Knowledge, attitude and beliefs amongst inhabitants of high density informal settlements with regard to sexuality and AIDS in Alexandra township

OBJECTIVE

The main purpose of this study was to gain information on the knowledge that people living in squatter conditions have about AIDS, their attitude towards this disease and their sexual practices.

METHOD

The study had two parts, in-depth interviews and a survey. The in-depth interviews were held with 68 male informal settlement dwellers to obtain information on the type of questions to ask in the quantitative part of the study, taking into account the sensitivity of the information we were seeking, and how best to phrase these questions. For the survey, the 300 male informal settlement residents who were interviewed, were located by means of systematic sampling techniques.

RESULTS

The results of the survey showed that most of the respondents were living in squalid conditions, without recreation facilities. They were also likely to have had more than one partner (54%). Most of the respondents (90%) had heard about AIDS as a disease. Even though they were aware of AIDS as an epidemic in the country as a whole, they were not convinced that the disease exists in their community, the main reason being that they have never heard about nor seen a person with AIDS in the township.

CONCLUSION

There is an urgent need for AIDS education. But this education cannot take place as a separate activity from other upliftment activities in squatter areas.

The use of television series in health education

This paper reviews evidence of the impact which television generally, and drama series in particular, can have on health beliefs, attitudes and behaviours. It describes how a television series, The Family House, was planned in Egypt to disseminate key health messages in an entertaining context. As only a very small number of television series were specifically developed to address health issues, and even fewer were evaluated, this paper presents important new data derived from focus group discussions and survey interviews which help in understanding the potential television series can have for health education. Finally, the paper presents data on the cost-effectiveness of The Family House series.

Further observations on ghee as a risk factor for neonatal tetanus

BACKGROUND

Previous case-control studies of neonatal tetanus (NNT) in the North West Frontier Province of Pakistan indicated that clarified butter (ghee) applied to the umbilical wound of newborns was a significant risk factor for NNT. However, the mechanisms underlying the risk remained undisclosed.

METHODS

A hospital-based case-control study was undertaken to evaluate further ghee and other factors possibly associated with risk of NNT. Mothers of several recent ghee-associated cases were visited in their homes, asked to simulate the procedures used in preparing the ghee, and samples of ghee were collected for culture.

RESULTS

Topical application of ghee to the umbilical wound was again shown to pose a significant risk for NNT. In-use contamination of ghee was documented as mothers repeatedly heated and manipulated samples of ghee set aside in special containers for this purpose. Ghee was usually applied to the umbilical wound of the baby several times each day for the first few days of life. Mothers of cases were again confirmed to be substantially more likely to report prior NNT cases than mothers of controls.

CONCLUSIONS

Educational interventions to reduce umbilical ghee use or to wash hands before each manipulation might reduce the risk of NNT in babies exposed to ghee who are born to non-immunized mothers. Increased efforts to immunize women of childbearing age with tetanus toxoid are also needed, with special priority for mothers known to have been associated with a previous NNT case. Topical antibiotics should be further evaluated for protective effects in non-immunized mothers.

Slowing heterosexual HIV transmission

HIV-1 is spreading rapidly through heterosexual intercourse in many societies. Slowing the transmission of this virus is the most urgent global public health priority. Our understanding of the biologic differences between societies that account for most vacancies in heterosexual HIV transmission are now understood. Effective interventions to slow transmission must be designed, implemented, and evaluated. Human and fiscal resources must be provided through a shared global effort. The consequences of failing to do so will lead to a world catastrophe of unprecedented magnitude.

Mothers' attitudes towards donated breastmilk in Jos, Nigeria

In many developing countries, the use of pooled human milk is not widely accepted. Six hundred eighty breastfeeding mothers were interviewed to ascertain their acceptance of donated breastmilk. Their attitudes toward stored breastmilk, human milk banking, and breastfeeding in the event of human immunodeficiency virus (HIV) positivity were solicited. About 71 percent would not accept donated breastmilk for their baby while the rest would consent only if the donor were a close family relative, owing to fear of transfer of diseases (28 percent), fear of transfer of genetic traits (22 percent), and religious and cultural taboos (14 percent). However, 60 percent were willing to donate breastmilk. Only 38 percent would accept milk from a breastmilk bank. None would breastfeed if she were HIV positive.

The relationship of substance use with sex to the use of condoms among young adults in two urban areas of Scotland

The relationship of the use of alcohol or drugs in conjunction with sexual activity and the use of condoms and other contraceptives was examined among 1378 respondents in a household survey of two urban areas of Scotland. In bivariate analyses, respondents who reported having had sex under the influence of alcohol or drugs were no less likely than respondents with no such experience to report consistent use of condoms, and having had sex under the influence of substances was positively related to lifetime condom use. Multivariate analyses that included gender and urban area as predictors yielded similar findings. The results suggest that individuals who combine sex with alcohol or drugs are not necessarily more likely to engage in riskier sex.

The impact of a lecture on AIDS on knowledge, attitudes and beliefs of male school-age adolescents in the Asir Region of southwestern Saudi Arabia

The aim of this study was to assess the levels of knowledge, attitudes and beliefs and AIDS among secondary school students in the Asir Region of Southwestern Saudi Arabia, and to assess the impact of a one-session AIDS education lecture given in some schools in the region during World AIDS Day, December 1992. An Arabic version of a previously reported self-administered questionnaire including factual and attitudinal items about AIDS was constructed. The questionnaire was given to two randomly selected groups of students; an experimental group of 335 students who had been exposed to a one-session lecture program about AIDS, and a control group of 503 students not previously exposed to the lecture. The results showed marked variability in correct responses to various specific items within and between groups. However, overall, 65% of the experimental group and 63% of the control group gave correct responses (P=0.517). Both groups were particularly less aware that casual contact cannot spread AIDS. However, fear of getting AIDS was significantly less among the experimental than among the control group (47% versus 58%, P = 0.011). Student knowledge about AIDS is inadequate, and the impact of an isolated one-session AIDS education lecture is less than satisfactory. AIDS education through a comprehensive school health program is recommended.

Unintended pregnancies and use, misuse and discontinuation of oral contraceptives

Unintended pregnancies are a recognized occurrence among women using oral contraceptives (OCs) as a consequence of both user and method failure. However, OCs also influence the occurrence of unintended pregnancies through an additional, poorly recognized, route: cessation of OC use by women who do not wish to become pregnant but stop using OCs because of side effects or other reasons. Many such women fail to immediately substitute a new contraceptive and/or adopt a less reliable contraceptive. This is a particularly important consideration for the approximately 3.7 million women who begin taking OCs in the United States each year since this group commonly experiences side effects and has a high discontinuation rate. Using a decision tree to follow a cohort of OC users over one year, we estimate that over 1 million unintended pregnancies are related to OC use, misuse or discontinuation. The greatest proportion of these, 61%, occur in women who discontinue OCs; of these, 66.6% occur in women who fail to immediately substitute other contraceptives and 33.3% because of the adoption of less reliable contraceptive methods. Of continuing OC users, the majority, exhibiting good compliance, contribute 24% of pregnancies because of their large numbers. Continuing OC users who are poor compliers, though many fewer, are responsible for 15% due to their high pregnancy rate. Unintended pregnancies in women who discontinue OCs account for approximately 20% of the 3.5 million annual unintended pregnancies in the United States, incurring costs of nearly +2.6 billion.(ABSTRACT TRUNCATED AT 250 WORDS)

HIV-1 infection in Juba, southern Sudan

Thirty years of civil war in the Sudan have resulted in the isolation of the southern provinces which border Central and East Africa. Consequently, little is known about the epidemiology of HIV-1 infection in this region. To estimate the prevalence of HIV-1 infection in southern Sudan and the risk factors associated with disease transmission, a seroepidemiologic survey was conducted in the township of Juba. Study subjects invited to participate in this study included medical outpatients, inpatients hospitalized for active tuberculosis, and female prostitutes. A total of 401 subjects participated in the study. HIV-1 infection was confirmed in 25 subjects. The prevalence of HIV-1 infection was 19% (8/42) among tuberculosis patients, 16% (8/50) among prostitutes, and 3% (9/309) among outpatients. A significantly higher prevalence of HIV-1 infection was found among female prostitutes when compared to female outpatients: 16% (8/50) vs. 2% (4/178), P < 0.001. Correspondingly, the prevalence of seropositives was significantly higher among male outpatients reporting a history of sexual relations with prostitutes during the prior 10 years compared to male outpatients denying relations with prostitutes: 14% (5/37) vs. 0% (0/94), P = 0.0011. A history of a sexually transmitted disease (STD) was also associated with HIV-1 infection among male outpatients. The findings of this study indicate that HIV-1 infection is highly prevalent in southern Sudan and that prostitutes and their sexual partners represent a major reservoir of HIV infection in this population. This epidemiologic pattern resembles that seen in the African nations neighboring southern Sudan.(ABSTRACT TRUNCATED AT 250 WORDS)