Dear editor,
We read with interest the article by Perkins et al. (1) titled “Is knowledge enough? Considering HIV/AIDS risk taking behavior and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) knowledge with African-American women” which recently has been published in your prestige journal. The authors have presented a simple, yet fascinating study on the determinant of behavioral change regarding HIV/AIDS. While we wish to address minor issues, we would like to provide additional evidence confirming the conclusion made by authors. First, as stated by Levine, “research results are no more valid than the data gathering tool” (2). The study investigated knowledge and risk-taking behaviors regarding HIV/AIDS among African-American women, using two measurement tools, the validity indexes of which were not reported by authors completely. Just reporting reliability provides no information on the validity of the scale. Furthermore, reliability is not sufficient for validity measurement and does not provide a guarantee of validity (2); in turn, they are two distinct psychometric properties of a tool. If they rely on. the validity and reliability reported by the earlier study, the cultural differences might inflate the validity and reliability of the questionnaire, as the population of concerns had a different background (3). This shortcoming might fluctuate the conclusion made by authors. If we neglect the validity and reliability of the questionnaire, we would want to provide additional evidence confirming the results of the study. A research by Araban (4) showed that while the knowledge of unhealthy behavior (hazards of exposure to air pollution) are enough among pregnant women in Tehran, they did not do any preventive behavior in terms of air pollution. In other words, to change unhealthy behavior, we should go beyond knowledge and include other determinants of behavior such as cultural belief, health care system, skills, and economy, as the nature of human behavior is so dynamic and complex.
