When knowledge does not equal behavior (the spread of HIV)

Knowing something isn't always enough to change (or even influence) behavior. A study by Dinkelman makes the difference between knowledge and behavior all too clear.

In many parts of the world, the spread of the HIV epidemic is still fueled by ignorance. Yet, in other parts of the world, HIV is still spreading despite knowledge. With this in mind, Dinkelman et al. examined the difference between knowledge of HIV/AIDS and its prevention. They found that knowledge was not enough: 91% of men said they knew that the use of a condom could help to prevent the spread of HIV/AIDS, yet only 70% of them used a condom. The numbers for women were even more frightening: 92% knew they should use one but only 63% used them. Overall, these findings suggest that public health information campaigns that are successful at reaching the masses may alone not be successful in combating the disease. (Of course other factors like availability, alcohol, drug use, etc. also influence the gap between knowing and doing. )

Abstract: The spread of the HIV/AIDS epidemic is still fueled by ignorance in many parts of the world. Filling in knowledge gaps, particularly between men and women, is considered key to preventing future infections and to reducing female vulnerabilities to the disease. However, such knowledge is arguably only a necessary condition for targeting these objectives. In this paper, we describe the extent to which HIV/AIDS knowledge is correlated with less risky sexual behavior. We ask: even when there are no substantial knowledge gaps between men and women, do we still observe sex-specific differentials in sexual behavior that would increase vulnerability to infection? We use data from two recent household surveys in Botswana to address this question. We show that even when men and women have very similar types of knowledge, they have different probabilities of reporting safe sex. Our findings are consistent with the existence of non-informational barriers to behavioral change, some of which appear to be sex-specific. The descriptive exercise in this paper suggests that it may be overly optimistic to hope for reductions in risky behavior through the channel of HIV-information provision alone.