RISKY BUSINESS: AN EXAMINATION OF THE RELATIONSHIP BETWEEN MESSAGE FRAME, RISK PERCEPTIONS AND INTENTIONS TO SEEK HIV-ANTIBODY TESTING
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In 2006, over half of HIV-infected adolescents were unaware of their status (CDC, 2006) which raises the possibility that increases in HIV testing could reduce HIV transmission. There are multiple ways to construct a message promoting HIV testing. The way in which a message is framed has implications for its persuasiveness. The discussion around gain/loss framing has centered on whether framing effects are consistent and systematic with little empirical investigation of the mechanisms of framing effects. Applying prospect theory (Kahneman & Tversky, 1981) in the context of health communication research, researchers argue that gain framed messages should be more effective for prevention behaviors while loss frames should be more effective for detection behaviors (Rothman & Salovey, 1997). Evidence in support of this taxonomy has been mixed. This dissertation examines whether the effects of message framing on intentions to be tested for HIV-antibodies is moderated by perceived risk of a positive test result and potential mechanisms of effect. This experiment utilizes a single factor (frame: gain/loss) between subjects design, with a separate HIV test promotion control group and a no message control group. Stimulus messages utilize an exemplar of the story of a young Black woman who describes how she discovered her HIV+ status. Consequently, this study also includes an examination of exemplification effects. The sample (N=1052) was recruited through Survey Sampling International and included 51% Black women (49% White). Average age was 22 (SD =2.22). It was hypothesized that perceived risk moderates framing effects such that among women with high perceived risk, loss framed messages would be more persuasive with no differences in frame effectiveness among women with low perceived risk. Results demonstrate that the HIV test promotion messages were more effective than no message but there were no other main effects for condition. Perceived risk moderates the framing effects, not in the hypothesized directions but in ways consistent with Rothman and Salovey (1997). Framing effects were mediated through message elaboration, which was partially mediated through attitudes and normative perceptions. Exemplification effects were evident but not mediated through homophily. Limitations and implications for theory and practice are discussed.