Background: Previous research shows that perceptions of disease prevalence, particularly infectious diseases, are also related to health behaviors, but the association between perceived disease prevalence and risk perceptions is unknown. We chose to survey women who have sex with women (WSW) because they are an understudied population who are at risk for human papillomavirus (HPV). Prevalence rate of HPV infection among WSW is around 13%. We sought to test the relationship between having had an abnormal Pap smear and perceived risk for HPV. Perceived prevalence was also hypothesized as being a mediator and moderator of the relationship between abnormal Pap smear and perceived risk of HPV. Methods: Participants were approached at a gay pride festival and asked if they would like to complete a survey concerning same-sex relationships. Regression analyses, including moderation and mediation testing, were used to examine women who have and have not had an abnormal Pap smear. Results: Participants (n = 275) completed anonymous surveys. Eighty-four (27%) women had a history of abnormal Pap smears, and 16 (5%) women had been diagnosed with HPV. Women with a history of abnormal Pap smears perceived themselves at greater risk for and greater prevalence of HPV. The association between history of abnormal Pap smears and risk perceptions was mediated by perceived disease prevalence. The association between perceived disease prevalence and perceived risk was significant only among women with a history of abnormal Pap smears. Conclusions: Perceived local disease prevalence is important for understanding risk perceptions in relation to health behaviors and health outcomes. Interventions can use local disease prevalence as a means for motivating behavior change.
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