Examining the effects of HIV knowledge and perceived risk of HIV infection on condom use among youth: The case of South Africa

Abstract

HIV/AIDS continues to be a major health concern in Sub-Saharan Africa. South Africa, with an HIV prevalence of 10%, is one of the worst affected countries. The majority of new infections occur among young people aged 15-24 years and this is largely a result of not using condoms. The government and many NGOs have responded to this problem by introducing HIV education into the school curriculum and launching awareness campaigns and programmes. This was done with the expectation that an increase in HIV knowledge would lead to an increase in condom use among youth. Research based on the Health Belief Model has also found that people are more likely to adopt healthy behaviours if they think they are at risk of illness. In this regard perception of HIV infection among youth and the effect it has on condom use needs to be assessed. Objective The aim of the study was to investigate the relationships between HIV knowledge, perceived risk of HIV infection and condom use among youth aged 16-24 in South Africa. Methods The study was conducted using the National HIV Communication Survey of 2012 using a sample of 1795 sexually active males and females aged 16-24 years. For the descriptive statistics cross tabulations were conducted to assess the levels and distribution of condom use. Additionally, non-condom use rates were computed to assess the level of lack of condom use among youth. To investigate the association between HIV knowledge, perceived risk of HIV infection and condom use among youth a binary logistic regression was run at a bivariate and multivariate level. Results The study found that 38% of youth do not use condoms. The study also found that the association between lack of condom use and HIV knowledge was insignificant [p-value > 0.005], however the odds ratios show that as HIV knowledge increases there is a slight increase in condom use. The study found a significant association between perceived risk and lack of condom use [p-value < 0.005] however, the results show that youth who perceive themselves as being at risk of infection are less likely to use condoms. In addition the study found associations between lack of condom use and the other socio-demographic and relationship factors, namely, age, place of residence, province, education level, employment status, age at first sex, relationship status and knowledge of partners’ other sexual partners. Conclusion The study found that the association between HIV knowledge and condom use was insignificant, however there was a significant association between perceived risk of HIV infection and condom use at last sex. The results of the study has shown that it is important to increase HIV knowledge among youth but this is not enough to prevent HIV infection. More needs to be done particularly in regard to perception of risk of HIV infection.