The knowledge, attitudes, beliefs and reported sexual behaviour relating to HIV/Aids amongst adolescents in a general practice population in Port Elizabeth

Volkwyn, Sean (2010-03)

Thesis (MFamMed)--Stellenbosch University, 2010.


ENGLISH SUMMARY : Background: HIV /Aids is a global epidemic which has caused tremendous human suffering around the world. Young people are especially vulnerable to HIV, due to the period of adolescence being one of experimentation and risk-taking. With South Africa having one of the most severe HIV/Aids epidemics in the world, it is crucial that the family physician is familiar with the local drivers of the epidemic and health needs of their practice population, and be able to initiate or support appropriate community based interventions designed to either prevent the spread of HIV, offer care or support treatment. Objectives: This study aimed to assess the knowledge, attitudes, beliefs and reported sexual behaviour amongst adolescents in a general practice population in Port Elizabeth. A better understanding of the drivers of the epidemic in this setting should inform the development of a general practice based HIV/Aids intervention. Methods: A descriptive cross- sectional study of grade 11 adolescents at 2 schools in an urban general practice catchment area in Port Elizabeth was conducted. Both quantitative (questionnaire) and qualitative (focus group interviews [FGI]) research techniques were utilised in order to triangulate the results. One hundred and thirty nine adolescents (52 males and 85 females) completed a confidential, self-administered questionnaire. Two focus group interviews were held with 22 volunteers from the original sample that had completed the questionnaire. Results: Knowledge levels about HIV/Aids were found to be moderately high, although gaps in their knowledge and a few misconceptions were noted. Sexual knowledge was low, as only 17% thought that oral sex was really sex, and 33% that anal sex was really sex. The majority of the adolescents exhibited a mostly positive attitude towards people who were living with HIV/Aids. Some, however, were uncertain, and displayed contradictory attitudes. Almost half (49%) of the participants indicated that they were sexually active. Fourty percent of the sample had been sexually active in the last year. The median age of first sexual debut was 16. Of those who were sexually active 32% had 1 partner, 10% had 2 partners and 7% had 3 partners. The use of condoms received much negative attitude from participants in the FGI’s, with many reasons being given for not using condoms. Of those who were sexually active, 69.7% reported that they always used condoms, 35.7% that they used condoms sometimes, while 12.5% reported that they never used condoms during sex in the last year. It was found that alcohol and drug use and ‘sugar –daddyism’ were high risk activities which contributed to risky sexual behaviour. A number of key factors which influenced adolescents’ sexual decision-making emerged as physical appearance, reputation, whether or not someone uses drugs, peer pressure when making decisions about whether or not to have sex with a prospective partner. The preferred sources for HIV/Aids information by the participants were health care workers (45%), trained peer educators (41%) and parents (21%).It was also evident from the study that peers (81%) were the group that adolescents confided in the most about sex., followed by parents/guardians (53%). Participants in the FGI’s were unanimous in recommending that HIV/Aids education should be presented in ‘fun’ ways in order to bring the message across. Conclusion: The study has provided some insight into the knowledge, attitudes, beliefs and practices of adolescents in an urban general practice area. It highlighted the factors which may contribute to the spread of HIV/Aids among adolescents. Although the level of knowledge regarding HIV/Aids was moderate, this did not translate into safer behaviour and practices, or improved attitudes towards people affected by HIV/Aids. Gaps in their knowledge need to be filled and misconceptions corrected. The results of this study could be used to make recommendations to the departments of education and health, and other non-governmental organizations to develop a programme which is focused on the needs of similar adolescents in the broader community. Recommendations are based on the principles of family medicine and the physician as an advocate for school-based health promotion.

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