Prevention in practice: obstacles and opportunities

General Practitioners are excellently placed within the community to provide health education and advice in relation to HIV infection and AIDS. This paper will report on some of the findings from the first national study of HIV infection and general practice in England and Wales. The findings cast light on the preparedness of practitioners to undertake health education on HIV infection. Findings that relate to the extent of contact that practitioners have with people with HIV infection, people with AIDS and people with worries about HIV infection or AIDS will be discussed in the light of opportunities that are created for HIV-related health education and prevention. Findings that relate to practitioners' opinions about providing health education and counselling, about working with people who are gay, bisexual and injecting drugs, and about confidentiality and consent, will be discussed in the light of obstacles that exist to the effective provision of HIV-related health education and prevention. The paper will conclude by discussing the implications of these findings for primary health care responses to HIV infection in Britain.     

The impact of social environments on the effectiveness of youth HIV prevention: a South African case study

Few would disagree that 'social context' shapes the effectiveness of HIV-prevention programmes. However much work remains to be done in developing systematic conceptualisations of HIV/AIDS-relevant aspects of social environments in vulnerable communities. This paper contributes to this challenge through a case study (44 interviews, 11 focus groups with 55 people and fieldworker diaries) of the impact of social context on a participatory peer education programme involving young people in a peri-urban community in South Africa. Three interacting dimensions of context undermine the likelihood of effective HIV-prevention. Symbolic context includes stigma, the pathologisation of youth sexuality (especially that of girls) and negative images of young people. Organisational/network context includes patchy networking amongst NGOs, health, welfare and education representatives and local community leaders and groups. This is exacerbated by different understandings of the causes of HIV/AIDS and how to manage it. These challenges are exacerbated in a material-political context of poverty, unemployment and crime, coupled with the exclusion of young people from local and national decision-making and politics. HIV-prevention initiatives seeking to promote health-supporting social environments should work closely with social development programmes to promote young peoples' social and political participation, increase opportunities for their economic empowerment, challenge negative social representations of youth, and fight for greater recognition of their sexuality and their right to protect their sexual health.     

HIV/AIDS prevention through peer education and support in secondary schools in South Africa

The implementation and evaluation of a peer education and support programme in secondary schools to prevent and reduce high-risk sexual behaviour amongst adolescents is discussed. The aims of the programme were to provide accurate information about HIV/AIDS, discuss and reconsider peer group norms, and establish support for learners. In the programme that was implemented in 13 secondary schools in Tshwane, South Africa, peer educators were identified, trained and supported to implement the programme in their schools with the assistance of a teacher and postgraduate students as facilitators. Peer educators organised HIV awareness activities, facilitated class discussions on risk behaviour and gender relationships, and supported learners in solving personal problems. Process evaluation included weekly reports and focus group discussions with peer educators and teachers. A quasiexperimental design involving an experimental and control group, as well as pre- and post-assessments, was used to evaluate the impact of the programme on psychological well-being, personal control, school climate and reported high-risk behaviour of learners aged between 13 and 20 years. The results showed that the percentage of learners in the experimental group who were sexually experienced remained unchanged over the time period of 18 months. In contrast, a significantly increased percentage of learners in the control group were sexually experienced after the same time period. The control group also perceived more of their friends to be sexually experienced. No differences were reported in condom use in either of the groups. The findings of this study suggest that peer education can contribute to a delayed onset of sexual activity, and can therefore contribute to the prevention of HIV/AIDS amongst adolescents.     

Obstacles to local-level AIDS competence in rural Zimbabwe: putting HIV prevention in context

We explore the wider social context of an HIV-prevention programme in rural Zimbabwe. We make no comment on the programme itself, rather seeking to examine the wider community dynamics into which it was inserted, to highlight how pre-existing social dynamics may have influenced community "readiness" to derive optimal benefit from the intervention. Using the concept of "the AIDS competent community", we analysed 44 interviews and 11 focus groups with local people. Despite high levels of HIV/AIDS-related knowledge, there were several ways gender, poverty and low literacy may have undermined its perceived relevance to peoples' lives. Lack of opportunities for dialogue in the social milieu beyond the intervention may have limited opportunities for translating factual AIDS knowledge into action plans, or sharing hidden individual experiences of HIV/AIDS-affected family members or friends, given stigma and denial. The initiative of women and young people to respond effectively to AIDS was limited in a context dominated by adult males. People spoke of HIV/AIDS in a passive and fatalistic way, expecting outsiders to solve the problem. This tendency was exacerbated given the community's previous experiences of HIV/AIDS-related NGOs, which had often regarded local people as unpaid volunteer labour rather than building their capacity to make significant decisions and play leadership roles in health programmes. Despite obstacles, however, there were many potential community strengths and resources. There were high levels of HIV/AIDS-related knowledge. Public denial of HIV/AIDS masked huge reservoirs of private support and kindness to AIDS-affected family and friends. There were many strong community organisations and clubs, potentially forming the springboard for more empowered community responses to HIV/AIDS. HIV/AIDS programmers should pay greater attention to community readiness for interventions, especially around: (1) identifying and anticipating pre-existing obstacles to programme success and (2) mobilising the social assets that exist, even in contexts of poverty and gender inequality.     

HIV prevention in Latin America: reaching youth in Colombia

The aim of this paper is to describe and evaluate a school-based peer education programme on HIV primary prevention implemented in urban marginal districts of three cities of Colombia from 1997 to 1999. Its main objective was to promote risk awareness and safe sexual behaviours among urban youth populations. Methodology included the collection of baseline information through qualitative methods (focus groups and in-depth interviews), a knowledge, attitudes and practices (KAP) survey, a health education intervention, and post-intervention data collection. Direct beneficiaries were adolescents 10 to 19 years of age, and secondary school teachers of 6th to 9th grades. Main strategies used were peer education and classroom sessions conducted by trained teachers. Short-term results suggest that the programme had a positive effect on knowledge and attitudes related to HIV/AIDS (as the mean knowledge summary indicator among adolescents and secondary school teachers increased 24% and 21%, respectively). The main outcome has been the development of a sex education programme, emphasizing the role of schools in the promotion of sexual and reproductive health. Mass education by a combination of interventions and events at school level, backed up by effective interpersonal communication such as peer education, classroom teaching and community actions are effective primary prevention strategies for HIV sexual transmission and should be more extensively considered.     

Life skills training as HIV/AIDS preventive strategy in secondary schools: evaluation of a large-scale implementation process

A life skills and HIV/AIDS education programme was implemented in secondary schools as a strategy to combat the spread of HIV/AIDS among school-going young people in South Africa. As part of a joint effort of the Departments of Health and Education, two teachers per school were trained to implement life skills training and HIV/AIDS education in schools as part of the school curriculum. The implementation of the intervention was evaluated in 24 schools in two educational districts in Gauteng province using an action research approach. Data about the implementation were gathered through interviews and focus group discussions with school principals, teachers and learners. A repeated measurement research design was used to assess the impact of the intervention in terms of knowledge, attitudes and reported risk behaviour in a sample of 667 learners representing learners from grades 8 to 12 from different population groups. Results showed that the programme was not implemented as planned in schools due to organisational problems in the schools, lack of commitment of the teachers and the principal, non-trusting relationships between teachers and learners, lack of resources and conflicting goals in the educational system. In an outcome evaluation over the period of a year it was found that learners' knowledge of HIV/AIDS increased and their attitudes were more positive although the changes may not be attributed to the programme alone. In the post-test more learners were sexually active, although preventive behaviour did not increase. The programme as implemented in the area did not succeed in changing high-risk behaviour patterns among school-going young people. From the evaluation of the intervention a few valuable lessons were learned about the content and implementation of HIV/AIDS preventive interventions, which could be useful in the implementation of various other HIV/AIDS preventive interventions in the community.     

Implementation of a comprehensive AIDS education programme for schools in Masaka District, Uganda

As part of a large IEC (Information, Education and Communication)/STD intervention trial, a 19-lesson, comprehensive school-based AIDS education programme was implemented and evaluated in 50 primary and 16 secondary schools in 12 parishes of Masaka District, Uganda. A series of three teacher-training and evaluation workshops spread over a year was held in each parish, between which teachers implemented the programme in the classroom. One hundred and forty-eight teachers were trained and about 3,500 students were subsequently exposed to the programme. Both teachers and students responded positively, which suggests that this type of programme has much to offer young people who attend school. However, some problems were encountered: language, programme content, community resistance to teaching about condoms, and several practical issues. Proposed solutions include flexibility with the English language policy, alternative approaches to role play activities, targeting influential individuals with information about the need for young people to learn about safer sex, and a parallel community-based IEC programme to facilitate community acceptance of the need for the programme. In addition, implementation may be incomplete unless comprehensive AIDS education is fully incorporated into the curriculum, and properly examined. These findings are placed in the context of other life skills/AIDS education programmes being introduced both in Uganda and elsewhere in Africa.     

HIV testing among racial and ethnic minority adolescents living in an urban community

ABSTRACT

This study examined the factors that influence HIV testing among a sample of African American and Hispanic/Latino adolescents (N?=?747) living in an economically disadvantaged community in the Northeastern United States. The majority of sexually active participants in our study (77%) have never been tested for HIV. However, youth engaging in risky sexual behaviors, interacting in positive peer networks, and having access to sources of prevention information were more likely to seek HIV testing services. Our findings underscore the importance of developing multifaceted HIV/AIDS prevention protocols that provide direct education and skill-building activities, leverage peer education as a means to disseminate health-related information, and deliver broad-based prevention messaging that is both culturally-tailored and gender-specific.     

HIV peer counseling and the development of hope: perspectives from peer counselors and peer counseling recipients

Peer counseling is becoming an increasingly viable treatment option when working with people living with HIV and AIDS, especially during the diagnostic process. Unfortunately, little research has looked at the perceived benefits of peer counseling from the perspectives of clients receiving the services and those providing the services. In addition, research suggests that hope can help people living with HIV to deal with the HIV diagnosis and to improve their lifestyles; however, the authors were unable to locate any research exploring the benefits of peer counseling in fostering the hope of people living with HIV/AIDS. The present paper, following a community-based research paradigm embedded within a qualitative case study methodology explores the benefits of peer support counseling from the perspective of 12 participants living with HIV who have had experiences with peer counseling. Participants identified several thematic benefits of peer support counseling, including the role of peer counselors in the process of fostering hope. Roles and benefits of peer counseling, in relation to the facilitation of hope for people living with HIV/AIDS, suggest potentially interesting implications for future research and practice in HIV/AIDS care.     

Towards a "fourth generation" of approaches to HIV/AIDS management: creating contexts for effective community mobilisation

Many biomedical and behavioural HIV/AIDS programmes aimed at prevention, care and treatment have disappointing outcomes because of a lack of effective community mobilisation. But community mobilisation is notoriously difficult to bring about. We present a conceptual framework that maps out those dimensions of social context that are likely to support or undermine community mobilisation efforts, proposing that attention should be given to three dimensions of social context: the material, symbolic and relational. This paper has four parts. We begin by outlining why community mobilisation is regarded as a core dimension of effective HIV/AIDS management: it increases the "reach" and sustainability of programmes; it is a vital component of the wider "task shifting" agenda given the scarcity of health professionals in many HIV/AIDS-vulnerable contexts. Most importantly it facilitates those social psychological processes that we argue are vital preconditions for effective prevention, care and treatment. Secondly we map out three generations of approaches to behaviour change within the HIV/AIDS field: HIV-awareness, peer education and community mobilisation. We critically evaluate each approach's underlying assumptions about the drivers of behaviour change, to frame our understandings of the pathways between mobilisation and health, drawing on the concepts of social capital, dialogue and empowerment. Thirdly we refer to two well-documented case studies of community mobilisation in India and South Africa to illustrate our claim that community mobilisation is unlikely to succeed in the absence of supportive material, symbolic and relational contexts. Fourthly we provide a brief overview of how the papers in this special issue help us flesh out our conceptualisation of the "health enabling social environment". We conclude by arguing for the urgent need for a 'fourth generation' of approaches in the theory and practice of HIV/AIDS management, one which pays far greater attention to the wider contextual influences on programme success.     

北京市石景山区某社区外来流动人员艾滋病知识现状调查及连续宣教效果评价

目的了解北京市石景山区某社区流动人员的来源、构成、文化水平、艾滋病（HIV/AIDS）相关知识、对AIDS病人的态度,以及在为期1年的连续宣教后其知识、态度的改变情况。方法对某社区内外来流动人员在为期1年时间内（每2个月1次,共6次）进行问卷调查与AIDS相关知识宣教,问卷包括流动人员人口学现状、HIV/AIDS相关知识知晓情况、对待HIV感染者的态度等方面。结果 6次宣教后,受访者对HIV/AIDS的性、血液和母婴3种传播途径的知晓率达到或超过90%,较宣教前提高20个百分点;对HIV感染者的态度改善,但对疾病普遍存在恐惧。结论针对北京市石景山区某社区流动人员的连续艾滋病宣教取得良好效果,应当进一步加强教育,改善流动人员对HIV感染者的态度。     

HIV/AIDS risks among Native American drug users: key findings from focus group interviews and implications for intervention strategies.

A multisite study funded through the National Institute on Drug Abuse and the Office of Research on Minority Health was conducted in 1996 to determine the HIV/AIDS prevention needs of Native American out-of-treatment drug users. In an effort to recommend directions for HIV/AIDS prevention programming, one component of this study entailed conducting a series of focus groups at each of four sites: Anchorage, Alaska; Denver, Colorado; Flagstaff, Arizona; and Tucson, Arizona. While some site differences were noted, several consistent thematic findings were revealed across all locations. Specifically, focus group members strongly recommended directly involving key members of the Native American community in conducting outreach and intervention activities, involving Native people as the sources of information, and utilizing local and tribally relevant forms of delivering the message. Other consistent themes included getting messages to smaller communities to prevent the potential "annihilation" of tribes, educating youth, and linking alcohol prevention education to HIV/AIDS education. Findings from this study support the idea that future HIV/AIDS prevention programs must take into account subgroup and individual level differences among Native American drug users.     

The effects of gender and socioeconomic status on youth sexual-risknorms: evidence from a poor urban community in South Africa

HIV and AIDS remains one of the most serious problems facing youths in many sub-Saharan African countries. Among young people in South Africa, gender is linked with a number of HIV-risk behaviours and outcomes. The literature suggests that factors such as socioeconomic status, intimate partner violence, and several psychosocial factors contribute to gendered differences in sexual behaviour among youths in South Africa. However, the existing body of literature scarcely addresses the interaction between gender, confounding factors (particularly peer norms) and sexual behaviour outcomes. This study uses a survey design (n = 809) to examine how gender and socioeconomic status moderate the effects of norms and attitudes on higher-risk sexual behaviours among secondary school learners in a low-income community in South Africa. The findings suggest that gender interacts significantly with peer norms to predict sexual behaviour. Peer norms and the experience of intimate partner violence were significantly associated with sexual risk behaviour among girls participating in the study. The article discusses both the wider implications of these findings and the implications for school-based and peer-facilitated HIV interventions.     

Building blocks for peer success: lessons learned from a train-the-trainer program

The National HIV/AIDS Strategy (NHAS) calls for a reduction in health disparities, a reduction in new HIV infections, and improved retention in HIV care and treatment. It acknowledges that HIV-positive peers can play an important role in supporting these aims. However, peer training must be comprehensive enough to equip peers with the knowledge and skills needed for this work. This article describes the development of a national train the trainer (TTT) model for HIV peer educators, and the results of its implementation and replication. A mixed methods evaluation identified who was trained locally as a result of TTT implementation, what aspects of the TTT were most useful to trainers in implementing local training sessions, and areas for improvement. Over the course of 1 year, 91 individuals were trained at 1 of 6 TTT sessions. These individuals then conducted 26 local training sessions for 272 peers. Factors that facilitated local replication training included the teach-back/feedback model, faculty modeling of facilitation styles, financial support for training logistics, and faculty support in designing and implementing the training. The model could be improved by providing instruction on how to incorporate peers as part of the training team. TTT programs that are easily replicable in the community will be an important asset in developing a peer workforce that can help implement the National AIDS Strategy.     

HIV/AIDS-related knowledge, attitudes and perceptions: a cross-sectional household survey

This study aimed to assess knowledge of and attitudes toward HIV/AIDS among a community in a semi-urban setting in Malaysia, to determine factors affecting perceptions toward people living with HIV in the community, and to provide baseline information for planning preventive measures against HIV/AIDS. This cross-sectional study was conducted in August 2009. Two hundred sixty-two household members were interviewed with a semi-structured questionnaire. Most respondents (232; 88.5%) had heard of HIV/AIDS. Only a few respondents (6; 2.6%) could correctly answer all the questionnaire items. Misconceptions about disease transmission were seen among surveyed participants, such as the belief HIV/AIDS can be contracted from saliva (104; 44.8%), mosquito bites (95; 40.9%) or casual touch (86; 37.1%). A multivariate linear regression model showed better perceptions towards people living with HIV depend on an improved knowledge of HIV/AIDS transmission. Current data emphasize the need to scale up HIV/AIDS education incorporating the mode of disease transmission.     

Peer-led HIV prevention among gay men in London: process evaluation

A peer-led HIV prevention initiative, based on a diffusion of innovation model, was developed for gay men attending gyms in central London. Peer educators were recruited from people who used the gym regularly according to standard selection criteria. After initial training, peer educators agreed to talk to gay men at their gym about HIV prevention, focusing on sexual risk and steroid injecting behaviour. Outcome evaluation revealed that the peer education programme had no significant impact on the risk behaviours of gay men using the gyms. Process evaluation, based on interviews with peer educators, the health promotion team and gym managers threw light on this finding. While it was feasible to set up a peer education programme among gay men in central London gyms, attrition was an important factor. Only one in five potential peer educators initially identified remained with the project throughout, thus limiting the potential for diffusion. Those who did work as peer educators reported barriers to communication within the gyms further limiting the extent to which diffusion occurred. In fact, it appears that the critical mass required for diffusion was never established. This could explain why the intervention had no significant impact on gay men's risk behaviours. A person-time analysis demonstrated that the peer education programme required a substantial input from the health promotion team, equivalent to one team member devoting 2.5 days a week to recruit, train and support peer educators over 18 months. Peer education should not, therefore, be viewed as a low-cost approach to prevention. Many of the insights gained through this process evaluation can inform others planning peer education programmes in other settings.     

Measuring change in vulnerable adolescents: Findings from a peer education evaluation in South Africa

Introduction: In the context of poverty and HIV and AIDS, peer education is thought to be capable of providing vulnerable youth with psychosocial support as well as information and decision-making skills otherwise limited by scarce social and material resources. As a preventative education intervention method, peer education is a strategy aimed at norms and peer group influences that affect health behaviours and attitudes. However, too few evaluations of peer-led programmes are available, and they frequently fail to reflect real differences between those who have been recipients of peer education and those who have not. This article reports on an evaluation of a pilot peer-led intervention, entitled Vhutshilo, implemented on principles agreed upon through a collaborative effort in South Africa by the Harvard School of Public Health and the Centre for the Support of Peer Education (the Rutanang collaboration). Vhutshilo targeted vulnerable adolescents aged 14–16 years living in some of South Africa's under-resourced communities. Methodology: The research design was a mixed-method (qualitative and quantitative), longitudinal, quasi-experimental evaluation. Tools used included a quantitative survey questionnaire (n?=?183) and semi-structured interviews (n?=?32) with beneficiaries of peer education. Surveys were administered twice for beneficiaries of peer education (n?=?73), immediately after completion of the programme (post-test) and 4 months later (delayed post-test), and once for control group members (n?=?110). The three main methodological limitations in this study were the use of a once-off control group assessment as the baseline for comparison, without a pre-test, due to timing and resource constraints; a small sample size (n?=?183), which reduced the statistical power of the evaluation; and the unavailability of existing tested survey questions to measure the impact of peer education and its role in behaviour change. Findings: This article reports on the difficulties of designing a comprehensive evaluation within time and financial constraints, critically evaluates survey design with multi-item indicators, and discusses six statistically significant changes observed in Vhutshilo participants out of a 92-point survey. Youth struggling with poor quality education and living in economically fraught contexts with little social support, nonetheless, showed evidence of having greater knowledge of support networks and an expanded emotional repertoire by the end of the Vhutshilo programme, and 4 months later. At both individual and group level, many with low socio-economic status showed great improvement with regard to programme indicator scores. Conclusion: For the poorest adolescents, especially those living in the rural parts of South Africa, peer education has the potential to change future orientation, attitudes and knowledge regarding HIV and AIDS, including an intolerance for multiple concurrent partnerships. When well organised and properly supported, peer education programmes (and the Vhutshilo curriculum, in particular) provide vulnerable youth with opportunities to develop psychosocial skills and informational resources that contribute to the changing of norms, attitudes and behaviours. However, the article also flags the need for effective peer education evaluations that take into account limited financial resources and that possess tested indicators of programme effectiveness.     

Impact of education in promoting the knowledge of and attitude to HIV/AIDS prevention: a trial on 17,000 Iranian students

The aim of this study was to assess the impact of an educational course on knowledge and attitude of students regarding HIV/AIDS prevention in Tabriz, Iran. The study was conducted by self-assessment technique among university students before and after an educational training programme. The findings showed that the knowledge of students increased significantly (P<0.05). The attitude to the problem also improved positively in the subjects (P<0.05). It is concluded that short-term training courses and continuous educational programmes (i.e. peer education, etc.) should be provided to young students through the course materials in the universities and schools promoting the awareness and attitude to this ever-increasing health problem.     

对STD高危人群进行全方位干预的社会效应

目的：通过性传播疾病(STD)门诊对STD高危人群进行全方位的干预，探索推广“同伴教育”，实行“STD／网络干预”的可行性。方法：以STD高危人群为中心，运用双向咨询、规范治疗、小组讨论、健康教育等全方位的健康促进方式进行干预，培养愿意从事“同伴教育”的自愿者，试行STD／艾滋病(AIDS)网络干预。结果：(1)干预后，高危人群的STD／AIDS知识水平有很大提高，就诊态度有明显转变，与干预前比较差异有极显著的统计学意义。(2)干预后，商业性行为者的性观念较干预前的差异有极显著的统计学意义，有35．71％和41．89％的性工作者仍赞同性自由和婚前、婚外性行为，干预前后差异无显著的统计学意义；92．91％的非商业性行为者仍然赞同婚前、婚外性行为，干预前后差异无显著的统计学意义。(3)不论干预前后，大部分人在不安全性交后，首先关心自己是否患病，在患病后，首先关心的是能否治愈。(4)干预后，＞95％的调查对象愿意参加同伴教育。40名同伴教育志愿者在3个月内引来204位高危朋友，干预面是其本身的510％。结论：平等、宽松、匿名的就诊环境与有效的生物学干预，是吸引高危人群就诊的重要保证。全方位的健康促进式STD／AIDS干预，对提高STD高危人群的STD／AIDS知识水平，转变就诊态度有明显效果。由于大多数受干预者愿意参加同伴教育，使STD／AIDS网络干预计划得以实施，并取得了初步成效。因此，在SET门诊进行STD／AIDS全方位干预，推广“同伴教育”实行“网络干预”是可行的。     

Perception of HIV/AIDS among the Igbo of Anambra State,Nigeria

Perception is fundamental in the fight against stigmatization of people living with HIV/AIDS (PLHIV). Perception generally influences discriminatory attitudes towards PLHIV which exacerbates their problems and quickens the degeneration of the disease from HIV to AIDS. This study examined the Anambra people's perception and knowledge of HIV/AIDS with the goal of creating knowledge on these issues in order to design effective intervention programmes towards the reduction of social stigmatization associated with the pandemic. The study was carried out in Idemmili North and Oyi local government areas of Anambra State. Qualitative and quantitative methodologies were used to elicit information from respondents who were adult males and females of 18 years and above. The research instruments were questionnaires and in-depth interview schedule. Questionnaires were administered on 1000 respondents while 13 people were interviewed in-depth. Analysis of quantitative data were conducted by using the Statistical package for Social Sciences. Univariate analysis in the form of frequencies were conducted which generated the distribution of respondents across the research variables. Furthermore, multivariate analysis were conducted to test the hypotheses and sought for relationships among variables. The qualitative data were reported in themes based on the research objectives and were analysed jointly with the quantitative data. The findings were that majority of the respondents viewed HIV/AIDS as a disease that afflict immoral people and as a punishment from God. Only a handful of them saw the disease as a disease that could afflict anybody. Also, many of the respondents said that AIDS is real but showed a low level of knowledge. It was further indicated that there were significant relationships between educational level, sex, occupation, income influence perception and peoples' reactions to HIV positive status of a relative while there were no significant relationships between these variables and knowledge of HIV/AIDS. It was concluded that these negative perceptions were as a result of the people's low level of knowledge and cultural belief systems, which see a strange illness as punishment from God for disobedience. Furthermore, the fact that most of the socio-economic characteristics of the respondents had significant relationship with perception and reaction to HIV was an indication that most people in the study area had a uniform perception. It was also an indication that government HIV/AIDS awareness programmes were not effective. It was recommended that strategies for effective HIV educational programme should be sought and carried out in the study area. Effective intervention programme have the power to change behaviours and would likely change the people's negative perception and low level of knowledge of HIV/AIDS, thereby reducing stigmatization of people living with HIV/AIDS.