Knowledge, attitudes and practices concerning AIDS in Ugandans

Abstract

A survey of the knowledge, attitudes and practices of 3928 Ugandans concerning AIDS was done in two semi-rural communities in August 1987. Eighty-eight per cent of the respondents knew that AIDS could be acquired from other people and that having multiple sexual partners was high-risk behaviour. There were, however, many incorrect beliefs about HIV transmission, including belief in transmission by insect bites (37%), witchcraft (22%) and casual contact with ill people (21%). AIDS was believed to be curable by 15% of the respondents. As part of the survey, blood was obtained from 3907 (99%) participants; 421 (10.8%) had antibody to HIV-1 by enzyme-linked immunosorbent assay (ELISA) and females were more likely to be infected than males (12.5 versus 8.8%, relative risk 1.42). Factors significantly associated with HIV infection on univariate analysis include multiple sexual partners, sexually transmitted diseases (STDs), injections, and being female. Stratified analysis of a history of STDs in people who were monogamous still showed an association with HIV infection. Information about the AIDS epidemic is reaching the Ugandan population; however, changes in behaviour are slower to follow.

PIP: Knowledge, attitudes, and practices with regard to acquired immunodeficiency syndrome (AIDS) were surveyed among 3928 adults in 2 semi-rural communities of Uganda in 1987. 54% of respondents were female; the average age was 33 years and 57% were married. 203 (5%) were personally acquainted with an AIDS victim and 74% could identify at least 1 clinical symptom of AIDS. 88% correctly identified infected individuals as the major source of disease transmission; however, 37% believed AIDS could be spread by insect bites, 22% thought it could be spread through witchcraft. 22% identified dirty drinking water as a source of AIDS, and 47% thought sharing clothes with an AIDS victim would spread the disease. Ways of avoiding AIDS cited by respondents included avoiding sex with prostitutes (92%), reducing the number of sexual partners (89%), using condoms (41%), using antibiotics (23%), and getting protection from a witchdoctor (11%). 72% indicated they would be ashamed if a family member contracted AIDS, 38% felt AIDS victims deserve their punishment, and 56% favored isolating AIDS patients from the community. As part of the survey, blood samples were obtained from 3907 respondents, 421 (11%) of whom were seropositive for infection with human immunodeficiency virus (HIV). The HIV infection rate was 12.5% among females and 8.8% among males. Multiple sexual partners and a history of sexually transmitted diseases (STDs) were the factors most strongly associated with seropositivity. Although males in this study reported more sexual partners than females, the effect of multiple partners on HIV infection was more pronounced in females. This suggests that male-to-female heterosexual transmission predominates in Uganda.