The Discriminatory Attitudes of Health Workers against People Living with HIV

Letamo discusses the implications of a new study suggesting that some health professionals discriminate against people with HIV

Does correct knowledge about HIV and AIDS lead to safer sexual behaviour? The case of young people in Botswana

This article investigates the extent to which acquired correct knowledge about HIV and AIDS prevention and transmission is translated into protective sexual behaviours among young people in Botswana. This research uses a nationally representative sample of the Botswana AIDS Impact Survey (BAIS) conducted in 2004. The sample for the current study was limited to all people aged 10-24 who had completed the individual questionnaire of BAIS and have had sexual intercourse at the time of the survey. Both bivariate and multiple regression analyses are used to investigate the topic. The results from both bivariate and multivariate analyses indicate that a consistent and significant predictor of safe sex behaviours among young people is the knowledge that something can be done to prevent becoming infected with HIV. In the multivariate analysis, knowledge that people cannot get HIV because of witchcraft is significantly associated with the likelihood to report safe sexual behaviours whilst knowledge that a person cannot get infected with HIV through mosquito bites is significantly associated with decreased odds of reporting safe sexual behaviours. The study concludes that although correct knowledge of HIV/ AIDS prevention and transmission methods does not necessarily translate into safe sexual behaviours, some knowledge of HIV prevention and transmission methods among young people is associated with safe sexual behaviours. There are other predictors of safe sexual behaviours other than HIV-related knowledge of prevention measures. Further research that combines both qualitative and quantitative approaches is needed to clarify the exact nature of how knowledge of HIV and AIDS prevention and transmission influences protective sex behaviours. The research should also explore the role played by these unknown factors in predicting safe sex behaviours.Résumé Cet article examine dans quelle mesure les acquis correcte sur la prévention du VIH et du SIDA et transmission est traduite en protection des comportements sexuels parmi les jeunes au Botswana. Cette recherche utilise un échantillon représentatif au niveau national de le Botswana AIDS Impact Survey (BAIS) menée en 2004. L'échantillon pour l'étude actuelle a été limitée à tous les gens âgés de 10 à 24 ans, qui avait rempli le questionnaire individuel de BAIS et ont eu des relations sexuelles au moment de l'enquête. Les deux bivariée et plusieurs analyses de régression servent à enquêter sur le sujet. Les résultats des analyses multidimensionnelles tant bivariées indiquent qu'un prédicteur cohérente et significative des comportements safe sex chez les jeunes est la connaissance que quelque chose peut être faite pour empêcher l'infection par le VIH. Dans l'analyse multivariable, connaissance que les personnes ne peut pas obtenir penvent VIH en raison de la sorcellerie est fortement associé à la probabilité de comportements sexuels sécuritaire de rapport tandis que les connaissances qu'une personne ne peut pas obtenir infectée par le VIH par le biais de piqûres est considérablement associé à odds diminution des rapports des comportements sexuels en toute sécurité. L'étude conclut que, bien que la bonne connaissance des méthodes de prévention et de la transmission du VIH/SIDA ne se traduit pas nécessairement par les comportements sexuels en toute sécurité, certaines connaissances de prévention du VIH et de méthodes de transmission parmi les jeunes est associée à des comportements sexuels en toute sécurité. Il existe des autres indicateurs de sécurité des comportements sexuels autres que les connaissances liient au VIH de mesures de prévention. D'autres recherches qui combinent la fois qualitative et quantitative sont nécessaire de préciser la nature exacte du comment connaissance de prévention du VIH et du SIDA et de la transmission influe sur les comportements sexuels de protection. La recherche devrait examiner également le rôle joué par ces facteurs inconnus en prévision des comportements safe sex.Mots clés : Botswana jeunes ; le VIH/SIDA ; comportement sexuel ; prévention ; transmission

The influence of gender role attitudes on risky sexual behaviour: Evidence from the 2008 Botswana AIDS impact survey III

Abstract Previous studies have posed seemingly contradictory arguments that either traditional attitudes or egalitarian attitudes are associated with riskier behaviour. Little research has been conducted to document how gender role attitudes influence sexual behaviour in Botswana. The purpose of this study is to examine the association between gender role attitudes and risky sexual behaviour. Data used in this study are from the 2008 Botswana AIDS Impact Survey which was a nationally representative, population-based survey. Cross-tabulations and logistic regression analysis were used to assess the influence of gender role attitudes on risky sexual behaviour such non-use of condom and multiple sexual partners. The cross-tabulated results of the study showed that generally women had egalitarian gender role attitudes towards sexual behaviours compared to the men. Bivariate analysis showed that about 47% of the respondents believed men can have more than one sexual partner at a time while 42% indicated that women can have more than one sexual partner at a time. Over one in ten reported that it is a wife’s duty to have sex with her husband even if she does not want to and about 24% of the respondents reported that it is not a woman’s right to decide if she will have safe sex. The logistic regression results showed that the selected gender role attitude variables were not significantly associated with risky sexual behaviour except the belief that it is acceptable for a partner to be in possession of a female condom. In short, after controlling for important socio-demographic variables, the analysis showed that traditional gender role attitudes were not significantly associated with risky sexual behaviour of non-use of condoms and engagement in multiple sexual relationships. The relationship between gender role attitudes and sexual behaviour is very complex and detailed qualitative research may provide more answers to the research questions than a cross-sectional study design. Additional research is required to understand this complex relationship. Keywords: Gender role attitudes; risky sexual behaviour; BotswanaRésumé Les études précédentes ont posé les arguments apparemment contradictoires que des attitudes traditionnelles ou les attitudes égalitaires sont associé au comportement riskier. Peu de recherche a été conduite au document comment les attitudes de rôle de genre influencent le comportement sexuel au Botswana. Le but de cette étude est d'examiner l'association entre les attitudes de rôle de genre et le comportement sexuel risqué. Les données utilisées dans cette étude sont de l'enquête 2008 d'impact de SIDA du Botswana qui était un aperçu nationalement représentatif et basé sur la population. des Croix-tabulations et l'analyse logistique de régression ont été employées pour évaluer l'influence des attitudes de rôle de genre sur le comportement sexuel risqué tel sur-emploient du condom et des associés sexuels multiples. Les résultats croix-sous forme de tableaux de l'étude ont prouvé que généralement les femmes ont eu des attitudes égalitaires de rôle de genre envers des comportements sexuels comparés aux hommes. L'analyse Bivariate a prouvé qu'environ 47% des répondants a cru que les hommes peuvent avoir plus d'un associé sexuel à la fois tandis que 42% indiquait que les femmes peuvent avoir plus d'un associé sexuel à la fois. Plus d'un dans dix a rapporté que c'est le devoir d'une épouse pour avoir le sexe avec son mari même si elle ne veut pas à et environ 24% des répondants signalait qu'il n'est pas le droit d'une femme de décider si elle aura le sexe sûr. Les résultats logistiques de régression ont prouvé que les variables choisies d'attitude de rôle de genre n'ont pas été sensiblement associées au comportement sexuel risqué excepté la croyance qu'il est acceptable que un associé soit en possession d'un condom femelle. En bref, après contrôle pour des variables socio-démographiques importantes, l'analyse a prouvé que des attitudes traditionnelles de rôle de genre n'ont pas été sensiblement associées au comportement sexuel risqué du non-usage des condoms et à l'enclenchement dans des rapports sexuels multiples. Le rapport entre les attitudes de rôle de genre et le comportement sexuel est très complexe et la recherche qualitative détaillée peut fournir des réponses aux questions de recherches et à une conception d'étude transversale. La recherche additionnelle est exigée pour comprendre ce rapport complexe.Mots-clés: Attitudes de rôle de genre; comportement sexuel risqué ; Le Botswan

The influence of beliefs and attitudes about antiretroviral treatment on inconsistent condom use in Botswana

There is little evidence on the influence of attitudes and beliefs of people about ART and inconsistent condom use in Botswana. Using the 2008 Botswana AIDS Impact Survey Data (BAIS III) this study examined the influence of beliefs and attitudes of people about ART on inconsistent use of condoms. A sample of 2087 men and women aged 15-64 years who had ever had sex and had completed BAIS III individual questionnaire were considered for analysis. Bivariate and multivariate analyses were used to explore the relationship between variables of interest. Results have shown that 23% of respondents held the belief that ARVs cure AIDS. Multivariate analyses have shown positive association between the belief that ARVs cure AIDS (OR, 1.2) and inconsistent condom use. Inconsistent condom use was also associated with females (OR, 4.7), no education (OR, 1.9) Primary education (OR, 2.1), having ever married (OR,4.2) and living together (OR, 1.07). Results of this study underscore the need for enhanced efforts to consolidate HIV prevention messages and the need for more widespread dissemination of accurate information about ART

Association between experience of sexual coercion and sexual behaviour: insights from the 2008 Botswana AIDS impact survey III

Objective: Little is known about the prevalence and the effect of sexual coercion on risky sexual behaviour in the context of Botswana. The aim of this study was to investigate the association between the experience of sexual coercion and risky sexual behaviour.Methods: The study used a nationally representative population-based survey data from the 2008 Botswana AIDS Impact Survey III. We used cross-tabulations and multivariate logistic regression analysis to investigate an association between the experience of sexual coercion and risky sexual behaviour.Results: Out of the 2,455 respondents, the prevalence of sexual coercion was 5% (3.1% males and 8.1% females). The adjusted odds ratios showed that only the respondents who reported having experienced sexual coercion compared to those who did not were 1.9 times more likely to report having engaged in multiple sexual partnerships and this relationship was statistically significant at 1% level.Conclusion: The results suggest that in order to implement effective HIV/AIDS prevention strategies it is imperative to adopt a more holistic and multifaceted approach that includes issues of sexual violence

The socio-economic and cultural context of the spread of HIV/AIDS in Botswana

The first case of AIDS in Botswana was diagnosed in 1985. Despite the fact that AIDS is a relatively new phenomenon in Botswana, the rate at which it is spreading is alarming. The 1994 Sentinel Surveillance study estimated that the number of people infected with HIV rose from 60,000 in 1992 to over 125,000 by 1994. The 1995 Sentinel Surveillance Survey stated that approximately 13 per cent of the general population was infected by HIV. The projected cumulative figures of persons infected by HIV by the year 2000 will stand at 332,000 (AIDS/STD Unit, AIDS Update 1996). Obviously the rate of HIV/AIDS infection is increasing very fast. What are the socio-economic factors and practices that promote this fast increase

HIV/AIDS-Related Stigma and Discrimination Among Adolescents in Botswana

The primary goal of this study is to examine and determine factors influencing stigmatisation and discrimination among adolescents towards people living with HIV/AIDS in Botswana. HIV/AIDS-related stigma and discrimination result from fear, ignorance, and denial. There exists little or no research in Botswana dealing with how people living with HIV/AIDS or suspected of having HIV/AIDS are perceived and treated. Data analysed in this paper are taken from the Botswana AIDS Impact Survey conducted in the year 2001. Both descriptive and multivariate logistic regression models are used to analyse the data. The results show that many of the adolescents expressed negative attitudes towards people living with HIV/AIDS. Logistic regression analysis shows that misconceptions about HIV transmission often encourage stigmatisation and discrimination of people living with HIV/AIDS. Interestingly, although the majority of the adolescents stigmatise and discriminate against PLWA, many of them are willing to care for a family member who has HIV/AIDS. There is need to address issues of stigma and discrimination as part of prevention of further spread of HIV/AIDS in Botswana

Prevalence of substance use and correlates of multiple substance use among school-going adolescents in Botswana

The purpose of the current study was to estimate the prevalence of substance use and correlates of multiple substance use among adolescents in Botswana. The study was a cross-sectional study in which a random sample of 3,763 students aged 10 to 19 years. A survey questionnaire was self-administered using a personal digital assistant in 15 education districts of Botswana. Bivariate and multinomial logistic regression analyses were used to analyse the data. The study results indicate that the lifetime prevalence was 18.1% for tobacco use and 15.9% for alcohol use. The multiple substance use among adolescents in descending order were: alcohol and tobacco (42.5%); illicit drugs and tobacco (26.6%); alcohol, tobacco and illicit drugs (18.7%); and illicit drugs and alcohol (12.3%). Male adolescents were more likely than their female counterparts to have experienced multiple substance use of drugs and alcohol (OR, 2.0; 95% CI, 1.3-3.3); alcohol, tobacco and drugs (OR, 2.4; 95% CI, 1.7-3.4), tobacco and alcohol (OR, 2.2; 95% CI, 1.6-2.8) and illicit drugs and tobacco (OR, 1.5; 95% CI, 0.9-2.3). Lifetime use of habitforming substance and multiple substance use were common in Botswana and as such require immediate programme intervention.Keywords: Smoking, drinking, drug prevalence, multiple substance use, adolescents, Botswan