Table 1 Key hypotheses of associations between increase in condom use and change in HIV risk perception

Among those not perceiving a risk for HIV infection at the beginning of the period between surveys:

Hypothesis 1: An increase in HIV risk perception leads to an increase in condom use

Risk perception is a motivating factor for condom use. A positive association between increased risk perception and increased condom use would support a causal role of risk perception as it is theoretically implausible that an increase in condom use causes an increase in risk perception.

Among those perceiving a risk for HIV infection at the beginning of the period between surveys:

Hypothesis 2: An increase in condom use leads to a decrease in HIV risk perception

Starting to use condoms may lead to a downward adjustment of risk perception as protective measures are implemented. This would be supported by a positive association between decreased risk perception and increased condom use as it would be implausible that a decrease in risk perception causes an increase in condom use.