Citation

Richens J, Imrie J, Copas A. Lancet 2000; 355(9201): 400-403.

Affiliation

Department of Sexually Transmitted Diseases, Royal Free and University College Medical School, The Mortimer Market Centre, London, UK. jrichens@gum.ucl.ac.uk

Comment In:

Lancet 2000;355(9214):1555-6.

Copyright

(Copyright © 2000, Elsevier Publishing)

DOI

10.1016/S0140-6736(99)09109-6

PMID

10665571

Abstract

This paper investigates the relation between behavior adaptation and safety benefits of seat belts and whether condom promotion can be undermined by unintended changes in sexual risk perception and behavior. The comparison between 13 countries that passed seat belt laws and 4 countries without such laws shows a significant number of deaths among countries with seat belt laws. It has been suggested that drivers who wear seat belts feel safer and drive faster and more carelessly compared to those without seat belts. A model of individual risk management, postulating that every individual is comfortable with a certain level of risk and aims to balance the rewards of risk-taking against perceived hazards was developed to describe the behavior. This increase in seat belt use was then paralleled with condom use since the rise of HIV, with 3 ways in which a large increase in condom use could fail to affect transmission: 1) it appeals to risk-averse individuals who contribute little to epidemic transmission; 2) increased use of condom increases the number of transmission caused by condom failure; and 3) the increased use of condoms reflect the change in the decision of individuals from one partner to maintaining higher rates of partners and reliance on condoms. This paper, in conclusion, emphasizes the need for program development and implementation in response to this sexual behavior, particularly among developing countries.

Language: en