Adolescent Sexual Behavior and the HIV/AIDS Risk in the Czech Republic

Although the number of HIV-infected persons registered in the Czech Republic might appear very low, the authors caution against false optimism. They point to the risky sexual behavior of Czech youth, who, in spite of having solid knowledge about HIV/AIDS prevention, do not consistently apply it to their sexual practice. From the analysis of this paradox, based primarily on data collected in the city of Brno in 1997, the authors suggest replacing the so-far preferred rational choice theory or the Health Belief Model, as models explaining human behavior, with the more adequate theory of expected utility. While the former theories assume that individuals will make rational decisions and practice safer sex once they are better informed about HIV infection and ways to protect themselves, the latter one allows for the existence of "rationality of intimacy", which differs from the scientific "rationality of the health system". The theory maintains that, within the realm of intimate relationships, it might appear rational to practice unsafe sex if this is compensated by other benefits. In order to be able to reconcile the two rationalities and understand unsafe sexual behavior, the general context of an intimate situation must be analyzed, including the social norms and values involved, the emotional load, individual intentions and goals of the partners, and also the complex mechanisms of interaction and "power" negotiation between sexual partners.