Cultural values and HIV prevention intentions: integrating Hofstede's dimensions and the theory of planned behavior in Amazonian Indigenous communities.

HIV prevention remains a priority challenge in Indigenous communities, where conventional public health strategies often fall short by failing to adequately incorporate the cultural factors associated with preventive behavior. This study addresses this gap by integrating Hofstede's individual cultural dimensions with the Theory of Planned Behavior (TPB) to analyze HIV prevention intentions in Awajún and Wampis native communities of the Peruvian Amazon. Using a quantitative structural equation modeling design, the relationship between cultural values on attitudes, subjective norms, and preventive behavior intentions was examined. The results show that cultural dimensions are associated with the TPB constructs in different ways. Long-term orientation and masculinity showed positive and significant associations with attitudes toward HIV prevention, although uncertainty aversion exhibited a negative effect, and indulgence did not show a significant relationship. At the normative level, power distance and indulgence emerged as significant positive predictors of subjective norms, while collectivism did not show a direct effect. Consistent with the TPB, attitudes, subjective norms, and perceived behavioral control were significant positive predictors of the intention to prevent HIV, with perceived behavioral control showing the strongest predictive effect. These findings provide novel empirical evidence on the differential role of individual cultural values within the TPB framework and highlight the importance of considering cultural orientations and perceived capabilities when designing HIV prevention strategies in indigenous contexts.