Perception of illness among secondary school pupils in South Africa: malaria, tuberculosis, HIV/AIDS, and alcoholism

The study investigated beliefs of 121 high school students in Grade 11 about people who are ill with malaria, tuberculosis, HIV/AIDS, and alcoholism. The sample of Black pupils were chosen at random from two rural secondary schools in one region in the Northern Province of South Africa. Analysis indicated that HIV/AIDS was clearly distinguished from the other three illnesses by being seen as the least easily cured, having the most gradual onset, being the most contagious, showing the least look of illness, and the patients being likely those most blamed for their illness.

Perceptions of interventions for child sexual abuse in an urban South African sample

A questionnaire was used to study perceptions of interventions for child sexual abuse in a nonrepresentative urban South African population of 132 African/Black participants (61 men and 71 women) from the general public of Mankweng. Their ages ranged from 21 to 60 years (M age = 32.2 yr., SD = 10.4). Analysis indicated these participants clearly supported most of the components of nonadversarial approaches. Women were more positive about a nonadversarial approach than men; however, participants disagreed on questions about controlling the offender and whether an accused relative should move out of the home of the victim. Participants supported prosecuting offenders and longer prison sentences and did not favour leniency for first-time offenders. They further believed children, the family, and even less the offenders should receive treatment.

Perceptions of epilepsy among black students at a university in South Africa

The present study sought to investigate the relationship between familiarity, attitudes, causative and treatment beliefs about epilepsy in a sample of black young adults (university students) in South Africa. The sample included a convenient sample of 253 second year social science students, 98 (38.7%) males and 155 (61.3%) females in the age range from 18 to 42 years (M = 25.0 years, (SD = 4.2). The questionnaire administered to students in a class room situation included sociodemographic data, and sections on familiarity, beliefs about cause and treatment, sources of information, attitudes about epileptics, and prevention of epilepsy. Results showed that the majority of students, in particular from a rural background, were familiar with epilepsy. Health care institutions were the most important source of information on epilepsy, especially for women. Those who believed in traditional causes of epilepsy also endorsed traditional treatment for it, though they did not see such treatment as curative. Those who believed in a medical treatment did however see such treatment as curative. Although the majority of the students had a positive attitude towards epileptics through sharing a meal or room and willingness to marry an epileptic, 17% thought that epileptics can infect others with their saliva during a seizure, 12% felt an epileptic is a witch or wizard, and about 10% said an epileptic must be isolated. Findings should be included in educational programmes for young adults.

Tobacco use among black South African university students: attitudes, risk awareness and health locus of control

OBJECTIVES

To provide data on African/black South African university students' tobacco use status, belief in the benefits to health of not smoking, risk awareness in terms of knowledge of the links between smoking and disease, health locus of control, value for health, subjective health status and well-being.

DESIGN

Cross sectional.

SETTING

University of the North.

SUBJECTS

793 Black University students from non-health courses chosen by random sampling, of these 370 (46.7%) were males and 423 (53.3%) were females in the age range of 18 to 25 years (M age 21.0 years, SD = 3.48).

MAIN OUTCOME MEASURES

A measure of smoking, the Multidimensional Health Locus of Control Scale, the Health as a Value Scale, and a measure for subjective health and subjective well-being.

RESULTS

The average prevalence of current tobacco use was 15% in men and 1% in women. The proportion of tobacco users who were classified as light users (1-10 per day) averaged 10% in men and 1% in women. Age and being male were significantly positively associated with status and frequency of tobacco use. Awareness of the link between smoking and lung cancer was high (93%), but awareness of the role of smoking in heart disease was very low (16%). The importance to health of not smoking was associated with smoking status (non-smoking versus smoking). Overall, 75% of the current smokers stated that they would like to reduce the amount they smoked. Poor subjective health status and low subjective well-being was associated with smoking status. No significant differences were found among non-tobacco users and tobacco users in relation to the three subscales of the Health Locus of Control (Internal, Chance, and Powerful others) and Value for health.

CONCLUSION

For about 9% of the male students investigated, a high risk exists to become regular tobacco users for the next 30 years.

Concepts and treatment for diabetes among traditional and faith healers in the northern province, South Africa

The purpose of the study was to assess the concepts and treatment modalities for diabetes among traditional and faith healers in the Northern Province in South Africa. The sample consisted of 50 traditional healers (13 females and 37 males) and 50 faith healers (12 females and 38 males). They were interviewed on local terminology, clinical manifestations, causes, curability, and treatment for diabetes, help-seeking behaviour of diabetes patients, and the healers' sources of information about diabetes. Results indicate that all healers were familiar with "diabetes", however, not all of them had seen patients suffering from diabetes. The perceived causes of diabetes by both traditional and faith healers could be divided into (1) diet (especially too much of sugar), (2) heredity, (3) supernatural, and (4) psychological causes. Most traditional healers (92%) and faith healers (90%) indicated that diabetes is curable. Treatments used by the healers in this study included the use of prayer, diet, and herbs. The authors conclude that the concepts and treatment modalities for diabetes among traditional and faith healers should be taken note of by health workers while developing health education programmes in the Province.

Smokeless tobacco use among adults in the Northern Province of South Africa: qualitative data from focus groups

The aim of this study was to investigate perceptions on the use of smokeless tobacco in the Northern Province, South Africa. Ten focus groups were conducted in 1999 with two heterogeneous groups (5 with middle-aged and 5 with the aged). They were mainly Northern Sotho speaking. From 72 participants 16 women and 8 men admitted to using snuff. The most popular types of smokeless tobacco used were homemade snuff and only a few used "commercial" snuff. The basic ingredients for homemade snuff were tobacco and other plant leaves. Snuff was found to have important functions and to be socially acceptable in the groups studied mainly for ceremonial and medicinal use and to a lesser degree for relaxation and pleasure. Generally, positive and medicinal effects were noted for snuff use. Most participants agreed that it is addictive, but only a few acknowledged the negative effects in terms of causing cancer.

Knowledge and practice of condom use among first year students at University of the North, South Africa

The aim of the study is to investigate knowledge and sexual practices with reference to correct use of condoms among first year South African University students. The sample consisted of 206 participants, 146 female and 60 male, the mean age was 20.9 years (SD = 3.4), with a range from 17 to 34 years. Results indicated that one third (29.2%) of the sample reported never using condoms, 35.4% always, 19.8% regularly and 8.5% irregularly in the past three months. About 90% levels of correct answers for condom use were found for the items of 'condoms as protection against STD and AIDS', 'expiry date of condoms', and 're-using condoms'. More than 15% were not aware that a condom should be put on before any contact with the vagina. The most common mistakes with respect to condom use were ignorance about the correct moment to put on a condom (56%), and when to take off a condom (55%). Male sex and especially increasing recent sexual encounters was associated with correct condom knowledge. The most common reasons for not using a condom were 'I do not have the AIDS virus' and 'I thought I was safe' seems to indicate a low perceived susceptibility. Findings are discussed in view of condom promotion programmes.

Tobacco smoking in Black and White South Africans

OBJECTIVES

To provide data on black and white South Africans' tobacco use status, belief in the benefits to health of not smoking, risk awareness in terms of knowledge of the links between smoking and disease, health status, subjective health status and well-being.

DESIGN

Randomised study.

SETTING

Two urban communities in the Northern Province of South Africa.

PARTICIPANTS

Two hundred and fifty blacks and 250 whites. The black participants were 100 (40%) men and 150 (60%) women in the age range of 18 to 80 years (mean = 38.9 years, SD=4.7), and the white participants were 111 (44.4%) men and 139 (55.6%) women in the age range of 19 to 91 years (mean = 41.8 years, SD=3.5).

MAIN OUTCOME MEASURES

A measure of smoking, health benefits, risk awareness, health status, subjective health and subjective well-being.

RESULTS

The average prevalence of current smoking was 11.2% in Blacks, 23.6% in whites, 31.8% in men and 6.9% in women. Age, being male, being white, and being married or living with a partner were significantly positively associated with smoking status and smoking frequency. Risk awareness of the negative effects of smoking and the belief in the importance of not smoking were both significantly negatively associated with both smoking status and smoking frequency.

CONCLUSION

The prevalence of smoking tobacco, especially among males and Whites as well as the low risk awareness of smoking is a cause of concern. Stronger beliefs in the importance of not smoking, being female and lower age were identified as independent predictors among non-smokers than smokers.

PSYCHOLOGICAL CORRELATES OF SUBSTANCE USE AMONG SOUTH AFRICAN UNIVERSITY STUDENTS

The present study sought to investigate the relationships between substance use and psychological variables among 799 first-year South African university students chosen by random sampling. Psychological correlates (in terms of minor psychiatric morbidity, perceived stress, sensation-seeking, self-esteem, subjective health, and anomia) of substance use were found to be associated with the use of specific substances. Sensation-seeking was associated with the use of cannabis, alcohol and tobacco; minor psychiatric morbidity with cannabis and alcohol use; and anomia with cannabis use. Logistic regression on cannabis use identified male gender and sensation-seeking as independent predictors for current cannabis use.

PSYCHOSOCIAL CORRELATES OF HEALTHY LIFESTYLES IN BLACK AND WHITE SOUTH AFRICANS

The purpose of this study was to assess the prevalence and psychosocial correlates of healthy practices among 250 Black and 250 White South Africans chosen by systematic random sampling. Results indicated that Blacks practiced on average above 7 and Whites above 8 healthy behaviors from a total of 13. For most healthy practices significant differences were found between Whites and Blacks. Analysis of Variance showed that a number of sociodemographic variables, health benefits, subjective health and subjective well-being were positively associated with healthy practices. Multiple stepwise regression analysis found that independent predictors for the health practices index were women, having children, Whites, formal education, and worse health status.

Risk for traumatization among violent crime victims in an urban community sample in South Africa

This study intended to investigate risk factors for the development of trauma symptoms as a consequence of violent crime in an urban South African community. The sample included 128 adult victims of violent crime chosen by snowball sampling. The adults were 36 (28.1%) males and 92 females (71.9%) in the age range of 18 to 52 years (M age 36.6 yr., SD = 8.9). Results indicate that the most common violent crimes experienced among the participants were rape (attempted rape), followed by physical assault, armed robbery, attempted murder and threat in that order. The majority of the victims scored high on the Kölner Risk Index (for traumatization)--several case examples are given. Analysis of Variance indicated that almost all factors of the Kölner Risk Index seem to be significantly correlated with PTSD outcome measures (PTSS-10, IES-R, Peritraumatic Dissociation and Trauma Belief). It is concluded that the Kölner Risk Index can be a useful tool for identifying crime victims at risk for the development of trauma symptoms, especially in (mental) health care settings.

Health Behaviour in Black South African University Students

Four important health behaviours – dietary fat avoidance, regular exercise, smoking and alcohol consumption - were assessed by questionnaire, together with measures of risk awareness, beliefs about the importance of each behaviour for health, health status, health locus and health value. The sample included 793 Black University students from non-health courses chosen at random from the University of the North, South Africa. The students were 370 (46.7%) males and 423 (53.3%) females in the age range of 18 to 25 years (M age 21.0 years, SD=3.48). The following prevalences for healthy behaviour was found: almost half (44.7%) avoided fat and cholesterol and likewise 48% had exercised in the past 14 days. More than 90% were non-smokers and 84% were non-drinkers or drank alcohol only very occasionally. Sex emerged as an independent predictor for smoking and drinking. Men smoked and drank more than women did. The level of risk awareness about healthy behaviour seemed to be low in this sample. Risk awareness and prevalence of health behaviour was only found to have significant effects for non-smoking and not for the other health behaviours (exercise, fat intake, alcohol consumption). Beliefs were more important independent predictors of dietary fat intake and exercises than was risk awareness.

Factors affecting condom use among senior secondary school pupils in South Africa

OBJECTIVES

The aim of the study was to investigate factors affecting condom use among senior secondary school pupils in South Africa. Objectives were to identify the sociodemographic characteristics and sexual history, knowledge about correct condom use, source of condom information, AIDS health beliefs, self efficacy of condom use, correlates and predictors of condom use in Grade 12 students.

DESIGN

Cross sectional survey.

SETTING

460 Grade 12 secondary school pupils from three rural schools.

SUBJECTS

The sample included 460 Grade 12 secondary school pupils, 170 (37%) males and 290 (63%) females in the age range of 16 to 30 years (mean age 19.7 yrs, SD = 2.5).

MAIN OUTCOME MEASURES

Self reported sexual activity and condom use (12 items); source of 'condom' information (12 items); knowledge of correct condom use (10 items); a 16 item AIDS Health Belief Scale and a 28 item Condom Use Self-Efficacy Scale.

RESULTS

About half of those sexually active (52.6% males and 40.5% females) reported never having used condoms. About 90% levels of correct answers on condom knowledge were found for the items of "protection against AIDS" and "expire date of condoms". Knowing someone with HIV/AIDS was related to current condom use and a history of STD with lifetime condom use. The four AIDS beliefs sub-scales were all related to self efficacy of condom use. Behavioural norm to use condoms, attitudes towards condom use, normative beliefs to use of condoms and subjective norm to use condoms were all related to condom use intention. Normative beliefs and subjective norms to use condoms were both negatively related with lifetime condom use, current condom use, and self efficacy in condom use. Normative beliefs, attitudes and subjective norms about condoms predicted condom use intention, AIDS susceptibility and AIDS benefits predicted condom use with last sexual partner, and AIDS benefits and AIDS barriers predicted condom use intention.

CONCLUSION

Findings have relevant implications and are discussed in the context of developing an educational or intervention programme.

Knowledge and practice of condom use in an urban adult community sample of the Northern Province, South Africa

There is a paucity of data concerning condom use, especially regarding knowledge about the correct use of condoms in South Africa. Therefore, the aim of the study is to investigate knowledge and sexual practices with reference to correct use of condoms among an urban adult community in the Northern Province. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Community perceptions of biomedical health care in a rural area in the Northern Province South Africa

The success of strategies to revitalize primary health care services such as those advocated by the Bamako Initiative requires a response adapted to the expectations of the populations, especially in terms of quality. The goal of this study was to investigate community perceptions of availability, accessibility, acceptability and affordability of biomedical health care services in a rural area of the Northern Province in South Africa. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Factors affecting condom use among junior secondary school pupils in South Africa

The aim of the study is to investigniefi2ctors affecting condom use among junior Secondary School pupi1s in South Africa. The sample included 446 Grade 10 Secondary school pupils, 200 (44.896) ma1e and 246 (55.2%),females within the age range of I0 to 30 years (M age 16.6 years, SD = 2.5) from three rural schools in one region of the Northern Province in South Africa. Main outcomes measures included sexual activity and condom use (12 items), source of “condom” information (12 items), knowledge of correct condom use (10 items), a 16-item AIDS Health Belief Scale and a 28-item Condom Use Self-Efficiency Scale. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Substance use among urban and rural secondary school pupils in South Africa

This study investigated the prevalence and frequency of substance use among a sample of 209 urban and 191 rural school pupils in South Africa. The three most predominantly used substances were alcohol, tobacco, and cannabis. Urban and rural differences in substances used were found.

Opinion on AIDS prevention and education among rural secondary school pupils in the northern province of South Africa

The study investigated perceptions of AIDS prevention and education among 308 Grade 11 pupils (132 boys and 176 girls), secondary school pupils (mainly Northern Sotho and Tsonga) in the Northern Province of South Africa. They were chosen randomly from three rural schools in Mankweng district and were ages 17 to 25 years (M age = 19.1 yr., SD = 2.8). Analysis of ratings given on items of a questionnaire on AIDS prevention and education indicated that 'Isolating people who are HIV positive' and 'How to protect yourself from getting HIV/AIDS' received the highest ratings. Factor analysis extracted three factors on AIDS education explaining 48% of the variance. The items loading strongly on the first factor were use of condoms (.54), giving information (.53), finding a cure (.52), and no sex outside marriage (.42). On AIDS education two factors were extracted accounting for 52% of the variance. The first factor had significant item loadings for 'sexual behaviour and HIV/AIDS' (.75), 'knowledge of self-protection' (.68), 'how AIDS/HIV affects the body' (.66), and 'alcohol and sexual behaviour'. These findings should contribute to the development of health promotion initiatives directed at AIDS/HIV.

Gambling attitudes among black South African university students

Political change in South Africa since 1994 has led to a marked increase in opportunities to gamble. The purpose of the study was, therefore, to investigate attitudes towards gambling in African University students with the Gambling Attitude Scales by sex, course of study, and personality traits such as conservatism and risk-taking. The sample included 136 University of the North students, 80 first-year psychology and 56 second-year African law students. The students were 69 men and 65 women in the age range of 18 to 32 years (M of 21.8 yr., SD = 3.9). Analysis showed that men held more positive attitudes than women did towards gambling. Positive attitudes toward gambling were related to individual differences in risk-taking, liberalism, and course of study.

Knowledge, self-efficacy and behavioural intent towards AIDS prevention behaviours among culturally diverse secondary school pupils in South Africa

OBJECTIVE

To investigate knowledge, self-efficacy, and behavioural intent towards AIDS prevention behaviours among culturally diverse secondary school pupils in South Africa.

DESIGN

Randomised study.

SETTING

Three urban secondary schools in Pietersburg, South Africa.

PARTICIPANTS

Three hundred and sixty six Grade 11 secondary school pupils, comprising 150 (41%) males, and 216 (59%) females, aged 17 to 24 years (mean age 19.3 years, SD=2.6). The three cultural groups were 142 Blacks, 112 Whites and 112 Asians.

MAIN OUTCOME MEASURES

The questionnaire included items on socio-economic and family background, knowledge about HIV, perceived self-efficacy and behavioural intent regarding AIDS preventive behaviours.

RESULTS

Overall, the participants showed an adequate level of AIDS knowledge. However, there was considerable inaccuracy regarding AIDS transmission myths or how AIDS cannot be transmitted. The different cultural groups generally felt most self-efficacious regarding how to protect themselves from becoming infected (75-90%) and least self-efficacious on knowing where to go for information on AIDS (72-74%). Generally, participants reported a high behavioural intent. The Whites stand second in knowledge and more or less second in self-efficacy and behaviour intent. The Blacks stand third in knowledge and more or less second in self-efficacy and behaviour intent.

CONCLUSION

Culturally diverse knowledge, self-efficacy and behavioural intent towards AIDS prevention was found among White, Black and Asian pupils, which should inform a culturally sensitive and appropriate AIDS health promotion programme in South Africa.

Cross-cultural attitudes towards suicide among South African secondary school pupils

OBJECTIVE

To investigate the attitudes towards suicide among Grade II secondary school pupils among three cultural groups in South Africa.

DESIGN

Cross sectional study.

SETTING

Grade II Secondary school pupils chosen at random from three urban schools in Pietersburg.

PARTICIPANTS

The sample included 366 pupils, 150 (41%) males and 216 (59%) females, the mean age was 19.3 years (SD = 2.6), with a range from 17 to 24 years. The three cultural groups were 142 blacks, 112 whites and 112 Asians.

MAIN OUTCOME MEASURES

Socioeconomic and family background (14 items), suicide data (4 items), and a 30-item Multi-Attitude Suicide Tendency Scale for Adolescents (MAST-12).

RESULTS

Suicide ideation and plans to commit suicide are the highest among Asians, closely followed by Whites and lowest among Black pupils. The frequency of attempted suicide was lower among Blacks (11.3%) than that among Asians (13.5%) and Whites (13%). Analysis of variance indicated a significantly higher score among suicide attempters on attraction to death and repulsion by life and a significantly lower score on attraction to life and repulsion by death. Furthermore, this study found a significant correlation between total MAST, suicide ideation, suicide intent, history of completed suicide in family or friend, parents divorced, family size and suicide attempt.

CONCLUSION

This study found differential effects across diverse ethnocultural adolescent groups for suicidal ideation, plants and attempts. This gives indications on how suicide prevention programmes can be constructed in culture-congenial ways.

Perceived treatment efficacy of the last experienced illness episode in a community sample in the northern Province, South Africa

This study determined the perceived efficacy of various health care providers for the last illness episode patients had suffered. 104 African/Black participants (50 male and 54 female), chosen by quota sampling from the general public (urban population of Mankweng), Northern Province, were interviewed. The research design was a one-shot case study. Medical treatment (68%) was the major choice of treatment for minor, major and chronic medical condition as well as psychological/mental disorders. The second most important treatment choice was the herbalist (19%) for minor and chronic conditions as well as traditional illness, followed by the diviner (9%) prophet or faith healer (4%) and psychologist (2%). Combined traditional or faith healing was utilized by 32% of the sample and combined western treatment by 68%. Regarding the self-rated treatment efficacy for the last illness episode western treatment was generally perceived as more effective than traditional or faith healing. However, traditional or faith healing was considered almost as long lasting as western therapy.

Risk factors and child sexual abuse among secondary school students in the Northern Province (South Africa)

OBJECTIVE

This is an investigation into the risk factors that could discriminate childhood sexual abuse (CSA) from non-abuse in the Northern Province (South Africa).

METHOD

414 students in standard 9 and 10 in three secondary schools in the province filled-in a retrospective self-rating questionnaire in a classroom setting. Questionnaires included modified and adapted questions from the Finkelhor's (1979) Risk Factor Checklist, and asked for physical contact forms of sexual abusive experiences of participants before the age of 17 years with an adult or a person at least 5 years older or a person in a position of power.

RESULT

It shows an overall (N = 414) CSA prevalence rate of 54.2%. Only four factors (from eight)-ethnicity not Northern Sotho, mother employed and not as laborer, a stepparent present in the family during childhood, and violence at home not seldom-significantly discriminated CSA from non-abuse. Increase in the number of combination of the four significant factors also increases the probability of the discrimination in a linear manner.

CONCLUSION

With some caution, we recommend the four significant risk factors for use while planning preventive strategies against childhood sexual abuse, and a massive campaign against child sexual abuse in the province. More job opportunities should be created in the province.

Factors affecting condom use among South African university students

OBJECTIVE

To investigate factors affecting condom use among South African university students.

DESIGN

Cross-sectional survey.

SETTING

Department of Psychology, University of the North, South Africa.

PARTICIPANTS

One hundred and forty six female and sixty first year male psychology students, mean age 20.9 years (SD = 3.4), with a range from 17 to 34 years.

MAIN OUTCOME MEASURES

Sexual activity and condom use (6 items), A 16-item AIDS Health Belief Scale and a 28-item Condom Use Self-Efficacy Scale.

RESULTS

Almost one third (29.2%) of the sample reported never using condoms, 35.4% always, 19.8% regularly and 8.5% irregularly in the past three months. Perceived barriers were associated with increasing age and reduced condom use intentions. In addition, perceived susceptibility was associated with past condom use. The total AIDS Health Belief was not related with age, gender, past condom use and condom use intentions. Self-efficacy of condom use was associated with decreasing age, past condom use and condom use intentions but not with gender.

CONCLUSION

Findings have relevant implications and are discussed in the context of developing an educational or intervention programme.