Adolescent AIDS Knowledge Scale

Abstract

The Adolescent AIDS Knowledge Scale (AAKS) is a seminal psychometric instrument developed by Dr. Gregory D. Zimet and colleagues to assess adolescents’ objective understanding of the transmission, prevention, clinical course, and epidemiology of Acquired Immunodeficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV). Designed amidst the public health crisis of the late 1980s, the AAKS directly addresses critical methodological shortcomings in contemporaneous health assessment inventories, most notably the conflation of factual awareness with subjective personal beliefs. The instrument contains 22 dichotomously scored items derived from the benchmark 1988 United States Government brochure distributed to every household by the Centers for Disease Control (CDC), entitled Understanding AIDS. To isolate cognitive recognition of medical and epidemiological consensus from personal denial or skepticism, each item is framed with the epistemic prompt: “Do most experts say…?” Respondents select among three options: “Yes,” “No,” or “Don’t Know.” Correct answers receive 1 point, while incorrect answers and “Don’t Know” responses receive 0 points, yielding a total score between 0 and 22. Because health knowledge spans functionally diverse biological and behavioral domains rather than a single homogeneous psychological trait, standard internal consistency indices such as Cronbach’s alpha or the Kuder-Richardson Formula 20 (KR-20) are psychometrically inappropriate; instead, the instrument demonstrates robust reliability using a content-matched Spearman-Brown split-half coefficient of .82 in a sample of 721 secondary school students. Construct and convergent validity are documented by statistically significant linear increases in knowledge across grade levels ($F(5, 611) = 8.8, p < .0001$), significant inverse correlations with inaccurate AIDS beliefs ($r = -.65, p < .001$), and significant inverse associations with social anxiety regarding interpersonal contact with persons living with AIDS ($r = -.28, p < .001$). This article provides a comprehensive psychometric review of the AAKS, encompassing its theoretical foundations, structural characteristics, scoring architecture, and continued relevance for adolescent public health assessment.

Keywords

Adolescent AIDS Knowledge Scale, AAKS, HIV/AIDS knowledge measurement, adolescent sexual health, Gregory D. Zimet, psychometrics, health belief model, HIV transmission myths, health education assessment, split-half reliability, stigma reduction, pediatric psychology.

Authors

The Adolescent AIDS Knowledge Scale was developed by Gregory D. Zimet, Ph.D., in collaboration with an interdisciplinary team of pediatricians, public health specialists, and behavioral scientists. At the time of scale development, Dr. Zimet was affiliated with the Department of Pediatrics at Case Western Reserve University School of Medicine and Cleveland Metropolitan General Hospital, and subsequently established his long-term academic laboratory at the Indiana University School of Medicine, Section of Adolescent Medicine (Indianapolis, Indiana, United States). Co-investigators on the foundational clinical validation studies included:

• T. Michael Anglin, M.D. — Department of Pediatrics, Case Western Reserve University School of Medicine; Rainbow Babies and Children’s Hospital, Cleveland, Ohio.
• Rina Lazebnik, M.D. — Department of Pediatrics, Case Western Reserve University School of Medicine; Cleveland Metropolitan General Hospital.
• Donna L. Bunch, M.A. — Behavioral Health Division, Cleveland Metropolitan General Hospital.
• P. Williams, R.N., M.S.N. — Adolescent Health Clinical Nurse Specialist, Department of Pediatrics, Cleveland Metropolitan General Hospital.
• Daniel P. Krowchuk, M.D. — Departments of Pediatrics and Dermatology, Wake Forest University School of Medicine (formerly of Case Western Reserve University).
• Ralph J. DiClemente, Ph.D. — Rollin School of Public Health, Emory University; prominent behavioral epidemiologist and scholar of adolescent HIV prevention.
• Susan A. Hillier, Ph.D. — Clinical research psychologist collaborating on pediatric and adolescent psychosocial coping mechanisms.
• E. M. Ellick, B.A. — Project coordinator and psychometric data manager, Adolescent Medicine Research Network.

Correspondence regarding the instrument may be addressed to: Gregory D. Zimet, Ph.D., Indiana University School of Medicine, Section of Adolescent Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202; E-mail: [email protected].

Purpose

The Adolescent AIDS Knowledge Scale was designed to provide a psychometrically sound, standardized, and developmentally sensitive metric for evaluating adolescents’ comprehension of HIV infection and AIDS during a period marked by pervasive misinformation, societal panic, and shifting epidemiological paradigms. During the initial decade of the HIV pandemic, public health authorities recognized that adolescents represented a subpopulation at profound biological and behavioral risk due to developmental experimentation with sexual activity and substance use, paired with cognitive vulnerabilities such as the imaginary audience and personal fable constructs characteristic of early-to-middle adolescence (Elkind, 1967). Consequently, accurate monitoring of adolescent awareness was paramount for guiding policy and designing preventative curricula.

Prior to the introduction of the AAKS, existing measurement protocols suffered from a profound methodological confound: they systematically blurred the distinction between cognitive knowledge (i.e., objective awareness of what scientific and public health authorities state regarding disease mechanisms) and affective or evaluative beliefs (i.e., personal acceptance or internal endorsement of those scientific claims). Dr. Zimet and colleagues posited that an adolescent might possess complete awareness of scientific consensus regarding HIV transmission (e.g., recognizing that scientists state that HIV cannot be transmitted via casual contact such as sharing a drinking glass) while simultaneously harboring intense personal doubts, skepticism, or irrational anxiety driven by peer rumors or sensationalized media coverage. When an instrument fails to decouple knowledge from belief, researchers cannot discern whether a suboptimal score indicates an informational deficit requiring didactic instruction, or an entrenched cognitive bias requiring behavioral counseling and affective restructuring.

To eliminate this epistemic ambiguity, the AAKS established a distinct questioning format. Every item in the 22-item inventory opens with the stem: “Do most experts say…?” By anchoring the prompt to the perspective of scientific authorities, the scale explicitly measures the respondent’s factual retention of public health education rather than their idiosyncratic trust in that education. A parallel instrument, the AIDS Beliefs Scale, was engineered alongside the AAKS to measure personal endorsement using direct first-person statements (e.g., “Do you believe you can get AIDS from…?”), enabling empirical investigations into the divergence between knowing the facts and personally believing them.

The AAKS serves multiple clinical, pedagogical, and scientific applications:

• Educational Program Evaluation: Serving as a pre-test and post-test assessment to gauge the efficacy of school-based sexual health curricula, federal informational campaigns (such as the historic CDC 1988 mailer), and community-based interventions.
• Diagnostic Screening in Adolescent Medicine: Providing pediatricians, adolescent health specialists, and clinical psychologists with a rapid, 5-minute diagnostic instrument to identify persistent urban legends, irrational fears of casual contact, or perilous misunderstandings regarding sexual risk reduction.
• Behavioral Health Research: Facilitating structural equation modeling and regression analyses that clarify how information interacts with motivation, perceived vulnerability, and behavioral skills to predict actual barrier contraception utilization and avoidance of needle-sharing practices.

Psychological Construct

The psychological construct evaluated by the AAKS is objective health literacy and declarative epidemiological knowledge regarding HIV/AIDS. Within classical psychometric theory and cognitive educational measurement, declarative knowledge reflects the accurate storage, organization, and retrieval of factual propositions concerning a specific domain. The AAKS conceptualizes this domain as a multi-component cognitive structure comprising several distinct yet interrelated clinical and behavioral facets:

1. True Modes of Transmission (High-Risk Biological Vectors)

This core component measures the adolescent’s recognition of verified physiological pathways through which HIV is introduced into the bloodstream or mucosal surfaces. The scale appraises understanding across parenteral, perinatal, and sexual modes:

• Parenteral Transmission: Understanding that needle-sharing among injection drug users presents a potent vector for viral inoculation (Item 2).
• Perinatal Transmission: Awareness of vertical transmission from an infected mother to her fetus during gestation, labor, or delivery (Item 8).
• Sexual Transmission: Comprehension that sexual intercourse conveys significant transmission risk across heterosexual partnerships (Item 6: male-to-female; Item 10: female-to-male) and homosexual partnerships (Item 7: male-to-male).

2. Casual and Non-Transmission Misconceptions (Myths and Low-Risk Vectors)

A critical psychometric contribution of the AAKS is its exhaustive sampling of persistent myths regarding non-vectorial casual contact. Misconceptions regarding casual contact are major drivers of societal stigmatization, irrational anxiety, and counterproductive social avoidance. The scale evaluates adolescents’ awareness that scientific experts reject casual transmission pathways, including:

• Salivary and oral contact via mouth kissing (Item 1).
• Fomite and surface contact via shared drinking glasses (Item 4) or public toilet seats (Item 5).
• Casual skin-to-skin touch such as shaking hands with an infected person (Item 9).
• Solitary autoerotic behaviors such as masturbation (Item 11).
• Altruistic medical participation, specifically the myth that one can contract HIV by donating blood (Item 3).
• Iatrogenic transmission through blood transfusions under contemporary screening protocols (Item 13).

3. Behavioral Risk Multipliers and Protective Interventions

This dimension assesses whether respondents comprehend behavioral risk stratification and protective prophylactic mechanisms:

• Effective Prophylaxis: Recognition of the efficacy of latex barrier methods (condoms) in curtailing transmission probability during intercourse (Item 12).
• Ineffective “Magic Bullets”: Disconfirmation of erroneous lay beliefs that general dietary optimization or holistic nutrition acts as an immunological shield against viral acquisition (Item 15).
• Epidemiological Risk Elevation: Comprehension that sex with multiple partners (Item 16), commercial sex work/prostitution (Item 14), or sexual contact with injection drug users (Item 22) exponentially magnifies exposure risk.

4. Clinical Course, Virology, and Natural History of Disease

The final conceptual domain measures comprehension of the biological latency, visual imperceptibility, and clinical trajectory of HIV/AIDS:

• Asymptomatic Transmission and Latency: Understanding that individuals infected with HIV can remain entirely asymptomatic for years while still actively harboring the virus and transmitting it to sexual or needle-sharing partners (Items 20 and 21).
• Lack of Pathognomonic Physical Features: Recognition that visual inspection cannot reveal HIV serostatus, directly challenging the adolescent heuristic of judging risk based on a partner’s “clean” or healthy appearance (Item 17).
• Therapeutic Realities and Prognosis: Declarative awareness that, during the instrument’s inception period, AIDS remained universally fatal without a curative medical intervention (Items 18 and 19).

Theoretical Framework

The architecture of the AAKS is grounded in several prominent health behavior theories and cognitive developmental models, each positing that accurate cognitive mapping is an indispensable prerequisite for adaptive health behaviors.

The Information-Motivation-Behavioral Skills (IMB) Model

Developed by Fisher and Fisher (1992), the IMB model asserts that HIV risk-reduction behavior is a direct function of three interrelated components: factual information, personal and social motivation to act, and behavioral skills necessary to execute preventative actions. Within the IMB framework, information constitutes the fundamental foundation. However, the model dictates that information must be directly relevant to prevention. The AAKS operationalizes this conceptual tenet by discarding arcane biomedical trivia (e.g., CD4 glycoprotein morphology) in favor of functional behavioral intelligence: how the virus is contracted, how it is avoided, and how to identify high-risk versus zero-risk situations.

The Health Belief Model (HBM)

Originally formulated by Rosenstock and colleagues (Rosenstock et al., 1988), the Health Belief Model posits that individuals engage in preventative health actions (such as condom procurement and use) only if they perceive themselves to be susceptible to the condition (perceived susceptibility), evaluate the condition as severe (perceived severity), and recognize that the benefits of preventative action outweigh the associated psychological or behavioral barriers (perceived benefits and barriers). The AAKS maps onto the HBM across several key vectors:

• Perceived Susceptibility: Gauged by items demonstrating that heterosexual partnerships, partner volume, and asymptomatic viral carriage create legitimate individual vulnerability, disconfirming the myth that HIV is restricted to isolated demographic outgroups.
• Perceived Severity: Highlighted by items addressing the terminal nature of the illness and the absence of a pharmacological cure (Items 18 and 19).
• Perceived Barriers and Misguided Actions: By dispelling misconceptions (e.g., that healthy food prevents infection, or that toilet seats transmit the virus), the scale removes irrational barriers and directs cognitive resources toward empirically validated prophylactic behaviors (condoms).

Piagetian Cognitive Development and Adolescent Egocentrism

From a developmental perspective, the transition between late childhood, early adolescence, and late adolescence involves moving from concrete operational thinking to formal operational thought (Piaget, 1972). Concrete thinkers struggle with probabilistic causality, asymptomatic disease states, and microscopic biological agents. They rely heavily on visual cues (“He looks healthy, so he cannot be sick”). The AAKS explicitly operationalizes concepts that require formal operational reasoning: recognizing that an asymptomatic person can be contagious (Items 20 and 21) and that outward physical appearance does not reflect viral infection (Item 17). The documented developmental gradient across grade levels confirms that mastering these items reflects the maturation of deductive logical frameworks.

Validity

Extensive psychometric investigations have established the content, construct, convergent, and discriminant validity of the Adolescent AIDS Knowledge Scale.

Content and Face Validity

Content validity was established by utilizing the historic 1988 United States Government brochure, Understanding AIDS, prepared by the Centers for Disease Control under the direction of Surgeon General C. Everett Koop. This publication represented the authoritative, consensus-driven public health summary of HIV science. Zimet and colleagues (1989) systematically derived the 22 scale items to sample every substantive educational domain contained within the brochure: transmission modalities, high-risk practices, asymptomatic infection, lack of cure, mortality, and non-transmission vectors. Expert panels of adolescent medicine physicians, clinical nurse specialists, and pediatric psychologists reviewed the items to ensure linguistic appropriateness for secondary school reading levels, establishing exceptional face and content validity.

Construct Validity: Developmental Progression

Construct validity dictates that if an instrument measures cognitive health literacy, test performance should systematically track the cognitive and educational advancement of students. In a validation cohort of 617 students spanning grades 7 through 12, Zimet, DiClemente, et al. (1993) conducted an analysis of variance (ANOVA) evaluating AAKS performance across grade levels. The data revealed a robust, statistically significant linear increase in overall knowledge scores from junior high through senior high school:

$$F(5, 611) = 8.8, \quad p < .0001$$

Older adolescents demonstrated significantly fewer casual transmission misconceptions and superior comprehension of asymptomatic transmission compared to younger students, providing strong empirical support for the construct validity of the developmental gradient captured by the scale.

Convergent Validity: Negative Correlation with Inaccurate Beliefs

To establish convergent validity, Zimet et al. (1991) examined the association between the AAKS and the parallel AIDS Beliefs Scale in a diverse sample of 438 junior and senior high school students. The AIDS Beliefs Scale assessed the degree to which adolescents personally endorsed myths and misinformation regarding HIV. Theoretically, accurate knowledge of expert consensus should strongly and inversely covary with personal endorsement of inaccurate beliefs. Bivariate correlation analysis confirmed this hypothesis:

$$r = -.65, \quad p < .001$$

This high negative correlation demonstrates that adolescents with high scores on the AAKS were significantly less likely to hold unscientific beliefs about AIDS, demonstrating substantial convergent construct validity.

Criterion and Discriminant Validity: Stigma and Affective Anxiety

A central tenet of health psychology is that irrational fear, anxiety, and social stigmatization toward afflicted populations are fueled by informational voids and misconceptions regarding casual contagion. Zimet et al. (1991) evaluated whether AAKS knowledge scores predicted affective anxiety regarding hypothetical or real interactions with Persons Living with AIDS (PWAs). Among the 438 secondary school students, AAKS scores were significantly and inversely correlated with social anxiety toward PWAs:

$$r = -.28, \quad p < .001$$

Adolescents who understood that casual contact does not transmit the virus reported significantly lower avoidance and anxiety regarding interpersonal proximity to PWAs. Furthermore, in longitudinal evaluations following major public events (such as the November 1991 public disclosure of HIV infection by NBA basketball star Earvin “Magic” Johnson), the AAKS successfully captured significant attitudinal shifts and increased knowledge acquisition across adolescent cohorts (Zimet, Lazebnik, et al., 1993).

Reliability

Evaluating the reliability of a comprehensive health knowledge inventory presents unique psychometric challenges that differ from measuring unidimensional affective constructs (e.g., self-esteem or depressive symptomatology). As highlighted by Anne Anastasi (1982) and extensively detailed by Zimet (1992b), knowledge scales sample a broad array of heterogeneous factual topics rather than a single latent psychological state.

Inappropriateness of Cronbach’s Alpha and KR-20

Conventional measures of internal consistency, such as Cronbach’s alpha and the Kuder-Richardson Formula 20 (KR-20), are grounded in classical test theory assumptions that all scale items represent parallel indicators of a single common factor. In a knowledge test spanning disparate biological mechanisms, an adolescent might possess clear knowledge that condoms prevent transmission (Item 12) while harboring the false belief that blood donation causes infection (Item 3), or knowing about needle transmission (Item 2) while being ignorant of perinatal transmission (Item 8). Because mastery of one factual domain does not depend entirely on mastery of another, item intercorrelations fluctuate widely. Applying Cronbach’s alpha or KR-20 to broad-range knowledge batteries artificially penalizes the scale for broad content coverage, resulting in deflated, misleading reliability coefficients.

The Content-Matched Spearman-Brown Split-Half Method

To overcome this psychometric hurdle, Zimet (1992b) implemented a specialized, content-matched Spearman-Brown split-half reliability technique. Rather than randomly bisecting the scale (which could place all casual transmission items in one half and all sexual items in the other, attenuating the split-half correlation), the items were paired into two balanced 11-item sub-batteries matched on specific topical content:

• Half A and Half B each contained comparable numbers of items addressing needle use, sexual transmission, casual contact myths, asymptomatic latency, and prophylactic measures.
• Because the scale was not originally designed with an even number of duplicate items for every single topic (e.g., only Item 18 evaluated mortality), exact one-to-one conceptual matching was approximate for isolated items.

When evaluated in a large developmental cohort of 721 junior and senior high school students, this matched-item Spearman-Brown split-half calculation yielded a reliability coefficient of:

$$r_{sb} = .82$$

A coefficient of .82 denotes robust internal reliability, confirming that the scale provides stable, reproducible measurement across its comprehensive educational spectrum.

Factor Analysis

The structural dimensionality of the Adolescent AIDS Knowledge Scale has been examined through both classical exploratory factor analysis (EFA) and modern educational measurement perspectives.

Exploratory Factor Analysis Findings

Early psychometric evaluations involving exploratory factor analyses with varimax and oblimin rotations typically reveal a multi-factor structural solution rather than a single general factor. Across secondary school samples, EFA extractions (eigenvalues > 1.0) consistently delineate three to four primary empirical factors that align with the theoretical subdivisions of the CDC educational curriculum:

• Factor 1: Casual Transmission Myths / Non-Risk Vectors: Capturing high item loadings (> .55) from Items 1 (kissing), 3 (giving blood), 4 (sharing a water glass), 5 (toilet seats), 9 (handshakes), and 11 (masturbation). This factor accounts for the largest proportion of common variance, reflecting the prominent cognitive distinction adolescents make between true vectors and social contact.
• Factor 2: High-Risk Interpersonal and Parenteral Transmission: Characterized by robust loadings from Items 2 (sharing needles), 6 (heterosexual male-to-female), 7 (homosexual male-to-male), 8 (perinatal transmission), 10 (heterosexual female-to-male), and 22 (sex with injection drug users).
• Factor 3: Virology and Clinical Asymptomatology: Anchored by strong loadings from Items 20 (asymptomatic carrier status), 21 (asymptomatic transmission capacity), and 17 (absence of visible physical signs of infection).
• Factor 4: Prognosis and Medical Interventions: Loaded predominantly by Items 12 (condom efficacy), 15 (inefficacy of nutrition), 18 (fatality/mortality), and 19 (absence of cure).

Psychometric Considerations Regarding Factorial Purity

Psychometricians emphasize that factor analysis of dichotomous educational items often introduces structural artifacts known as “difficulty factors” (Lord & Novick, 1968). When items exhibit high skewness (e.g., nearly 95% of adolescents correctly recognize needle transmission, whereas only 50% understand the safety of donating blood), linear Pearson correlation matrices produce spurious multidimensionality. When evaluated under Item Response Theory (IRT) paradigms or two-parameter logistic (2PL) models, the AAKS behaves as an essentially unidimensional composite index of Overall AIDS Literacy, supporting the clinical and research practice of utilizing the summed total score (0 to 22) as the primary index of adolescent knowledge.

Instrument / Measurement Tool

The operational specifications of the AAKS are summarized below:

• Instrument Name: Adolescent AIDS Knowledge Scale (AAKS)
• Primary Author: Gregory D. Zimet, Ph.D.
• Target Population: Adolescents and young adults (specifically validated in grades 7 through 12, ages 12 to 19 years).
• Administration Format: Self-administered paper-and-pencil questionnaire or digital survey format.
• Completion Time: Rapid administration, typically requiring less than 5 minutes.
• Total Number of Items: 22 questions.
• Item Prompt Stem: “Do most experts say…?”
• Response Scale: Trichotomous categorical options: “Yes,” “No,” or “Don’t Know.”
• Scoring Protocol:
  • Each correct response is assigned 1 point.
  • Each incorrect response is assigned 0 points.
  • Each “Don’t Know” response is scored as 0 points (treated as an informational deficit, preventing inflated scores from forced guessing).
• Scoring Key:
  • Correct Response is “NO” (10 Items): Items 1, 3, 4, 5, 9, 11, 13, 15, 17, and 19.
  • Correct Response is “YES” (12 Items): Items 2, 6, 7, 8, 10, 12, 14, 16, 18, 20, 21, and 22.
• Total Score Range: 0 to 22 points. Higher cumulative scores indicate greater declarative knowledge of expert scientific consensus and fewer epidemiological misconceptions.

Permissions, Fee, and Test Year

The Adolescent AIDS Knowledge Scale was first introduced in clinical investigations published in 1989 (Zimet et al., 1989), with comprehensive psychometric reliability and structural properties documented in 1992 (Zimet, 1992b). The scale was developed under institutional academic sponsorship and federal research initiatives aimed at curbing the adolescent HIV epidemic.

The AAKS is considered an open-access, non-commercial psychological assessment tool for academic, scientific, clinical, and non-profit educational evaluation. No licensing fees or royalties are required to administer the instrument in educational or clinical research settings. Investigators utilizing the AAKS in empirical investigations are expected to maintain the integrity of item phrasing and provide formal scholarly attribution to Dr. Gregory D. Zimet and colleagues. Inquiries regarding scale permissions, adaptations, or parallel belief batteries may be directed to:

Gregory D. Zimet, Ph.D.
Indiana University School of Medicine
Section of Adolescent Medicine
410 West 10th Street, HS 1001
Indianapolis, IN 46202, USA
E-mail: [email protected]

References

• Anastasi, A. (1982). Psychological testing (5th ed.). Macmillan Publishing Company.
• Centers for Disease Control. (1988). Understanding AIDS: An information brochure being mailed to all U.S. households. Morbidity and Mortality Weekly Report, 37(17), 261–269. https://www.cdc.gov/mmwr/preview/mmwrhtml/00000030.htm
• Elkind, D. (1967). Egocentrism in adolescence. Child Development, 38(4), 1025–1034. https://doi.org/10.2307/1127100
• Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS-risk behavior. Psychological Bulletin, 111(3), 455–474. https://doi.org/10.1037/0033-2909.111.3.455
• Lord, F. M., & Novick, M. R. (1968). Statistical theories of mental test scores. Addison-Wesley.
• Piaget, J. (1972). Intellectual evolution from adolescence to adulthood. Human Development, 15(1), 1–12. https://doi.org/10.1159/000271225
• Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the Health Belief Model. Health Education Quarterly, 15(2), 175–183. https://doi.org/10.1177/109019818801500203
• Zimet, G. D. (1992a). Attitudes of teenagers who know someone with AIDS. Psychological Reports, 70(3_suppl), 1169–1170. https://doi.org/10.2466/pr0.1992.70.3c.1169
• Zimet, G. D. (1992b). Reliability of AIDS knowledge scales: Conceptual issues. AIDS Education and Prevention, 4(4), 338–344. https://pubmed.ncbi.nlm.nih.gov/1472491/
• Zimet, G. D., Anglin, T. M., Lazebnik, R., Bunch, D. L., Williams, P., & Krowchuk, D. P. (1989). Adolescents’ knowledge and beliefs about AIDS: Did the government brochure help? American Journal of Diseases of Children, 143(4), 518–519. https://doi.org/10.1001/archpedi.1989.02150160016008
• Zimet, G. D., Bunch, D. L., Anglin, T. M., Lazebnik, R., Williams, P., & Krowchuk, D. P. (1992). Relationship of AIDS-related attitudes to sexual behavior changes in adolescents. Journal of Adolescent Health, 13(6), 493–498. https://doi.org/10.1016/1054-139X(92)90013-Z
• Zimet, G. D., DiClemente, R. J., Lazebnik, R., Anglin, T. M., Ellick, E. M., & Williams, P. (1993). Changes in adolescents’ knowledge and attitudes about AIDS over the course of the AIDS epidemic. Journal of Adolescent Health, 14(2), 85–90. https://doi.org/10.1016/1054-139X(93)90226-U
• Zimet, G. D., Hillier, S. A., Anglin, T. M., Ellick, E. M., Krowchuk, D. P., & Williams, P. (1991). Knowing someone with AIDS: The impact on adolescents. Journal of Pediatric Psychology, 16(3), 287–294. https://doi.org/10.1093/jpepsy/16.3.287
• Zimet, G. D., Lazebnik, R., DiClemente, R. J., Anglin, T. M., Williams, P., & Ellick, E. M. (1993). The relationship of Magic Johnson’s announcement of HIV infection to the AIDS attitudes of junior high school students. The Journal of Sex Research, 30(2), 129–134. https://doi.org/10.1080/00224499309551694

Items of the Scale