Knowledge, attitude, beliefs and practices concerning HIV infection and AIDS among patients presenting with sexually transmitted diseases at a Soweto community health centre.

Abstract

Objectives. To investigate the knowledge, attitudes, beliefs and practices regarding HTV infection and AIDS among patients presenting with a sexually transmitted disease at the polyclinic department of the Chiawelo Community Health Centre in Soweto, Gauteng, South Africa.

Design. The data was collected using a structured interview administered by the researcher.Diagnosis of the sexually transmitted diseases (STDs) was based on the Syndromic Approach.

Subjects. The study sample consisted of 200 patients, over the age of eighteen years, presenting with a sexually transmitted disease at the polyclinic department. One hundred and ninety-seven patients, 152 men and 45 women, of the study sample consented to be interviewed, a response rate of 98%. The three patients that refused to partake in the study were all men.

Results. The median age of the men and women was 26 years and 24 years respectively. The median range of residence in Soweto was 19 years. Most of the respondents were single (68.5%) and unemployed (43.2%). At the beginning of the interview, most of the respondents, 53.3%(105),felt that their knowledge of HTV/AIDS was adequate. The median grade of education was 8.Education level of the respondents related significantly to their perceived knowledge of HTV/AIDS (p<0.05). Urethral discharge was the most common presenting STD (43.1%). Only 17.8% (20.1% men and 15.6% women) of the respondents’ main concern of their presenting illness was that of contracting the AIDS-virus. The majority of the respondents were aware of the common modes of transmission of STDs and HTV, yet only 4.1% of the respondents used condoms regularly with multiple sexual partners. The most significant reason cited for not using condoms was that it made sex less enjoyable (40.1%). Moreover 65.4% of the respondents had multiple sexual partners.Majority of the men, 80.3%(122) had multiple sexual partners, previous episodes of STDs (6"/.8%%) and had an extremely low level of condom usage (1.7%). Although most of the women,84.5%(38) had monogamous relationships with very low condom usage (11.2%), they still presented with STDs, indicating that they were at a high risk of contracting the AIDS-virus. The most influential source of information regarding HTV/AIDS proved to he the news media (television, radio, newspaper, and pamphlets/advertisement). Respondents had some negative attitudes to people living with HTV/AIDS, such as not befriending or accepting them as part of society. Of the 57.4% of the respondents who received treatment for a previous STD at the polyclinic, 33.6% did not receive counselling on HTV/AIDS and the use of condoms. Forty percent (18) of the women and 37.5%(57) of the men considered themselves at risk of HIV and were willing to be tested for the AIDS-virus. Significant differences existed between frequency of condom usage and multiple sexual partners (p<0,05), and between multiple partners and previous history of treatment for a sexually transmitted disease (p< 0.01). Being male, unemployed,between the age of 21 - 30 years, with multiple sex partners and having had a previous STDs,related to a significant risk of contracting HIV infection. More information about HIV/AIDS was requested by 98.5%(194) of the respondents.

Conclusions. The respondents’ factual knowledge, as assessed by most criteria regarding HTV infection and AIDS was relatively high, their use of condoms was low, their perceived level of risk of HTV infection was very low and therefore they did not feel the need to change their behaviour.

Recommendations. Future interventions regarding the prevention, of HTV infection need to move beyond providing information and to focus more on producing behavioural change in communities and to facilitate the target populations to achieve such changes. The integration of the Health Belief Model and use of patients’ reason for encounter in these prevention programmes may prove extremely useful in our endeavour to curb the spread of HTV-infection.