| Summary: | Objective
Research on HIV/AIDS in sub Saharan adolescents has been limited to students in
primary, secondary school, and college. There is a paucity of information on out-of school
adolescents. This research, conducted from July 1998 through June 1999, sought
to determine the predictors of HIV knowledge, condom use, and sexual risk taking in the
era of HIV/AIDS in a population of in-school and out-of-school adolescents aged 10-19
and resident in Ketu South, Upper Denkyira, and Offinso South electoral constituencies
in Ghana.
Methods
This cross sectional research incorporates in and out of school adolescents and
utilizes the AIDS Risk Reduction Model (ARRM) and other supplementary variables to
predict AIDS knowledge, condom use and sexual risk taking. Subjects were randomly
selected (n = 1415) and assessed via questionnaire on their knowledge of AIDS and other
STDs, attitude towards condoms and use, self-efficacy, peer norms, and sexual
behaviour.
Results
While certain aspects of AIDS knowledge were well known by respondents,
definite gaps in knowledge and misconceptions about infection through casual contact
were common. Three multivariate logistic models for knowledge, condom use, and
sexual risk taking, were developed after controlling for potential confounders such as age,
gender, location, educational status (being in school or out of school) and constituency.
In the HIV/AIDS-related knowledge model, independent associations for higher
knowledge scores were being male (p = 0.006), being an older adolescent (p = 0.011),
higher educational level (p = 0.005), not believing that one can get AIDS through
witchcraft (p = 0.024), believing that AIDS is a problem in Ghana (p = 0.001), having
ever had sexual intercourse (p - 0.023), having heard about syphilis (p < 0.001), knowing
that nobody can cure AIDS (p = 0.001), having taken steps to avoid HIV (p < 0.001), and
having discussed AIDS with friends and acquaintances (p = 0.010).
Significant predictors for condom use were being out of school (p = 0.002),
having discussed AIDS with regular sexual partner (p < 0.001), having discussed AIDS
with friends and acquaintances (p = 0.004), self-efficacy (p < 0.001), reliance on the
efficacy of condoms as protection against STDs including HIV (p = 0.019), and negative
attitude towards condoms (p = 0.004).
In the sexual risk-taking model, independent associations were found for being
male (p = 0.040), being a residence of Upper Denkyira (p = 0.001) and Offinso South
(p = 0.005), early age of first sexual intercourse (p = 0.001), having a relative or friend or
acquaintance who has AIDS (p = 0.025), believing that somebody can cure AIDS (p <
0.001), self perceived risk of contracting HIV in the following year (p = 0.018), and
having discussed HIV with family (p = 0.007).
Conclusion
Consistent with the literature, the results of the study demonstrate support that
increasing HIV knowledge alone will not stem the spread of HIV among adolescents in
Ghana. Rather, it appears that the solution lies in enhancing individual's appreciation of
his or her own risk and enhancing self-efficacy for reducing that risk. There should also
be policies that mitigate poverty and economic inequality, strict enforcement of sexual
assault legislation laws, as well as adoption of an integrated health care delivery system
that includes family planning, and the dissemination of correct and relevant materials on
AIDS. At the same time the government and other stakeholders should seek to create the
enabling environment which increases access to the means of prevention. This approach
should form the basis for AIDS risk reduction strategies in Ghana. === Medicine, Faculty of === Population and Public Health (SPPH), School of === Graduate
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