Prescribing HIV Prevention by Nicola Bulled

Author:Nicola Bulled [Bulled, Nicola]
Language: eng
Format: epub
Tags: Social Science, Anthropology, General
ISBN: 9781315421957
Google: brlmDAAAQBAJ
Publisher: Routledge
Published: 2016-06-16T06:03:02+00:00

Quantifying Youths’ HIV Knowledge

In order to further examine the HIV knowledge of youth in Lesotho, I developed a self-administered written survey to pair quantitative and qualitative data. The survey (written in English at a sixth grade reading level) contained a 26-item scale of knowledge. The items were drawn directly from the questions originally posed by students and included in the pile sort exercise. The scale assessed standard areas of HIV knowledge including HIV transmission, HIV prevention, and commonly-mentioned misconceptions. Based on the results of the pile sort exercise, the knowledge scale also included thematic areas identified by students as relevant to understandings of HIV in this youth population, for example, the origins of HIV. Response options were coded as dichotomous (correct=1; incorrect=0). A cumulative score was generated by adding all the correct responses.8

The overall knowledge scores ranged from 7 to 24. The scale had a mean of 18.46 (Std dev=2.92) and a standardized Cronbach alpha measure of reliability of 0.53. Scales are generally not considered reliable if alpha values fall below 0.70 (Nunnally and Bernstein 1978).9 An examination of the Cronbach alpha table, which shows alpha values when items are deleted, revealed that the overall alpha of the initial scale would not be improved by up to 0.05 if any of the items were removed.10 As the students had generated the questions and as the knowledge constructs included in the original scale were relevant and necessary for a comprehensive understanding of HIV, I decided to retain the original scale. The construct validity of the scale was measured by testing the association between this scale and selected constructs. The results showed that HIV-related knowledge was significantly associated with age (r=-0.16; p=0.0008), year of enrollment at LCE (χ2=42.00; p=0.0007), and gender (χ2=34.78; p=0.0066), as observed in the analysis of the pile sort data. The proportion of students who answered the dichotomous (yes/no) statements correctly, with correctness based on current biomedical evidence, is displayed on Table 5.3.

Supporting findings from the self-generated questions and pile sort, students appeared to comprehend or at least have memorized the basics of HIV transmission and prevention (i.e., that HIV is found in blood not saliva, condoms are an effective means of preventing HIV transmission, multiple sexual partners increase HIV risk, HIV is not a result of witchcraft, feeling healthy does not guarantee that you are not HIV-infected, and HIV has no cure). However, understanding HIV transmission to the point of comprehending levels of risk of specific behaviors remained limited. Approximately 70 percent of students believed that HIV can be transmitted when caring for an HIV infected individual without wearing protective gloves. Almost half of students believed HIV can be transmitted by sharing a toothbrush, and that a mother cannot transmit HIV through breastfeeding. Approximately 30 percent believed HIV can be transmitted through kissing or via mosquitoes. In addition, about 30 percent of students remained confused about the scientific claims of the benefits of male circumcision11 and about the safety of hospitals, and continued to regard HIV as a

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