Foundation for Professional Development, Pretoria, South Africa.
University of the Witwatersrand, School of Public Health, Johannesburg, South Africa.
BMC Public Health. 2020 Aug 17;20(1):1249. doi: 10.1186/s12889-020-09356-3.
With an HIV incidence of 1.00 skewed against women (1.51), adolescents in South Africa are at high HIV risk. This paper assesses young adults' (18-24 years) knowledge, attitudes and practices regarding HIV prevention in Nkangala and OR Tambo districts.
A cross-sectional household survey was conducted in two districts in 2017/8. Participants completed computer-assisted self-interviews on HIV knowledge, attitudes, behaviour practices, use of social media and condom use at last sex (proxy for high-risk sex). HIV knowledge was assessed using the South African-adapted UNAIDS scale. Descriptive analyses were conducted and logistic regression models were built to assess factors associated with being knowledgeable of HIV and condom use at last sex.
One thousand nine hundred fifty-five participants were interviewed (90% response rate). Less than half (44.7%) had correct knowledge of HIV prevention and 73% used a condom at last sex. Social media use predicted high HIV knowledge as higher odds were observed among participants using the print media (aOR1.87; 1.34-2.60), WhatsApp (aOR1.55; 1.26-1.90), radio/television (aOR2.75; 1.15-6.55) although social networking sites' use protected against knowledge acquisition (aOR0.53; 0.34-0.82). Females (aOR0.75; 0.58-0.97) and participants reporting sexual risk were less likely to have HIV knowledge as negative associations were found for having multiple sexual partners in the last 3 months (aOR0.63;0.48-0.82) and ever having sex (aOR0.37;0.23-0.61). Participants who abused drugs (aOR1.40; 1.05-1.88) and had attitudes accepting people living with HIV (aOR2.05; 1.14-3.69) had higher odds of having HIV knowledge. Females (aOR0.70; 0.54-0.91), students (aOR0.52; 0.40-0.66) and participants who abused drugs (aOR0.58; 0.43-0.77) were less likely to report condom use at last sex.
There is a correlation between media use and HIV knowledge, non-condom use and HIV knowledge, and high-risk sexual behaviours and less HIV knowledge. An aggressive community media campaign utilising locally available, preferred and accessible media platforms among young adults is required for behaviour change.
南非的艾滋病发病率为 1.00，偏向于女性（1.51），青少年处于高艾滋病毒风险之中。本文评估了 Nkangala 和 OR Tambo 两个地区的年轻人（18-24 岁）对艾滋病毒预防的知识、态度和实践。
2017/8 年在两个地区进行了一项横断面家庭调查。参与者完成了有关艾滋病毒知识、态度、行为实践、使用社交媒体和上次性行为时使用避孕套（高危性行为的代表）的计算机辅助自我访谈。使用南非改编的艾滋病规划署量表评估艾滋病毒知识。进行描述性分析，并建立逻辑回归模型，以评估与了解艾滋病毒和上次性行为时使用避孕套相关的因素。
共采访了 1955 名参与者（90%的回应率）。不到一半（44.7%）的人对艾滋病毒预防有正确的认识，73%的人在上次性行为时使用了避孕套。社交媒体的使用预示着较高的艾滋病毒知识水平，与使用印刷媒体（优势比 1.87；1.34-2.60）、WhatsApp（优势比 1.55；1.26-1.90）、广播/电视（优势比 2.75；1.15-6.55）的参与者相比，观察到更高的几率，尽管使用社交网络网站的使用可预防知识的获取（优势比 0.53；0.34-0.82）。女性（优势比 0.75；0.58-0.97）和报告有性风险的参与者不太可能了解艾滋病毒，因为在过去 3 个月内有多个性伴侣（优势比 0.63；0.48-0.82）和曾经有过性行为（优势比 0.37；0.23-0.61）与阴性关联。滥用药物的参与者（优势比 1.40；1.05-1.88）和对艾滋病毒感染者持接受态度的参与者（优势比 2.05；1.14-3.69）获得艾滋病毒知识的几率更高。女性（优势比 0.70；0.54-0.91）、学生（优势比 0.52；0.40-0.66）和滥用药物的参与者（优势比 0.58；0.43-0.77）不太可能报告上次性行为时使用避孕套。
媒体使用与艾滋病毒知识之间存在相关性，非避孕套使用与艾滋病毒知识之间存在相关性，高危性行为与艾滋病毒知识较少之间存在相关性。需要针对年轻人开展积极的社区媒体运动，利用当地现有的、首选的和易于获取的媒体平台来改变行为。
