DOCUMENT RESUME ED 407 373 SP 037 287 AUTHOR Du Plessis, G. E.; And Others TITLE Study of Knowledge, Attitudes, Perceptions and Beliefs Regarding HIV and AIDS (KAPB). Memorandum Presented to the Directorate Primary Health Care of the Department of National Health and Population Development. INSTITUTION Human Sciences Research Council, Pretoria (South Africa). PUB DATE 93 NOTE 204p PUB TYPE Reports Research (143) EDRS PRICE MF01/PC09 Plus Postage. DESCRIPTORS *Acquired Immune Deficiency Syndrome; Adults; *Behavior Change; *Communicable Diseases; Elementary Secondary Education; Foreign Countries; Health Promotion; *Knowledge Level; *Public Opinion; Students; Surveys IDENTIFIERS Health Behavior; *Sexually Transmitted Diseases; *South Africa ABSTRACT This document reports on a study that assessed levels of knowledge, types of attitudes, perceptions, and beliefs (KAPB) of the general South African public regarding Human Immunodeficiency Virus (HIV) infection and Acquired Immune Deficiency Syndrome (AIDS). Interviews were conducted with 5,360 participants; survey data are summarized in 49 tables. After describing the theoretical background and methodology used in the study, findings are grouped according to differences by gender, age group, language, geographic area, educational level, population group, occupation, and differential access to sources of information about AIDS. Study results indicated: knowledge of sexually transmitted diseases (STDs) was not very high, especially regarding prevention; and many believed that contraceptives also provided protection against STDs and HIV. Overall, awareness of AIDS seemed to be high, but with a mixture of appropriate and inappropriate knowledge about HIV/AIDS in terms of transmission, nature of the disease, seriousness, prevention, and cure. Conclusions and recommendations are grouped by knowledge about HIV/AIDS, perceptions of seriousness, condom use, support for behavioral change, self-efficacy in health, perceptions of social distance, the role of communication media, and further research needs. Appendices include the AIDS KAPB Study questionnaire, and schematic presentations of the data.(Contains 9 figures, 49 data tables, and 33 references.) (ND) ******************************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. ******************************************************************************** STUDY OF KNOWLEDGE, ATTITUDES, PERCEPTIONS AND BELIEFS REGARDING HIV ANDAIDS(KAPB) G.E. DU PLESSIS A.J. MEYER-WEITZ M. STEYN 1993 U.S. DEPARTMENT OF EDUCATION 'Office of Educational Research and Improvement PERMISSION TO REPRODUCE AND EDUCATIONAL RESOURCES INFORMATION DISSEMINATE THIS MATERIAL CENTER (ERIC) HAS BEEN GRANTED BY 0 This document has been reproduced as received from the person or organization originating It tv-a-thA/ 0 Minor changes have been made to improve reproduction Quality. Points of view or opinions stated in this docu- ment do not necessarily represent official TO THE EDUCATIONAL RESOURCES AmIIIMISN OERI position or policy. INFORMATION CENTER (ERIC) HSRC-RGN BEST COPY AVA6LABLE MEMORANDUM PRESENTED TO THE DIRECTORATE PRIMARY HEALTH CARE OF THE DEPARTMENT OF NATIONAL HEALTH AND POPULATION DEVELOPMENT G.E. du Plessis, M.A. (Sociology) A.J. Meyer-Weitz, B.A. Hons. (Psychology) M. Steyn, M. Soc. Sc. (Nursing) Technical layout by Mrs I. Rice Statistical calculations by Mr J. Pietersen Language editing by Mrs I. Stahmer Human Sciences Research Council, 1993 Focus Group Health Care Private Bag X41 PRETORIA 0001 Telephone (012) 202-2904 Telefax (012) 202-2149 Toll-free telephone number 0800-117755 TABLE OF CONTENTS PAGE 1. BACKGROUND AND AIM 1 1.1 Background 1 1.2 Aim 1 2. THEORETICAL BACKGROUND 2 2.1 Psychosocial models 8 2.1.1The health belief model 8 2.1.2Fishbein and Ajzen: theory of reasoned action 12 2.1.3The Triandis model 13 2.1.4The construct accessibility perspective 14 2.1.5Other psychosocial variables 15 2.2 Social perspectives 15 2.2.1 The epidemiological model 19 3. METHODOLOGY 20 3.1. Research design 20 3.1.1 Quantitative method 20 3.1.2Development of the questionnaire 21 3.1.3Validity 22 3.1.4Reliability 22 3.2 Sampling 23 3.2.1 Sampling frame 23 3.2.2Sampling method 28 3.2.3Sample realization 30 3.3 Fieldwork 31 3.4 Analysis of the data 32 3.4.1 Descriptive statistics 32 3.4.2Inferential statistics 32 PAGE 4. FINDINGS 40 4.1 Background characteristics of the sample population 40 4.2 Perceptions of community problems 40 4.3 Knowledge of HIV, AIDS and related aspects 40 4.3.1 Knowledge of HIV transmission via proven means 40 4.3.2Knowledge of HIV transmission via casual contact 47 4.3.3Responses to unstructured questions on HIV transmission 49 4.3.4Knowledge of STDs 50 4.3.5Knowledge of prevention of HIV infection 51 4.4 Perceptions of AIDS-related aspects 58 4.4.1 Perceptions of the seriousness or of the outcome of HIV infection and AIDS 58 4.2.2Perceptions regarding the use of condoms 62 4.4.3Perceptions regarding sexual matters 66 4.4.4Perceptions of social distance regarding HIV infected people and PWAs 74 4.4.5Locus of control 81 4.4.6Perceptions of susceptibility 86 4.4.7Perceptions of blood tests regarding HIV 88 4.4.8Perceptions regarding confidentiality in the doctor/nurse-patient relationship 89 4.5 Communication regarding AIDS-related factors 90 4.5.1 Exposure to sources of information on HIV and AIDS 90 4.5.2Efforts to obtain information on HIV and AIDS 98 4.5.3Social sources of information on AIDS: sources contacted recently 98 4.5.4Sources of information on AIDS: subjective indications of influential agents in behavioural change 101 4.5.5Preferred method of communication regarding AIDS 103 4.6 AIDS-related behavioural intentions and behaviour 104 4.6.1 Sexual partners 104 4.6.2Reported use of condoms during sex in the previous three months: past behaviour 109 PAGE 4.6.3Reported use of condoms in a casual sexual liason, irrespective of when this encounter took place: past behaviour 111 4.6.4Sexually transmitted diseases: past behaviour 113 4.6.5Reported intentions to change sexual behaviour in response to hearing about AIDS 114 4.7 Overall effects of explanatory variables on factors relating to knowledge, attitudes and beliefs 117 5. SUMMARY, CONCLUSIONS AND RECOMMENDATIONS 118 5.1 Summary of findings 1 18 5.1.1Findings of other KAPB studies and the current study 118 5.1.2Findings of the current study in terms of statistically significant differences in explanatory variables 121 5.2 Conclusions and recommendations 126 5.2.1 Knowledge about HIV and AIDS 126 5.2.2Perceptions of seriousness 127 5.2.3Condoms 127 5.2.4Support for behavioural change 128 5.2.5Self-efficacy in health 129 5.2.6Perceptions of social distance 130 5.2.7The role of the different communication media 132 5.2.8Further research needs 132 LIST OF SOURCES 134 LIST OF TABLES PAGE TABLE 1 GEOGRAPHICAL DISTRIBUTION OF AIDS CASES AND NUMBER OF DEATHS 24 TABLE 2 STUDY DOMAINS, PLANNED AND REALIZED SAMPLE SIZES 30 TABLE 3 FACTORS, ITEMS AND RELEVANT STATISTICS 34 TABLE 4 ANALYSIS OF VARIANCE OF KNOWLEDGE OF HIV TRANSMISSION VIA PROVEN MEANS, SUBGROUP 1 44 TABLE 5 DUNCAN STATISTICS FOR SIGNIFICANT VARIABLES FROM THE VARIANCE ANALYSIS FOR KNOWLEDGE OF HIV-TRANSMISSION VIA PROVEN MEANS, SUBGROUP 1 44 TABLE 6 ANALYSIS OF VARIANCE OF KNOWLEDGE OF HIV TRANSMISSION VIA PROVEN MEANS, SUBGROUP 2 46 TABLE 7 DUNCAN STATISTICS FOR SIGNIFICANT VARIABLES FROM THE VARIANCE ANALYSIS OF KNOWLEDGE OF HIV TRANSMISSION VIA PROVEN MEANS, SUBGROUP 2 47 TABLE 8 ANALYSIS OF VARIANCE OF KNOWLEDGE OF HIV TRANSMISSION VIA CASUAL CONTACT 48 TABLE 9 DUNCAN STATISTICS FOR SIGNIFICANT VARIABLES FROM THE VARIANCE ANALYSIS OF KNOWLEDGE OF HIV TRANSMISSION VIA CASUAL CONTACT 48 TABLE 10 ANALYSIS OF VARIANCE OF KNOWLEDGE OF STDs 50 TABLE 11 DUNCAN STATISTICS FOR SIGNIFICANT VARIABLES FROM THE VARIANCE ANALYSIS OF KNOWLEDGE OF STDs 51 TABLE 12 ANALYSIS OF VARIANCE OF KNOWLEDGE OF PREVENTION OF HIV INFECTION: CORRECT KNOWLEDGE 52 TABLE 13 DUNCAN STATISTICS FOR SIGNIFICANT VARIABLES FROM THE VARIANCE ANALYSIS OF KNOWLEDGE OF PREVENTION OF HIV INFECTION: CORRECT KNOWLEDGE 53 TABLE 14 ANALYSIS OR VARIANCE OF INCORRECT MEANS OF PROTECTION AGAINST HIV INFECTION 55 TABLE 15 DUNCAN STATISTICS FOR SIGNIFICANT VARIABLES FROM THE VARIANCE ANALYSIS OF INCORRECT MEANS OF PROTECTION AGAINST HIV INFECTION 55 TABLE 16 PERCENTAGE RESPONDENTS WHO INDICATED AT LEAST ONE INAPPROPRIATE MEANS OF PROTECTION AGAINST HIV INFECTION 57 TABLE 17 ANALYSIS OF VARIANCE OF PERCEPTIONS OF SERIOUSNESS OR OF THE OUTCOME OF HIV INFECTION AND AIDS 59 7 PAGE TABLE 18 DUNCAN STATISTICS FOR SIGNIFICANT VARIABLES FROM THE VARIANCE ANALYSIS OF PERCEPTIONS OF THE SERIOUSNESS OR OF THE OUTCOME OF HIV INFECTION AND AIDS 60 TABLE 19 ANALYSIS OF VARIANCE OF PERCEPTIONS REGARDING THE USE OF CONDOMS 62 TABLE 20 DUNCAN STATISTICS FOR SIGNIFICANT VARIABLES FROM THE VARIANCE ANALYSIS OF PERCEPTIONS REGARDING THE USE OF CONDOMS 63 TABLE 21 ANALYSIS OF VARIANCE OF PERCEPTIONS REGARDING THE AVAILABILITY OF CONDOMS 64 TABLE 22 DUNCAN STATISTICS FOR SIGNIFICANT VARIABLES FROM THE VARIANCE ANALYSIS OF PERCEPTIONS REGARDING THE AVAILABILITY OF CONDOMS 65 TABLE 23 ANALYSIS OF VARIANCE OF PERCEPTIONS REGARDING THE ACCEPTABILITY OF PRESENTING AIDS INFORMATION COURSES TO SCHOOL CHILDREN 67 TABLE 24 DUNCAN STATISTICS FOR SIGNIFICANT VARIABLES FROM THE VARIANCE ANALYSIS OF PERSONS REGARDING THE ACCEPTABILITY OF PRESENTING AIDS INFORMATION COURSES TO SCHOOL CHILDREN .. 67 TABLE 25 ANALYSIS