Acquired immune deficiency syndrome and adolescents: A survey of knowledge, attitudes, beliefs, and sexual behavior among secondary school students in Swaziland, southern Africa

The continent of Africa is in jeopardy due to the devastating effect of Acquired Immune Deficiency Syndrome (AIDS). Africa continues to lead the rest of the world in the incidence and prevalence rates of the Human Immune Deficiency Syndrome (HIV) Virus infection and AIDS. Recent surveillance reports from the World Health Organization (WHO) and the United Nations AIDS Program (UNAIDS) estimate that 7 out of 10 people newly infected with HIV infection live in Sub-Saharan Africa (WHO/UNAIDS, 1998a). In the small country of Swaziland, more than 25% of adults have HIV/AIDS; 12,000 children have been orphaned, and 7,100 adults and children die each year (WHO/UNAIDS, December 2000). HIV/AIDS presents a crisis in this region because of its particular burden on the adolescent population. The behaviors the teens adopt now and how such behaviors are maintained throughout their sexual lives will certainly have an impact on the epidemic in many countries. This prompts the need for us to get a clearer understanding through research about teens behaviors and factors that puts adolescents at risk for contracting HIV infection. The importance of understanding barriers to AIDS prevention in Swaziland is hampered by the scarcity of information on adolescents' knowledge, attitudes, beliefs and skills related to HIV/AIDS prevention. Such information is essential for careful planning and implementation of health education and health promotion projects necessary for the success of HIV/AIDS prevention programs among adolescents.; The primary purpose of this descriptive study was to assess the HIV/AIDS and sexual risks behaviors among secondary school students in Swaziland, Southern Africa. A secondary purpose of the study was to obtain information from the principals of participating schools on institutional, community and cultural characteristics that may have some bearing on young people's exposure to HIV/AIDS risk factors. Eleven specific research questions were examined using quantitative data collected from 941 adolescents enrolled at four secondary schools. Inferential statistics including t-test, chi-square and F-ratios are computed where appropriate. Nine major findings are presented and discussed in this dissertation and include (a) adolescence in the African context, (b) participants' knowledge about HIV/AIDS, (c) students' misconceptions about HIV/AIDS, (d) primary and preferred sources for information on HIV/AIDS and sexual risk behavior, (e) perceived risk, vulnerability and susceptibility to HIV/AIDS, (f) students attitudes toward people with HIV/AIDS, (g) tobacco, alcohol and other drug use as risk factors for contracting HIV/AIDS, (h) sexual risk behaviors and activities that contribute to unintended pregnancy and STDS including HIV/AIDS, and, (i) social norms of risk discussion among the students with partner(s) related to HIV/AIDS. Implications for theory, research, education, practice and policy are presented.