Degree Name

DrPH (Doctor of Public Health)


Public Health

Date of Award


Committee Chair or Co-Chairs

Megan Quinn

Committee Members

Mary Ann Littleton, Ying Liu


Two Human Immunodeficiency Virus (HIV) outbreaks occurred almost simultaneously in the United States (US) (2014-2015) and in Cambodia (2015). Information is lacking on HIV-related knowledge, stigmatizing attitudes, and high-risk behaviors (KAB) among the general population, which may affect the transmission of HIV and lead to outbreaks. The current study aimed to: 1) assess KAB among the general population in a high-risk county in the US, 2) analyze KAB among the general population of Cambodia, and 3) compare KAB across samples from a high-risk county in Northeast Tennessee and a province in Cambodia. Tennessee data were collected in 2017 and Cambodian Demographic and Health Survey data were from 2014. Descriptive, Kruskal-Wallis, Wilcoxon, Bonferroni, and Spearman’s correlation as well as simple and multiple logistic regression analyses were conducted on individual questions and KAB variables. Among Northeast Tennessee participants, 92.6% had heard of HIV, 43.5% knew that HIV could not be transmitted by mosquitos, and 67.8% of participants had never tested for HIV. Cambodian females aged 20-29, 30-39, and ≥40 were more likely to have a high level of HIV knowledge than those aged 15-19 (Odds Ratio (OR): 1.4, 1.6, and 1.6, respectively). Cambodian males who completed secondary and higher education had significantly higher odds of having a high level of HIV knowledge (OR: 2.3 and 2.9, respectively) and lower odds of engaging in some high-risk behaviors (OR: 0.3 and 0.2, respectively) than those who had completed no level of education. Battambang participants were more likely to have a high level of HIV knowledge (OR: 4.44; 95% CI: 2.14-9.24) and less likely to have at least one stigmatizing attitude (OR: 0.47; 95% CI: 0.24-0.94) and one high-risk behavior (OR: 0.16; 95% CI: 0.08-0.33) compared to Northeast Tennessee participants. Future studies are needed to determine associations between results and policies/laws, frequency of personal contact, and other differences between the two locations. KAB can greatly impact the outcome of HIV prevalence within a community. Having a greater understanding of KAB and creating interventions based on that understanding can have a positive influence on HIV infection and related outcomes.

Document Type

Dissertation - unrestricted


Copyright by the authors.