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University of Zambia Medical Library Socio-Behavioural Aspects: Knowledge, Attitude, Practice and Belief (KAPB) Studies
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| Percentage | AIDS is becoming a serious problem in Zambia | AIDS is highly infectious | A person who is HIV-positive has AIDS | AIDS is a new name given to a disease already present in Africa | AIDS in Africa is not the same as it is in other parts of the world | Women are more likely to suffer from AIDS than men |
|---|---|---|---|---|---|---|
| Disagree (%) | 3.3 | 16.8 | 13.0 | 35.8 | 60.0 | 70.4 |
| Don't know (%) | 3.5 | 11.9 | 11.7 | 26.1 | 23.1 | 14.9 |
| Agree (%) | 91.8 | 70.9 | 74.8 | 36.8 | 15.5 | 14.2 |
On treatment of AIDS patients, 16.8 per cent stated that they should be treated in general hospital wards, 50.6 per cent stated that special units should be set up in all major hospitals, 15.1 per cent advocated for a new special hospital, and 17 per cent stated that AIDS patients should be treated at home.
This KABP survey was conducted between October and November 1990. The aim was to determine the impact of AIDS education materials produced by the Copperbelt Health Education Project (CHEP) for learning institutions. A self administered questionnaire was used to collect data from 210 respondents, who comprised of teachers and lecturers involved in AIDS education at each institution drawn from five districts in the Copperbelt; Kitwe, Chingola, Mufulira, Chililabombwe and Luanshya. Survey findings show that 83 per cent of the respondents knew the cause of AIDS and mode of transmission. However misconceptions on the mode of transmission still exist. Having sex with a woman who had an abortion and mosquito bites were possible causes of HIV infection. Fifty five percent believed that condoms are not effective for HIV/AIDS prevention.
The aim of study was to collect qualitative data through a series of discussions with Zambian adults. The focus group discussions (FGDs) were designed to lead the flow of discussion from general health issues dealing with AIDS and HIV infection. This information provides the foundation for developing educational materials that are meaningful and persuasive for Zambian men and women. Ten FGDs were conducted, three in Lusaka, three in Kitwe and four in Kasama. A total of 93 men and women participated. Male participants ranged in age from 25 to 39 and female participants from 16 to 25 years. Participants were selected from a variety of locations including markets, bars, colleges, community centres, factories and clinics. This ensured that Zambian citizens from a mix of socio-economic classes participated in the FGDs. The FGDs showed that the participants had heard of AIDS and recognised it as a serious disease. Nevertheless, few participants regarded AIDS as the first, second, or even third most significant health problem in Zambia. Generally, participants regarded malaria, cholera, diarrhoea, tuberculosis, eye diseases, and sexually transmitted diseases as the most important health concerns for Zambians.
The outbreak of acquired immune deficiency syndrome has caused fear and anxiety to both the general public and medical and nursing personnel. The aim of the study was to assess students' knowledge on HIV/AIDS and to see what their attitudes are towards the disease. Interviews were conducted with the four sisters in charge where the students nursed the HIV/AIDS patients. An interview schedule with both open ended and closed ended questions was used. The findings revealed that although student nurses had some knowledge on AIDS, such knowledge was not comprehensive. The findings also revealed that students did not seek clarifications of their questions from nurse educators but from doctors.
The study focuses at examining students' awareness of AIDS; the role of the media in promoting students' awareness of AIDS; students' sexual life styles; students' reactions to AIDS patients and the relationship between religious beliefs and perception of AIDS. A cross-sectional sample survey was designed for this study. The target population consists of students comprising males and females in Zambia within the age range of 10 - 33 years. The study concentrates on those in grades 9 and 12, colleges and Universities. A sample size of 1,150 was determined to represent urban and rural settings. An interview schedule was used to collect data and a total of 1121 students were interviewed.Out of this group 621 (53 per cent) were males and 500 (45 per cent) were females. The characteristics of these respondents include 9 per cent being in the age-range of 10 - 15 years; 67 per cent were 16 - 21 years, 20 per cent were 22 - 27 years; while 2 per cent were 28 to 35 years of age. Four hundred and one (36 per cent) were in grade 9; 421 (38 per cent) were in grade 12; 258 (23 per cent) in college; and 38 (3.4 per cent) were university students. The majority (90.2 per cent) were single; 93 (9.3 per cent) married; 4 (0.4 per cent) were widowed; 4.4 per cent were separated and 8.7 per cent divorced. Major findings indicate the majority (92 per cent) of the respondents are aware of the existence of AIDS in Zambia although most have no personal knowledge of being affected by HIV virus or AIDS. This affirms the existence of AIDS in the country. Knowledge of people with AIDS is identified by a small sample population (26.4 per cent). The majority (61.6 per cent) indicated not seeing anyone with AIDS. This confidently shows that AIDS education and communication campaigns by the Ministry of Health, the media and other private agencies have been successful in imparting the messages to reach intended targets.
The major channel for disseminating AIDS information identified to be most effective is the mass media - newspaper (87.5 per cent), radio (85.3 per cent), books/pamphlets (74.0), television (57.6 per cent). Casual talk with friends is also effective with 63.2 per cent. Newspaper and radio have proven to be important channels of AIDS information dissemination. Despite their awareness of safer sex practices, their non-approval of extra-marital sex and negative attitudes to people with multiple sexual partners is still evident. Efforts should be intensified to reach those who are resistant to changing behaviour. In view to treatment, care, acceptance and relationships to AIDS patients, attitudes need to change. The reactions to AIDS patients are still negative. Substantial numbers of the respondents do not want to work or associate themselves with AIDS patients. The need to emphasise that AIDS patients require network support from friends, relatives and the community to be highlighted in order to psychologically make them feel that they can contribute meaningfully to society. The present isolation and stigma AIDS patients experience will do very little to ameliorate the situation.
Objectives:
To investigate the knowledge, attitudes and behaviour towards HIV infection and AIDS of a group of Zambian students. To provide baseline data in order to be able to evaluate the Kara Outreach programme amongst Zambian college students.Method:
All the students at the Natural Resources Development College (NRDC) were asked to fill in self-administered pre-tested questionnaire at the beginning of the academic year (November 1992). The questionnaire was designed to test their knowledge, attitudes and behaviour towards HIV/AIDSResults:
A total of 195 (69 per cent) questionnaires were returned. 74.5 per cent said that they had received some education in the past regarding HIV/AIDS. The majority said that this education was at school (53 per cent), while others specified the media, health centres, work places although a considerable number (30 per cent) did not specify the source of their previous education. Knowledge regarding transmission modes was moderately good with 90.1 per cent of the students knowing that HIV could be transmitted through semen, 76.8 per cent through vaginal secretions and 94.3 per cent through blood transfusion. However, there were some misconceptions regarding non-transmittable sources with 91.6 per cent saying HIV could be transmitted through hugging and kissing, 95.3 per cent through shaking hands and 77.1 per cent through masturbation. 63.5 per cent and 65.3 per cent thought that HIV could be transmitted through saliva and insect bites respectively. Only 33.3 per cent of the people knew no one with HIV. 8.7 per cent had had a relative die of HIV and 30.1 per cent had a friend or acquaintance with HIV. Attitudes towards someone with HIV were generally positive but 16.8 per cent felt that people with HIV had led immoral lives and 75.4 per cent felt that people with HIV should be isolated to stop the further spread of the disease. 38.3 per cent felt they could share a plate with an infected person; 50.3 per cent felt that people with HIV should have equal opportunities. 34.4 per cent of the students had a regular partner, 29.3 per cent with more than 1 partner. 56 per cent had ever used a condom, 16 per cent using them always with regular partners and 60 per cent with non-regular partners. 43 per cent felt that condoms should be made more easily available at NRDC and 43.1 per cent said they would use them if they were.Conclusions:
- Basic knowledge about HIV was good although the students at NRDC felt that they were not receiving enough education about HIV at the college.
- A large percentage of those questioned have contact with people with HIV and programmes should be directed at improving attitudes to those who already have HIV and reducing the stigma of HIV.
- The majority of the students were sexually active but regular condom use was low. Condom use and safer sex advice should be made more available to the students at NRDC.
Objectives:
To assess the knowledge, attitudes, understanding and awareness of AIDS in a selected rural area of Zambia. To determine the impact of public awareness campaigns in changing the attitudes, knowledge and understanding of HIV/AIDS on rural people.Methods:
The study comprised two identical interview surveys of 30 random village clusters in rural Zambia in 1988 and 1991. The surveys were separated by a period (from August 1988 to February 1991) in which several anti-AIDS campaigns were carried out. Thus, 427 individuals were interviewed in 1988 (43 per cent men, 57 per cent women), and 494 in 1991 (48 per cent men, 52 per cent women). Median age was 28 years in 1988 (mean, 31,3 years; range, 15-69 years) and 29 years in 1991 (mean, 31.9; range, 15-79 years). In 1988, at least 12 adults (>15 years) were registered per cluster, versus at least 15 in 1991. In 1988, 460 adults from 388 households were registered, versus 499 from 442 households in 1991. Each household was visited in a random order with interviews focussing on knowledge, attitudes, understanding and awareness of AIDS.Conclusions:
- The study showed that the population had changed its awareness of and attitudes to AIDS because of the introduction of anti-AIDS campaigns.
- Almost everyone was aware of the main modes of transmission (sexual intercourse, blood transfusion, mother-to-child) although there were still misconceptions about non-transmittable ways: 30-60 per cent still believing AIDS could be transmitted by mosquitoes, second hand clothes, communal use of crockery, or kissing.
- There was increased awareness that condom use could prevent HIV infection.
- There were decreased numbers of STD cases.
This was a descriptive, exploratory study aimed at evaluating the knowledge of women on HIV/AIDS and the problems that rural women encounter with the prevention and control of AIDS in Zambia. It was also aimed at exploring women's perceptions of the cultural and traditional factors affecting them during the epidemic, and the role the women felt that health workers could perform for them; as well as what they were doing to protect themselves from the virus. The research design chosen for this study is the qualitative research design. A qualitative research design was chosen because the study sought to gain an insight into the perceptions of rural women as regards HIV/AIDS, and explore the pattern of meaning and belief amongst the respondents since the most fundamental characteristic of qualitative research is its express commitment to viewing events, actions, norms, values, etc. from the perspective of the people who are being studied.The sample was taken from a population of rural women living in the Southern Province of Zambia, in Chikankata. A purposive sampling technique, (judgemental sampling) was used. Altogether, 36 women from three villages in the area, Dede, Chikankata, and Ngangula were interviewed. A descriptive survey approach was used for data collection. In this study, the determinants of the prevention and control of the virus were identified. Some of the women not only identified the cause of AIDS as people being promiscuous, whether in a monogamous or polygamous marriage, but also knew the mode of preventing the spread of the virus. They knew that prevention was through sticking to one partner and the wearing of condoms.
A number of contextual variables influencing women in the rural areas to be at risk for HIV infection were identified. These included cultural practices, such as Nkolola and Makoga, the subservient role of women and their lack of decision-making power, as well as the lack of acceptance of the men to use the condoms. For the women in the study, their knowledge of HIV did not appear to change their behaviour but did contribute to their feelings of helplessness as regards not knowing what to do when their men were promiscuous. Identified also were the various roles that health and health-related workers can do to help the rural women during the epidemic.
The women in the study identified the following:
- A need for women to be taught HIV/AIDS education.
- The issue of cultural and traditional practices which they felt are a cause of concern as regards the spread of HIV.
- The issue of women forming organisations for the dissemination of the knowledge of the virus.
- The need for men to be taught as well as women.
The provision of patient education is considered to be an important aspect of care provided by nurses and other health care professionals. Since women are the main utilisers of health services, as well as the main providers of health care, it is suggested that women should be equal participants in the development of these services, and as health care providers they should utilise these opportunities and work with the rural women in the development of the services in which issues of their greatest concern are addressed. This should lead to successful changes in behaviour.
The Zambia Demographic and Health Survey (ZDHS) was a national survey of over 7,000 women aged between 15-49, conducted in 1992. The questionnaire contained a section on AIDS awareness. Some of the results are summarised below:
- 99 per cent of women said that they had heard of the disease. This does not differ according to age group or place of residence.
- 90 per cent of women are aware that HIV is transmitted through sexual intercourse. Knowledge of AIDS is better among more educated and urban women.
- 86 per cent of women were aware of perinatal transmission of HIV.
- Less than 20 per cent of women believe that it is possible to get HIV from shaking hands.
- Many women (61 per cent) believed that mosquitoes and biting insects transmit the virus.
- 75 per cent knew that a healthy-looking person can carry HIV.
- Sources of AIDS information were friends and relatives (mentioned by 60 per cent), radio (39 per cent), health workers (35 per cent), television (10 per cent).
- Attitudes towards those with AIDS were generally positive, with the majority stating that medical care should be provided.
A prospective study was conducted in May to June 1993 at George Health Centre to determine the knowledge of AIDS transmission and attitudes and practices concerning AIDS prevention in the community. The study was done on 100 males and 100 females aged 15-53 years who were seeking medical attention at George Health Centre. A pretested open ended questionnaire was used to conduct the interviews and a total of 200 subjects were interviewed.The data were analysed by computer and manually as applicable. There was high level of knowledge on modes of transmission. 99.0 per cent pointed out that AIDS is spread by sexual transmission. Parenteral transmission was known by 90.0 per cent of the subjects and perinatal transmission by 92.5 per cent. About 28.0 per cent of the subjects had a strong misconception that infection by casual contact was possible. A high percentage were aware that prevention of AIDS was possible and 98.5 per cent reported sticking to one partner as a mode of prevention. However 34.0 per cent did not identify condoms as effective in prevention of HIV transmission. 23.0 per cent were not aware that it was possible for a person who is HIV-positive and a symptomatic to transmit the virus to others.
There was a high level of risk behaviour detected in this community despite the knowledge level reflected above. 35.0 per cent (14 females and 56 males) had contracted a sexually transmitted disease over the last year and 31.0 per cent (56 males and 6 females) reported indulging in sexual relations with a prostitute or casual contact and only 34 per cent reported condom use. More than half of the subjects (64.5 per cent) were willing to be tested and informed of their result. Of all the subjects only 72.5 per cent would share the results if they tested HIV-positive.
The subjects were well informed on knowledge of modes of transmission and sufficiently aware of risk behaviour and preventive measures except there are still a few misconceptions on infection through casual contact and the use of condoms. There was a negative correlation demonstrated between knowledge and practice. On attitude towards testing, both negative and positive attitudes were revealed.
Objectives:
To investigate the knowledge, attitudes and behaviour of post-school young people in a higher education institution with a view to determine the role of HIV/AIDS education programmes in this age group.Methods:
Anonymous, self-administered, pre-tested questionnaires were distributed to all the students in a Zambian Government Agricultural College.Results:
195 (69 per cent) questionnaires were returned. 74 per cent of these students had received some previous HIV/AIDS education, predominantly at school. Knowledge regarding sources of transmission was generally good regarding transmitted sources (e.g., blood 97.9 per cent correct) yet there was considerable confusion regarding non-transmittable sources (e.g., insect bites 65.3 per cent correct). Attitudes were generally poor with 19.9 per cent saying that people with AIDS should be isolated, 16.8 per cent said that persons with AIDS deserve to suffer and only 50.3 per cent said that a person with HIV should be given the same opportunities as everyone else in life. These attitudes were regardless of previous education. Behaviour did not appear to be significantly affected by knowledge or previous HIV/AIDS education. Conclusions: HIV/AIDS education is warranted in this group yet should be carefully designed to ensure that it does not instil fear, but gives people the information and promotes attitudes which will enable them to chose appropriate lifestyles and live in comfort with those who are already HIV-positive.
Qualitative data were collected using focus group discussions. To ensure collection of appropriate and quality data, a comprehensive focus group discussion guide (FGDG) was developed, based on current knowledge on the subject and experiences from Zambia. FGDG was pretested before use. The study elicited information pertaining to various aspects of HIV/AIDS, general health problems, STDs/HIV/AIDS knowledge and attitudes, sexual and reproductive behavior, condom use, and youths' needs and expectations. A convenience sample of 82 youths aged between 15-30 years was systematically selected to participate in the study using a predetermined criteria. The study underscores that knowledge about HIV/AIDS is very high among the youths. However, this knowledge was not accompanied by behavioural changes and misconceptions about HIV/AIDS are quite common.
Objectives:
To determine the knowledge, attitudes and sexual practices towards AIDS of Zambian males. Method:
A pre-tested self-administered questionnaire was distributed to males aged between 30 and 49 years of age.Results:
- Of the 50 respondents 70 per cent were married and most of them had children; 90 per cent were in full-time employment.
- 90 per cent of the respondents
- Knowledge about HIV transmission was good with 62.7 per cent knowing that HIV was transmitted through sexual intercourse; 13.7 per cent through blood transfusion; 91 per cent through mother to child; while 13.7 per cent did not know how HIV is transmitted. There were some misconceptions concerning modes of transmission as some (9 per cent) felt that HIV can be transmitted through kisses.
- 37 per cent knew of someone with AIDS while 24 per cent had a close relative die of AIDS.
- 78 per cent of the respondents were using condoms to protect themselves from HIV and other transmitted diseases.
Conclusions:
Basic knowledge about the transmission of HIV was good. The majority of the respondents know of someone with HIV/AIDS and programmes should emphasise on destigmatising the disease.[Editor's note: adjectives such as good' must be treated with caution and in relation to other similar surveys. The implication here that 33 per cent of the males did not know that HIV is transmitted through sexual intercourse is, if that is the case, a great cause for concern. The difference between knowing and stating must be made clear].
Objectives:
To determine HIV knowledge and attitudes from students attending UNZA to aid the planning of an HIV education programme. To assess sexual practices and condom use amongst the students.Methods:
Anonymous self-administered, pre-tested questionnaires were distributed to UNZA during August 1993. The questionnaires were distributed to the halls of residence by the counselling department and the students were asked to fill them in at leisure and return them once completed.Results:
946 of the 2,000 questionnaires were returned. Knowledge regarding transmission was only moderately good: 92 per cent knowing that HIV was transmitted in semen, 87 per cent in blood and 85 per cent in vaginal fluid, and there was some confusion regarding non-transmittable sources with 15 per cent thinking that mosquitoes and 46 per cent saliva transmitted HIV. Only 32 per cent knew noone with HIV. 38 per cent had had a relative die of AIDS and 40 per cent had a friend or acquaintance with HIV. Despite this there were still many people with negative attitudes to those with HIV: 8 per cent felt that people with HIV led immoral lives, 15 per cent felt that they should be isolated and 40 per cent did not like the idea of sharing cups with HIV-positive people. 79 per cent felt that people with HIV should have equal opportunities. Only 23 per cent felt that they were definitely at risk from HIV, with 23 per cent not sure. 11 per cent had had one sexual partner while 71 per cent had had more than one. 62 per cent had ever used a condom, 17 per cent using always with a regular partner and 32 per cent with a non-regular partner. 75 per cent felt that condoms should be more easily available at UNZA and 51 per cent said that they would use them if they were. 88 per cent said that there was not enough information about HIV at the University and 71 per cent felt that HIV counselling should be available.Conclusions:
- Basic knowledge about HIV was only moderately good and the students felt that they were not receiving enough education about HIV at the university and many felt that counselling should be available.
- A large percentage of those questioned have contact with people with HIV and programmes should be directed at improving attitudes to those who already have HIV and reducing the stigma of HIV.
- The majority of the students were sexually active but regular condom use was low. Condom use and safer sex advice should be made more available.
This Basic School KAP survey is intended to limit the spread of HIV infection amongst school going children through the provision of appropriate health education which is meant to spell out the risks involved in pre-marital sexual relationships. The survey sought to collect and analyse data on pupils/parents about knowledge on AIDS transmission and prevention; sexual practices and safer sex methods adopted at present; HIV/AIDS-related attitudes towards PWA, relatives etc.; parents' involvement in the assimilation of health education as part and parcel of children's socialisation.Four basic schools were picked for the purpose of data collection in October 1994, two from urban and rural areas respectively. The respondents included 51 boys and 39 girls and 38 girls and 24 boys from urban and rural schools respectively. All together, 152 i.e. 89 and 63 boys and girls were covered. The type of sampling technique used was one based on serial number of class registers, and interviews were conducted by the use of questionnaires.
The demographic data have proved that 67 per cent of Basic School pupils' age mainly falls between 13 and 15 years, cutting across both sexes. On the other end, findings on sexual experience indicate that 81 per cent and 85 per cent of the sample from both urban and rural based schools respectively have gone through sexual intercourse, with either age mates or with more elder partners, in particular the girls. Occurrence of STD related diseases amongst the sample were verified at 21 per cent of respondents admitted to have had symptoms of burning on urination, 16.6 per cent and 14.4 per cent of the urban sample had suffered from gonorrhea and syphilis respectively. Rural respondents were noted to have been more open in answering questions and had a slightly higher percentage of 16 and 14.5 per cent for syphilis and gonorrhoea respectively. All respondents recorded a high degree of knowledge about AIDS and its impact. On control, 72.5 per cent know that condoms prevent HIV/AIDS and 50 per cent of the urban sample admitted using condoms while 73.6 per cent of the whole sample admitted engaging in unprotected sex due to the fact that condoms are not supplied to them.
The study concentrated on the knowledge, attitudes and practices in relation to HIV/AIDS among university students.Methodology:
A structured, open-ended questionnaire was prepared to collect the necessary information. The questionnaires were distributed to students at the University of Zambia main campus and Ridgeway campus.Population and Sampling Technique:
Random survey comprising:
- Group A: A sample collection of students at level of entry to the school of medicine: 31 students from a class of 55 at Ridgeway campus (6 female and 25 male students).
- Group B: A sample collection at level of entry to the University of Zambia; 41 students from a stream of 900 at Great East road campus (20 female and 21 male students).
Data Analysis:
Data was stored in questionnaire form and manual analysis of data was done by means of compilation and tally of results, and relevant statistical calculations.
- Part 1: Answers were marked, and percent score was given to each subject. Score and other information on knowledge were graphed and tabulated.
- Part 2: Frequency of responses was represented graphically and in tabular form.
- Part 3: Frequency of responses was recorded and analysed.
Results and Discussion:
The age range of students in group A was 18-29 years while that of group B was 18-22 years. The mean percentage for the specific knowledge on HIV/AIDS was 84 per cent in group A, a little lower than expected for this group, considering that the average score of group B was 82 per cent. Almost half of (42 per cent) group A and B students thought that among those who develop AIDS not all would die of the disease. 80.7 per cent of group A students and 90.2 per cent of group B students had personally known someone with HIV/AIDS. Generally, students at the point of entry have a greater knowledge of HIV/AIDS due to their inclination towards medicine. On AIDS information, 74 per cent of group A students and 81 per cent of group B students discussed AIDS with friends or neighbours in the 4 four weeks prior to receiving the questionnaire. Nearly half of both group A & B students admitted having read or seen something on AIDS in the media more than twice over the past 4 weeks. The attitudes of both groups of students towards HIV/AIDS do not differ significantly. Most students agree that students should be taught about HIV/AIDS, that people should refrain from premarital and extra-marital sex to avoid getting HIV/AIDS, that even "decent people" get AIDS. 32 per cent of group A students and 20 per cent of group B students think they are at risk of getting HIV/AIDS.
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Last updated February 4, 1999
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