Knowledge of HIV and AIDS in women in sub-Saharan Africa

Amy D. Burgoyne, Peter D. Drummond

Abstract

Although most African people have heard of HIV and AIDS, there is still widespread misunderstanding about how HIV is spread, the consequences of infection, and how to protect against infection. The most vulnerable groups are poorly educated women, those from rural backgrounds, and women who are economically dependent on men. Lower levels of education, taboos associated with the discussion of sexuality and sexual health, the submissive role of women in a relationship, and male control of decision-making regarding sexual relations might explain why African women are less knowledgeable about HIV/AIDS than men. Although most African men and women are aware of the protective benefits of condoms, negative attitudes towards the acceptability and safety of condom use are widespread. More sexual health campaigns tailored to women, especially those with low education levels and those from rural areas, are needed to reduce the spread of HIV in Africa. (Afr J Reprod Health 2008; 12[2]:14-31)

RÉSUMÉ

Connaissance du VIH/SIDA chez les femmes en Afrique sub-saharienne. Bien que la plupart des Africains aient entendu parler du VIH et du SIDA, il existe toujours une malconception répandue concernant la manière dont le VIH est propagé, la conséquence d´ une infection et comment empêcher l‘infection.  Les groupes les plus vulnérables sont les femmes peu instruites, celles qui viennent des milieux ruraux et les femmes qui dépendent économiquement des homes.  Les niveaux bas d‘ instruction, les tabous liés à la discussion de la sexualité et de la santé sexuelle, le rôle soumis des femmes dans une relation et la domination de l´homme par rapport à la prise de décision concernant les relations sexuelles peuvent expliquer pourquoi les femmes africaines s´y connaissent mieux en VIH/SIDA que les hommes.  Bien que la plupart des hommes et des femmes africaines soient au courant des avantages protecteurs des préservatifs, il existe un peu partout des attitudes négatives envers l´acceptabilité et la sécurité de l´ usage du préservatif.  Pour réduire la propagation du VIH en Afrique, il faut davantage des campagnes en faveur de la santé qui viseront les femmes, surtout celles qui ne sont pas bien instruites et celles des milieux ruraux. (Rev Afr Santé Reprod 2008; 12[2]:14-31)

 

KEY WORDS:  HIV/AIDS awareness; HIV myths; attitudes toward condom use

Full Text:

PDF

References

UNAIDS. 2006 Report on the Global AIDS Epidemic. Geneva: UNAIDS, 2006.

Aniekwu NI. Gender and human rights dimensions of HIV/AIDS in Nigeria. African Journal of Reproductive Health 2002; 6(3): 30-37.

UNAIDS. Keeping the Promise: An agenda for action on women and AIDS. Geneva: UNAIDS, 2006.

World Health Organisation (WHO). Fact Sheets on HIV/AIDS for nurses and midwives. Geneva: World Health Organisation, 2000.

Kapiga SH, Lyamura EF, Lwihula GK, Hunter D. The incidence of HIV infection among women using family planning methods in Dar es Salaam, Tanzania. AIDS 1998; 12: 75-84.

Central Statistical Agency (CSA) Ethiopia, ORC Macro. Ethiopia Demographic and Health Survey 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ORC Macro, 2006.

Cellule de Planification et de Statistique [Planning and Statistics Unit] of the Ministry of Health (MOH) Mali, the Direction

Nationale de la Statistique et de l’Informatique [National Directorate of Statistics and Computer Science], ORC Macro. Mali Demographic and Health Survey 2001: Key Findings. Calverton, Maryland, USA: MOH, Direction Nationale de la Statistique et de l’Informatique and ORC Macro, 2001.

National Population Commission (NPC) Nigeria, ORC Macro. Nigeria Demographic and Health Survey 2003. Calverton, Maryland: National Population Commission and ORC Macro, 2004.

National Statistics and Evaluation Office (NSEO) Eritrea, ORC Macro. Eritrea Demographic and Health Survey 2002.

Calverton, Maryland, USA: National Statistics and Evaluation Office and ORC Macro, 2003.

Ghana Statistical Service (GSS), Noguchi Memorial Institute for Medical Research (NMIMR), ORC Macro. Ghana

Demographic and Health Survey 2003. Calverton, Maryland: GSS, NMIMR, and ORC Macro, 2004.

Central Bureau of Statistics (CBS) Kenya, Ministry of Health (MOH) Kenya, ORC Macro. Kenya Demographic and Health Survey 2003. Calverton, Maryland: CBS, MOH, and ORC Macro, 2004.

Ministry of Health and Social Welfare (MOHSW) Lesotho, Bureau of Statistics (BOS) Lesotho, ORC Macro. Lesotho Demographic and Health Survey 2004. Calverton, Maryland: MOH, BOS, and ORC Macro, 2005.

Ministry of Health and Social Services (MOHSS) Namibia. Namibia Demographic and Health Survey 2000. Windhoek, Namibia: MOHSS, 2003.

Institut National de la Statistique du Rwanda (INSR), ORC Macro. Rwanda Demographic and Health Survey 2005. Calverton, Maryland, USA: INSR and ORC Macro, 2006.

Department of Health National Health Information Systems of South Africa (NHIS/ SA), Medical Research Council South Africa, Centre for Health Systems Research and Development, University of the Orange Free State, Macro-International. 1998 South Africa Demographic and Health Survey. Calverton, Maryland: NHIS/SA and MacroInternational, 1998.

Tanzania Commission for AIDS (TACAIDS), National Bureau of Statistics (NBS), ORC Macro. Tanzania HIV/AIDS Indicator Survey 2003-04. Calverton, Maryland, USA: TACAIDS, NBS, and ORC Macro, 2005.

Ministry of Health (MOH) Uganda, ORC Macro. Uganda HIV/AIDS Sero-behavioural Survey 2004-2005. Calverton, Maryland, USA: Ministry of Health and ORC Macro, 2006.

Yahaya MK. Analysis of women’s reproductive health situation in Bida Emirate of Niger State, Nigeria. African Journal of Reproductive Health 2002; 6(1): 50-64.

Sarker M, Milkowski A, Slanger T, et al. The role of HIV-related knowledge and ethnicity in determining HIV risk perception and willingness to undergo HIV testing among rural women in Burkina Faso. AIDS and Behavior 2005; 9: 243-249.

Roth EA, Fratkin EM, Ngugi EN, Glickman BW. Female education, adolescent sexuality and the risk of sexually transmitted infection in Ariaal Rendille culture. Culture, Health & Sexuality 2001; 3: 35-47.

Ibe SN. HIV/AIDS awareness study of fresh students in tertiary institutions in Rivers State of Nigeria Department of Nigeria. Journal of Applied Sciences & Environmental Management 2005; 9: 11-13.

Araoye MO, Adegoke A. AIDS-related knowledge, attitudes and behavior among selected adolescents in Nigeria. Journal of Adolescence 1996; 19: 179-181.

Oyo-Ita AE, Ikpeme BM, Etokidem AJ, Offor JB, Okokon EO, Etuk SJ. Knowledge of HIV/AIDS among secondary school adolescents in Calabar- Nigeria. Annals of African Medicine 2005; 4: 2-6.

Wagbatsoma VA, Okojie OH. Knowledge of HIV/AIDS and sexual practices among adolescents in Benin City, Nigeria. African Journal of Reproductive Health 2006; 10(3): 76-83.

Jansen van Rensburg MS. A comprehensive programme addressing HIV/AIDS and gender based violence. Journal of Social Aspects of HIV/AIDS 2007; 4: 695-706.

Negash,Y, Gebre B, Benti D, Bejiga M. A community based study on knowledge, attitude and practice (KAP) on HIV/AIDS in Gambella town, Western Ethiopia. Ethiopian Journal of Health Development 2003; 17: 205-213.

Alene GD, Wheeler JG, Grosskurth H. Adolescent reproductive health and awareness of HIV among rural high school students, North Western Ethiopia. AIDS Care 2004; 16: 57-68.

Cherie A, Mitkie G, Ismail S, Berhane Y. Perceived sufficiency and usefulness of IEC materials and methods related to HIV/AIDS among high school youth in Addis Ababa, Ethiopia. African Journal of Reproductive Health 2005; 9(1): 66-77.

Kalichman SC, Simbayi L. HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa. Sexually Transmitted Infections 2003; 79: 442-447.

Simbayi LC, Kalichman SC, Jooste S, Cherry C, Mfecane S, Cain D. Risk factors for HIVAIDS among youth in Cape Town, South Africa. AIDS and Behavior 2005; 9: 53-61.

UNAIDS. Step Up the Pace of HIV

Prevention in Africa. Geneva: UNAIDS, 2006.

Yerdaw M, Nedi T, Enquoselassie F. Assessment of awareness of HIV/AIDS among selected target groups in and around Addis Ababa, Ethiopia. African Journal of Reproductive Health 2002; 6(2): 30-38.

Nkya GM, Sindato C, Mcharo J, Kibona SN. Community knowledge on HIV/AIDS and its relationship with sexual practices in Tabora and Igunga Districts, western Tanzania. Tanzania Health Research Bulletin 2006; 8: 173-176.

Andargie G, Kassu A, Moges F, et al. Low prevalence of HIV infection, and knowledge, attitude and practice on HIV/AIDS among high school students in Gondar, Northwest Ethiopia. Ethiopian Journal of Health Development 2007; 21: 179-182.

Smith DJ. Imagining HIV/AIDS: Morality and perceptions of personal risk in Nigeria. Medical Anthropology 2003; 22: 343–372.

Rumisha SF, Senkoro KP, Ngadaya E, et al. Community knowledge and information commu- nication gaps on HIV/AIDS in Iringa Munici-pality, Tanzania. Tanzania Health Research Bulletin 2006; 8(2): 101-108.

Anarfi JK. Vulnerability to sexually transmitted disease: street children in Accra. Health Transition Review 1997; 7(suppl): 281-306.

Mabunda G. HIV Knowledge and Practices Among Rural South Africans. Journal of Nursing Scholarship 2004; 36: 300-304.

Adeokun LA, Ladipo OA, Kanki P, Delano GE, Carrington A, Odimegwu CO. The role of HIV/AIDS prevention campaigns on HIV-related behavioural changes in Ibadan, Nigeria. African Population Studies 2005; 20: 43-63.

Kalichman SC, Simbayi L. Traditional beliefs about the cause of AIDS and AIDS-related stigma in South Africa. AIDS Care 2004; 16: 572-580.

Smith DJ. Premarital sex, procreation, and HIV risk in Nigeria. Studies in Family Planning 2004; 35: 223-235.

Smith DJ. Youth, sin and sex in Nigeria: Christianity and HIV/AIDS-related beliefs

and behaviour among rural-urban migrants. Culture, Health & Sexuality 2004; 6: 425-437.

Thomsen S, Stalker M, Toroitich-Ruto C. Fifty ways to leave your rubber: How men in Mombasa rationalise unsafe sex. Sexually Transmitted Infections 2004; 80: 430-434.

James S, Reddy SP, Taylor M, Jinabhai CC. Young people, HIV/AIDS/STIs and sexuality in South Africa: The gap between awareness and behaviour. Acta Paediatrica 2004; 93: 264-269.

Jegede AS, Odumosu O. Gender and health analysis of sexual behaviour in south-western Nigeria. African Journal of Reproductive Health 2003; 7(1): 63-70.

Maharaj P, Cleland J. Condom use within marital and cohabitating partnerships in KwaZulu-Natal, South Africa. Studies in Family Planning 2004; 35: 116-124.

Manuel S. Obstacles to condom use among secondary school students in Maputo city, Mozambique. Culture, Health & Sexuality 2005; 7: 293-302.

Mufune P. Myths about condoms and HIV/ AIDS in rural northern Namibia. International Social Science Journal 2005; 57: 675-686.

Nuwaha F, Faxelid E, Neema S, Höjer B. Lay people’s perceptions of sexually transmitted infections in Uganda. International Journal of STD & AIDS 1999; 10: 709-717.

Plummer ML, Wight D, Wamoyi J, Mshana G, Hayes RJ, Ross DA. Farming with your hoe in a sack: Condom attitudes, access, and use in rural Tanzania. Studies in Family Planning 2006; 37: 29-40.

Prata N, Vahidnia F, Fraser A. Gender and relationship differences in condom use among 15-24-year-olds in Angola. International Family Planning Perspectives 2005; 31: 192199.

Reddy P, Meyer-Weitz A, van den Borne B, Kok G. STD-related knowledge, beliefs and attitudes of Xhosa-speaking patients attending STD primary health-care clinics in South Africa. International Journal of STD & AIDS 1999; 10: 392-400.

Sunmola AM. Evaluating the sexual behaviour, barriers to condom use and its actual use by university students in Nigeria. AIDS Care 2005; 17: 457-465.

Hart GJ, Pool R, Green G, Harrison S, Nyanzi S, Whitworth JAG. Women’s attitudes to condoms and female-controlled means of protection against HIV and STDs in South-Western Uganda. AIDS Care 1999; 11: 687-698.

Iwuagwu SC, Ajuwon AJ, Olaseha IO.

Sexual behaviour and negotiation of the male condom by female students of the University of Ibadan, Nigeria. Journal of Obstetrics and Gynaecology 2000; 20: 507-513.

MacPhail C, Campbell C. ‘I think condoms are good but, aai, I hate those things’: Condom use among adolescents and young people in a Southern African township. Social Science & Medicine 2001; 52: 1613-1627.

Nzioka C. Unwanted pregnancy and sexually transmitted infection among young women in rural Kenya. Culture, Health & Sexuality 2004; 6: 31-44.

Ackerman L, de Klerk GW. Social factors that make South African women vulnerable to HIV infection. Health Care for Women International 2002; 23: 163-172.

UNAIDS. HIV - Related Stigma, Discrimination and Human Rights Violations: Case studies of successful programmes. Geneva: UNAIDS, 2005.

World Health Organisation (WHO). HIVinfected women and their families: Psychosocial support and related issues. A Literature Review. Geneva: World Health Organisation, 2003.

Clark S. Early marriage and HIV risks in subSaharan Africa. Studies in Family Planning 2004; 35: 149-160.

Chimbiri AM. The condom is an ‘intruder’ in marriage: evidence from rural Malawi. Social Sciences and Medicine 2007; 64: 11021115.

Dunkle KL, Jewkes RK, Brown HC, Gray GE, McIntryre JA, Harlow SD. Genderbased violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. The Lancet 2004; 363: 1415-1421.

Maman S, Mbwambo JK, Hogan NM, et al. HIV-positive women report more lifetime partner violence: Findings from a voluntary counselling and testing clinic in Dar es Salaam, Tanzania. American Journal of Public Health 2002; 92: 1331-1337.

van der Straten A, King R, Grinstead O, Vittinghoff E, Serufilira A, Allen S. Sexual coercion, physical violence, and HIV infection among women in steady relationships in Kigali, Rwanda. AIDS and behaviour 1998; 2: 61-73.

Kalichman SC, Simbayi LC, Kaufman M, et al. Gender attitudes, sexual violence, and HIV/AIDS risks among men and women in Cape Town, South Africa. The Journal of Sex Research 2005; 42: 299-305.

Greig FE, Koopman C. Multilevel analysis of women’s empowerment and HIV prevention: Quantitative survey results from a preliminary study in Botswana. AIDS and Behavior 2003; 7: 195-208.

Kapiga SH, Sam NE, Mlay J, et al. The epidemiology of HIV-1 infection in northern Tanzania: Results from a community-based study. AIDS Care 2006; 18: 379-387.

Longfield K, Glick A, Waithaka M, Berman

J. Relationships between older men and younger women: Implications for STID/ HIV in Kenya. Studies in Family Planning 2004; 35: 125-134.

Karim QA, Karim SSA, Soldan K, Zondi M. Reducing the risk of HIV infection among South African sex workers. American Journal of Public Health 1995; 85: 15211525.

Lawson AL. Women and AIDS in Africa: Sociocultural dimensions of the HIV/AIDS epidemic. International Social Science Journal 1999; 51: 391–400.

Kabira WM, Gachukia EW, Matiangi FO. The effect of women’s role on health: The paradox. International Journal of Gynecology & Obstetrics 1997; 58: 23-34.

Institut National de la Statistique (INS)

Cameroon, ORC Macro. Cameroon Demographic and Health Survey 2004 Executive Summary [English]. Calverton, Maryland, USA: INS and ORC Macro, 2004.

Direction Nationale de la Statistique (DNS) Guinea, ORC Macro. Guinea Demographic and Health Survey 2005: Key Findings. Calverton, Maryland, U.S.A.: DNS and ORC Macro, 2006.

Institut National de la Statistique (INSTAT) Madagascar, ORC Macro. Madagascar Demographic and Health Survey 2003-2004: Key Findings. Calverton, Maryland, USA: INSTAT and ORC Macro, 2005.

National Statistical Office (NSO) Malawi, ORC Macro. Malawi Demographic and Health Survey 2004. Calverton, Maryland: NSO and ORC Macro, 2005.

Obiechina NJA, Diwe K, Ikpeze OC. Knowledge, awareness and perception of sexually transmitted diseases (STDs) among Nigerian adolescent girls. Journal of Obstetrics and Gynaecology 2002; 22: 302– 305.

Central Statistical Office (CSO) Zimbabwe, Macro International Inc. Zimbabwe Demographic and Health Survey 1999. Calverton, Maryland: Central Statistical Office and Macro International Inc, 2000.

Mbizvo EM, Msuya S, Hussain A, Chirenje MZ, Stray-Pedersen B. HIV prevalence in Zimbabwean women: 54-67% knowledge and perceived risk. International Journal of STD & AIDS 2003; 14: 202-207.

Olley BO, Rotimi OJ. Gender differences in condom use behaviour among students in a Nigerian University. African Journal of Reproductive Health 2003; 7(1): 83-91.

Refbacks

  • There are currently no refbacks.