010 than in 1992. Nevertheless, the proportion of individuals reporting condom use at their most recent intercourse in 2010 was the lowest reported since 1994, with an increase in young men reporting no contraception use from 9.2% in 2004 to 18.8% in 2010.

Young people appear to misunderstand certain sexually transmitted infection/HIV transmission mechanisms. Other indicators for 2010 reflected a low level of HIV risk perception, distrust in condom efficacy, and a decrease in adopting prevention practices, which highlights the need to adapt preventive strategies.