Are cognitive AIDS risk-reduction models equally applicable among high- and low-risk seekers?

Cognitively-based AIDS prevention programs using theoretical frameworks such as the AIDS risk reduction model (ARRM) may not be as effective among high-risk seekers as they are among low-risk seekers and yet, risk seekers may be engaging in more high-risk behaviors and, thus, need effective prevention programs. Latent variable structural equation models tested the ARRM’s ability to predict condom use among high- and low-risk seeking men (high risk N=330, low risk N=333). The separate models fit well. However, multiple group models contrasting high- and low-risk seekers on relationships among the constructs demonstrated a significant decrement in fit, indicating that several key relationships among the constructs differed for the two groups. Safe sex intentions predicted safer behavior in the low-risk group and Self-Efficacy predicted condom use in the high-risk group. Therefore, different ARRM constructs may be more salient and relevant for high versus low-risk seekers. Although leverage points for change may differ between high- and low-risk seekers, the explanatory power of the overall model is similar for both groups.