Association between knowing someone who died of AIDS and behavior change among South African youth.

In South Africa, the rising AIDS related mortality has increased the publicity of the HIV/AIDS epidemic and may have an impact on behavior change. We examined the association between knowing someone who has died of AIDS and self-reported behavior change, condom use at last intercourse, number of partners in the prior 12 months, and attitudes towards HIV, among South African youth aged 15-24. We found that over 40% of youth reported knowing someone who died of AIDS, most commonly a neighbor. Using multivariable logistic regression, we found that high school-educated youth who knew someone who died of AIDS were significantly more likely to report having changed their behavior as a result of HIV (OR 2.01, 95% CI: 1.32;3.06). We found no association between knowing someone who died of AIDS and other HIV prevention-related behaviors. While youth tended to have increased odds of perceiving HIV to be serious, they did not consistently perceive their risk of contracting HIV to be higher when they knew someone who died of AIDS. Our results suggest that part of the key to impacting behavior change in youth may lie in better understanding what factors increase youth's perceived risk of contracting HIV which will help us better target our interventions. If youth are impacted by personal knowledge of an AIDS death, to the point that they change their behaviors, we must continue to encourage discourse about HIV/AIDS with the hope that persons dying from AIDS will feel more comfortable disclosing their diagnosis to youth they know and others.