Do African-American men and women differ in their knowledge about AIDS,attitudes about condoms,and sexual behaviors?

This study identified a sample of young African-American men and women classified as having multiple sex partners or one sex partner. Of the 149 men, 71 (47%) were classified as having multiple sex partners and 78 (53%) as having one sex partner. Of the 165 women, 29 (19%) were classified as having multiple sex partners and 126 (81%) as having one sex partner. Results indicated that the groups did not differ in their knowledge about acquired immunodeficiency syndrome (AIDS). However, attitudes about condom use differed significantly by gender (P less than .01) and by multiple sex status (P less than .001). Angry reactions regarding the negotiation of condom use occurred more with men than with women (P less than .05). Men and members of the multiple sex partners group tended to engage in more risky sexual behavior. These two groups also had a significantly (P less than .001) higher incidence of gonorrhea. While the multiple sex partners group had significantly more smokers (P less than .01), drinkers (P less than .01), and crack users (P less than .05), men were significantly higher consumers of marijuana (P less than .001) and alcohol (P less than .01). Overall, the results indicate that African Americans are knowledgeable about AIDS, but there appears to be a gap between knowledge and risky sexual behaviors. Prospective studies are needed to clarify the factors that determine the relationship (or lack of) between knowledge and risky sexual behaviors. Without such studies, a major part of the foundation that is needed for the development of sensitive and effective AIDS prevention programs for African Americans will be missing.     

Barriers to HIV/AIDS treatment and treatment adherence among African-American adults with disadvantaged education

African Americans are disproportionately affected by acquired immunodeficiency syndrome (AIDS). New treatments that slow the progression of human immunodeficiency virus (HIV) infection offer hope for individuals living with HIV/AIDS, but lack of access to care and poor treatment adherence remain significant obstacles to HIV treatment. This study investigated the association between education literacy to HIV treatment adherence and barriers to care among African Americans living with HIV/AIDS. A community-recruited sample of 85 African-American men and 53 women receiving HIV treatment completed measures of health literacy, health status, treatment adherence, emotional well-being, and barriers to care. Nearly one-third (29%) of the participants had < 12 years of education or were functionally illiterate, and those with low-education literacy were less likely to be adherent to HIV medications within the previous two days. Lower-education literacy also was related to reasons for missing medications and barriers to accessing medical care. Individuals of law-education literacy also were more emotionally distressed, lacked social support, and were less optimistic than those with higher education. These results indicate that education and health literacy are important factors in HIV-treatment adherence and access to medical care. Interventions are needed for improving treatment adherence among law-income minorities, and such interventions will need tailoring for individuals with limited reading ability.     

Racial discrimination and health-promoting vs damaging behaviors among African-American adults

Studies have found relationships between racial discrimination and increased health-damaging behaviors among African-Americans, but have not examined possible concomitant decreased health-promoting behaviors. We explored the role of discrimination in two health-promoting behaviors, consuming ≥ 5 fruits/vegetables daily (FVC) and physical activity (PA), for the first time, and likewise examined discrimination's contribution to cigarette smoking, among a sample of N = 2118 African-American adults. Results revealed that discrimination contributed positively to smoking and to PA but was unrelated to FVC. These findings suggest that both adaptive and maladaptive health behaviors might be used to cope with the stress of discrimination.     

Conspiracy beliefs about the origin of HIV/AIDS in four racial/ethnic groups

We examined beliefs about the origin of HIV as a genocidal conspiracy in men and women of four racial/ethnic groups in a street intercept sample in Houston, Texas. Groups sampled were African American, Latino, non-Hispanic white, and Asian. Highest levels of conspiracy theories were found in women, and in African American and Latino populations (over a quarter of African Americans and over a fifth of Latinos) with slightly lower rates in whites (a fifth) and Asians (less than one in ten). Reductions in condom use associated with such beliefs were however only apparent in African American men. Conspiracy beliefs were an independent predictor of reported condom use along with race/ethnicity, gender, education, and age group. Data suggest that genocidal conspiracy beliefs are relatively widespread in several racial/ethnic groups and that an understanding of the sources of these beliefs is important to determine their possible impact on HIV prevention and treatment behaviors.     

HIV/AIDS and antiretroviral treatment knowledge, attitudes, beliefs, and practices in HIV-infected adults in Soweto, South Africa

A cross-sectional study of knowledge, attitudes, beliefs, and practices (KABPs) toward HIV and antiretroviral therapy (ART) was conducted in Soweto, South Africa, using a standardized validated questionnaire. Of 105 HIV clinic patients evaluated, 70% of whom were not on ART, 89% had good knowledge about the cause of HIV infection and 83% knew about modes of transmission. Fifty-nine percent reported they were not worried about ART side effects. Sixty-five percent agreed that missing ART doses can lead to disease progression. Ninety percent had disclosed their HIV serostatus to 1 or more persons, but only 62% of those with a current sexual partner reported having told that partner. Approximately 80% reported that if they were taking ART, they would not be worried about family or friends finding out. Forty-nine percent believed that ART can cure HIV, a belief that was associated with a low level of education (P<0.001). Overall, knowledge of the cause of HIV/AIDS, modes of transmission, and importance of ART adherence was good in our study population. Further research is warranted to assess the extent to which this knowledge and attendant attitudes predict ART adherence levels. The low rate of HIV serostatus disclosure to sexual partners calls for multidimensional interventions to reduce HIV-related stigma.     

Knowledge, attitudes, and behavior of homeless African-American adolescents: implications for HIV/AIDS prevention

The purpose of this pilot study was to describe the knowledge of HIV/AIDS, attitudes about condom use, and the sexual behavior of African-American adolescents who reside in a children's emergency homeless shelter. The Attitudes Toward Condom Usage Questionnaire, the AIDS Knowledge and Attitude Survey, and a Perceived Risk of HIV/AIDS Scale were modified and administered to 37 African-American male and female adolescents who reside in an emergency shelter. HIV/AIDS knowledge and attitudes about condoms among these respondents were comparable to those of other adolescents described in the literature in that there was a strong knowledge of HIV/AIDS, although sexual behavior and attitudes toward condoms were not consistent with this knowledge. Significant differences between male and female respondents were only found on three items of the Attitudes Toward Condom Usage Questionnaire and on the Perceived Risk of HIV/AIDS Scale at the 0.05 level. The knowledge, attitudes, and sexual behavior of homeless, African-American adolescents should be examined to develop and implement appropriate programs to address the specific needs of this population. Further research should focus on this population and expand on this preliminary data.     

Knowledge, beliefs, attitudes, and cancer screening among inner-city African-American women.

Three hundred twenty-one inner-city African-American women were interviewed to determine their knowledge, attitudes, and beliefs regarding cancer and cancer screening, and their cancer screening histories. The women were recruited from a variety of sources in Atlanta and were interviewed in their homes by trained lay health workers. Half of the subjects had an annual household income of < $15,000. About half had received a Pap smear and clinical breast examination within the year preceding the interviews. For women > 35 years old, 35% had received a mammogram within the recommended interval. Younger women and women with higher incomes were more likely than older women and those with lower incomes to have received a Pap test and clinical breast examination within the preceding year, but income was not significantly associated with mammography histories. In general, women who were more knowledgeable about cancer and its prevention were more likely to have been appropriately screened. However, various attitudes and beliefs regarding cancer generally were not associated with screening histories. We conclude that cancer screening programs for inner-city minority women should focus on improving knowledge levels among older women rather than attempting to alter attitudes and beliefs.     

Racial disparities in sexual risk behaviors and drug use among older gay/bisexual and heterosexual men living with HIV/AIDS

Adults over age 50 comprise 11% of yearly AIDS cases, yet little is known about their sexual risk behaviors and drug use following diagnosis with HIV/AIDS. The present questionnaire study examines potential racial differences in sexual risk and drug use behaviors among 59 HIV-infected gay/bisexual and heterosexual men over age 50 who were recruited from HIV-related organizations in New York City between 1996-1998. The majority (59%) of older men reported unprotected sex since diagnosis, and 36% had done so in the past six months. African-American gay/bisexual men (n=12) were significantly more likely than white gay/bisexual men (n=32) to report unprotected vaginal/anal sex in the past six months (67% versus 22%, p<0.01), since diagnosis (42% versus 9%, p<0.05), and to report a history of intravenous drug use (50% versus 3%, p<0.01), but did not differ from heterosexual African-American men (n=15). No differences were found in reports of unprotected oral sex or recent use of hard drugs (i.e., crack, cocaine, heroin). These findings suggest that interventions targeting older African-American men (both gay/bisexual and heterosexual) with HIV/AIDS are needed to reduce risk behaviors and prevent HIV transmission in this population.     

Knowledge, behaviors, and attitudes about hearing loss and hearing protection among racial/ethnically diverse young adults

Over 11 million individuals exhibit some degree of permanent noise induced hearing loss (NIHL). Despite such data, there remains a paucity of empirical evidence on the knowledge of noise exposure and hearing protection devices (HPDs) for young adults, particularly those of diverse racial/ethnic backgrounds. This lack of research is unfortunate, as prior research suggests that the incidence of NIHL can be reduced through educational programs, such as hearing conservation programs (HCPs). Moreover, research also indicates that such educational programs are more beneficial when developed for specific age and/or ethnic/racial groups. The primary aim of this investigation was to determine the knowledge base of 200 college-aged young adults aged 18-29, concerning the auditory mechanism, NIHL, and the use of HPDs. The second aim of this study was to identify race and ethnicity differences or similarities in knowledge of these areas among African-American and caucasian young adults. Overall, in many instances, a majority of the young adults in our study demonstrated a high degree of knowledge concerning factors associated with exposure to excessive noise and the risk of hearing loss. Yet, the results also revealed significant racial/ethnic differences in knowledge, behaviors, and attitudes about the use of HPDs. Recent estimates suggest that more than 11 million individuals in the United States exhibit some degree of NIHL. Moreover, 40 million individuals work in environments that contain potentially harmful noise levels, and over 50 million Americans routinely use firearms--a common cause of noise-induced hearing impairment. A specific hallmark manifestation of NIHL is a permanent decrease in hearing sensitivity from 3,000-6,000 Hz, with a characteristic notch at 4,000 Hz. Additional effects of exposure to high noise levels include physiological changes in heart rate and blood pressure, decrease in work productivity, and an interference with communication that results from the masking of speech. With these considerations in mind, the purpose of this study was to investigate the knowledge, behaviors, and attitudes of a young-adult population in the United States concerning the factors that contribute to NIHL and the use of hearing protection. Additionally, this study was interested in whether there were racial/ethnic differences or similarities in knowledge of hearing loss and the use of HPDs among African-American and caucasian young adults.     

Family communication about HIV/AIDS and sexual behaviour among senior secondary school students in Accra,Ghana

Background

Sexually active adolescents in Ghana are increasingly at risk of HIV and other sexually transmitted infections. As a primary agent of socialization, the family can exert a strong influence on adolescent sexual behaviour. Therefore, to aid in the design and implementation of effective prevention programmes, it is important to understand the role of the family in influencing sexual behaviour among school-going adolescents.

Objectives

To evaluate the relationship between family communications about HIV/AIDS and sexual activity and condom use among school-going adolescents in Accra, Ghana.

Method

A sample of 894 students (56.9% girls, 43.1% boys; mean age = 17.4 years, SD = 1.40) at two senior secondary schools in Accra completed a modified version of the Youth Risk Behavior Survey (YRBS) questionnaire, a self-administered instrument developed by the Centers for Disease Control and Prevention. Analytical techniques utilized included logistic regression and chisquare.

Results

Twenty-five percent of the participants reported being sexually experienced, and 73.6% had talked about HIV/AIDS with parents or other family members. Of the sexually experienced students, 64.7% initiated first sexual intercourse by age 16; and 55.7% did not use a condom at last sexual intercourse. Bivariate analysis showed significant gender differences in sexual activity, condom use, and family communication about HIV/AIDS. Logistic regression analysis showed that student-family communication about HIV/AIDS was not associated with sexual activity. However, communication about HIV/AIDS between students and parents or other family members increased the odds of using a condom at last sexual intercourse.

Conclusions

The findings of this study suggest that prevention programmes that seek to educate Ghanaian school-going adolescents about sexual risk behaviour must strongly encourage communication about HIV/AIDS between students and family members.     

HIV/AIDS and the African-American community: a state of emergency

HIV and AIDS disproportionately affect African Americans more than any other racial or ethnic group in the United States. Representing only 13% of the U.S. population, African-American adults and adolescents comprise more than half of all HIV/AIDS cases reported to the Centers for Disease Control and Prevention. The present incidence and prevalence of HIV/AIDS in the black community in the United States is of crisis proportions. The situation as it stands today is tantamount to a state of emergency for African Americans.     

Characteristics of African-American college students with HIV/AIDS.

This article examines the risky sexual behaviors, condom and drug usage, sexually transmitted diseases (STDs), and attitudes of African-American college students with the human immunodeficiency virus (HIV), which is the precursor of the acquired immunodeficiency syndrome (AIDS). A total of 408 (199 males, 209 females) African-American college students, representing 75% of the students enrolled in a southern university, were surveyed. The results revealed that 3.18% of the students reported having HIV/AIDS. The students with HIV/AIDS exhibited significant deficits in AIDS knowledge, particularly information concerning the transmission of HIV/AIDS. While subjects with HIV/AIDS did not differ from subjects without HIV/AIDS with regard to their perceived risk of being exposed to AIDS or their attitudes about using condoms, a significantly larger percentage of subjects with HIV/AIDS reported that they "always" used condoms with their partner. Nevertheless, subjects with HIV/AIDS were more likely to engage in anal intercourse, experience sex with prostitutes, and use drugs. Sexually transmitted diseases were more prevalent among subjects with HIV/AIDS, and syphilis was found to be the best predictor of HIV/AIDS.     

African-American sexuality and HIV/AIDS: recommendations for future research

HIV/AIDS continues to create a significant health crisis in African-American communities and health disparities within the United States. Understanding African-American sexuality within a culturally congruent and ethnocentric approach is critical to decreasing the HIV infection and transmission rates for African Americans. This brief discusses two major factors: 1) confusion about race-based stereotypes; and 2) historical health disparities and mistrust, which have influenced our understanding of African-American sexuality despite that fact that very little research has been conducted in this area. This paper discusses the limitations of what is known and makes recommendations for research surrounding sexuality and HIV/AIDS. Research trainings for new and established investigators and collaborations among health, community, religious, political organizations, and historically black colleges and universities are needed to disseminate relevant HIV prevention messages. Conducting research to better understand African-American sexuality will facilitate the development of behavioral interventions that address health, HIV and mental health risk reduction within the context of African-American life.     

Knowledge, beliefs and barriers associated with prostate cancer prevention and screening behaviors among African-American men

African-American men have the highest prostate cancer rates worldwide, and innovative efforts are needed to increase cancer prevention and screening behaviors among this population. Formative research was conducted to assess attitudes and behaviors linked to prostate cancer prevention activities that could be used to develop a culturally relevant intervention for an African-American church-based population. Four gender-specific focus groups were conducted with 29 men and women at two African-American churches in central North Carolina. Three primary themes emerged from the focus group discussions: culturally and gender-influenced beliefs and barriers about cancer prevention and screening; barriers related to the healthcare system: and religious influences, including the importance of spiritual beliefs and church support. These discussions revealed the importance of the black family, the positive influence of spouses/partners on promoting cancer screening and healthy behaviors, the roles of faith and church leadership, and beliefs about God's will for good health. These findings also revealed that there are still major barriers and challenges to cancer prevention among African Americans, including continued mistrust of the medical community and negative attitudes toward specific screening tests. Findings provide important insights to consider in implementing successful prostate cancer prevention interventions designed for church-based audiences.     

Knowledge of HIV/AIDS and attitude towards voluntary counseling and testing among adults

BACKGROUND: Nigeria has the third highest population of people living with human immunodeficiency virus (HIV). Despite this, the knowledge of HIV/AIDS and uptake of voluntary counseling and testing (VCT) is still low, especially in the rural areas. This study assessed knowledge of HIV/AIDS and attitude towards VCT among adults in a rural community in northern Nigeria. METHODS: A pretested questionnaire was administered on a cross-section of 210 adults in Danbare village, northern Nigeria. Information about knowledge of HIV/AIDS and attitudes toward VCT was elicited among respondents. RESULTS: The majority of respondents (59%) did not know the causative agent of AIDS; however, knowledge of route of disease transmission was high, with 71% and 64% of study participants mentioning sexual activity and unscreened blood transfusion, respectively, as possible transmission routes. Respondents listed avoidance of premarital sex, outlawing prostitution, condom use and screening of blood before transfusion as protective measures. Overall, 58 (27.6%), 80 (38.1%) and 72 (34.3%) of the respondents had good, fair and poor knowledge of HIV/AIDS, respectively. After adjusting for confounders, female gender and formal education remained significant predictors of HIV/AIDS knowledge. Reasons for rejection of VCT included fear of stigma, marital disharmony, incurable nature of the disease and cost of treatment. Formal education, female gender and HIV knowledge significantly predicted positive attitude toward VCT for HIV/AIDS among the study population. CONCLUSION: More than half of the respondents had adequate knowledge of HIV/AIDS, and the majority were willing to have VCT. However, misconceptions, fear, gaps in knowledge and limited access to VCT remain prevalent. Our findings suggest the need to provide health education and scale up VCT services in northern Nigeria by targeting the efforts of international and local development partners to underserved rural areas.     

HIV-risk behaviour and knowledge about HIV/AIDS among patients with schizophrenia

BACKGROUND: Recent literature has demonstrated that psychiatric patients, particularly those with a diagnosis of schizophrenia, may be at high risk for HIV infection. In fact, HIV-risk behaviour, such as intravenous drug with sharing needles, promiscuity associated with unprotected sex and high-risk sexual activity after using drugs has been reported by a substantial proportion of mentally ill patients. METHODS: In order to examine this problem in Italy, HIV-risk taking behaviour and knowledge about HIV/AIDS was investigated among 91 schizophrenic patients by using two self-report questionnaires (HIV-Risk Behaviour Questionnaire; AIDS-Risk Behaviour Knowledge Test). RESULTS: One-third of the patients reported having been tested for HIV infection and one tested seropositive (prevalence 3.4%). A high proportion of patients reported HIV-risk behaviour, such as injected drugs use (22.4%) and engaging in high risk sexual activity (e.g. multiple partners, 58%; prostitutes, 45%; occasional partners, 37%). Condoms were 'never used' by 41% of the patients and 'almost never used' by another 25%. In spite of these behaviours, 65% reported no concern of HIV infection. Knowledge about AIDS was lower among psychiatric patients than a healthy control group. Patients with long-lasting illness and numerous psychiatric admissions were less acknowledgeable about HIV infection. Certain misconceptions on HIV transmission were related to HIV risk behaviour. CONCLUSIONS: These results indicate the urgent need for HIV educational programmes within mental health community-care settings.     

Perceived barriers to social support from family and friends among older adults with HIV/AIDS

Research has found that HIV-infected adults age 50 and older are more socially isolated than younger HIV-infected individuals. This study examines the perceived barriers to obtaining emotional and practical social support from friends and family among 63 older adults (age 50+) living with HIV/AIDS. Many reported they did not receive enough emotional support (42%) or practical assistance (27%). Barriers to obtaining support included: (1) nondisclosure of HIV status; (2) others' fear of HIV/AIDS; (3) desire to be self-reliant and independent; (4) not wanting to be a burden; (5) unavailability of family; (6) death of friends to AIDS; and (7) ageism. These barriers may explain the greater social isolation of HIV-infected older adults and inform interventions targeted at reducing these barriers.     

Knowledge,attitudes, and beliefs related to hypertension and hyperlipidemia self-management among African-American men living in the southeastern United States

ObjectivePerceptions of illness affect cardiovascular disease (CVD) self-management. This study explores knowledge, attitudes, and beliefs regarding hypertension and hyperlipidemia management among 34 African-American men with hypertension and/or hyperlipidemia, age 40–65, living in the Southeastern United States.MethodsIn-person focus groups were conducted using semi-structured interview questions informed by the Health Belief Model (HBM).ResultsParticipants had a high level of knowledge about hypertension self-management, but less about cholesterol self-management. Perceived severity of both conditions was acknowledged, though participants perceived hypertension as more severe. Barriers to self-management included medication side effects and unhealthy dietary patterns. Facilitators included social support, positive healthcare experiences, and the value placed on family. Cultural implications highlighted the importance of food in daily life and social settings. Participants expressed how notions of masculinity affected self-management—noting the impact of feelings of vulnerability and perceived lack of control stemming from diagnosis and treatment expectations.ConclusionsThe findings highlight gaps in knowledge of hyperlipidemia versus hypertension, and the impact of cultural context and perceptions on engagement in self-management behaviors.Practice implicationsPublic health practitioners and healthcare providers serving African-American men should address cultural factors and notions of masculinity which can hinder effective disease management among this population.