KNOWLEDGE , ATTITUDES AND PRACTICE IN REGARD TO AIDS : THE CASE OF SOCIAL SCIENCE STUDENTS AT THE UNIVERSITY OF BOPHUTHATSWANA

The necessity o f AIDS educational campaigns is to reduce the spread o f HIV infection by changing attitudes and practices related to high-risk behaviours. However, before such progranvnes are implemented a needs assessment should be conducted This includes the existing knowledge and attitudes and sexual practices o f the specific risk-group. In this study the risk-group were social science students a t the University o f Bophuthatswana. The majority o f the respondents showed a general knowledge about AIDS in terms o f its main symptoms, common modes o f transmission and the non-availability o f a cure. They, however, expressed the need for more information about AIDS. Lack o f enough knowledge was shown by their negative altitudes towards those who had already contracted the disease and the number o f sexual partners they had Furthermore, despite the realization o f the necessity to use condoms during sexual intercourse, the majority o f them did not use them. The study also revealed the minimal role parents, teachers and lecturers play in the dissemination o f information about AIDS. The findings call for more AIDS educational program m es to clear aw ay m isconceptions about the transmission o f the HIV! AIDS virus; and the need to involve parents, schools and universities actively in the dissemination o f information about AIDS.


INTOODUCTION
Currently it is know n that specific behaviours w hich include having anal or vaginal sex with an infected person or sharing their IV drug needles and syringes spread the HIV infection.T he most im portant focus o f the educational cam paigns to reduce the spread o f H IV is to change attitudes and practices related with th e se h ig h risk b eh av io u rs.Sim bayi and N o m b e (1 9 9 3 ) em p h asiz e d that a health educational cam paign can only be effective if it results in changed behaviour.The latter can be accom plished if there are fundam ental c h a n g e s in b o th the general b eliefs and attitudes that people hold concerning any p ra c tic e .T h ey fu rth e r arg u e that before im plem enting any health education cam paign a needs assessm ent m ust be conducted.As regards AIDS, there is the necessity to assess the am ount of know ledge and attitudes people have about the disease, about those w ho are already suffering from it and about their existing sexual behavioural practices.Many studies have been carried out in different parts o f the worid w hich investigate the am ount of k n ow ledge, attitu d es tow ards, and sexual practices related to H IV infection.Such studies have been m otivated by the increasing num ber o f people infected with H IV and data obtained from such studies have been useful in helping the developm ent of intervention p ro g ram m es su itab le for sp ecific type o f risk-group (Tawanda, 1990).
M ost studies have show n that the level of know ledge about A ID S and its m odes o f transmission vary from country to country and from one social group to another.For instance, studies conducted in developing countries, especially in A frica, indicate that as a result of limited know ledge about AIDS, there are a num ber o f m isconceptions about its m echanism o f spread.This leads to negative attitudes tow ards those already infected with HIV.Lim ited know ledge is a result o f low le v e l o f li te r a c y a n d p o o r q u a lity o f information about A ID S dissem inated to the public.C oncerning sexual practices, the studies indicate little or no change in sexual behaviour patterns.This is inspite o f the little knowledge people have about the seriousness of the disease (Furley, 1989;Friedman, 1987).
Very few o f the existing studies on knowledge and attitudes tow ards AIDS and related sexual practices carried out in South Africa have been published.
F urtherm ore, m ost o f these investigations w ere conducted in the Republic o f South A frica proper among w hite sections o f so c ie ty , in c lu d in g s tu d e n ts in w h ite uni versities w ho live in First W orld conditions (Bedford, 1992;Van Deventer, 1990).There is, a need for further studies to be carried out in areas such as Bophuthatswana, w here the majority o f the black South A fricans live under Third W orld conditions.
ITie objective o f this study is to investigate the knowledge, practices and attitudes o f students in black universities in South Africa tow ards th e A ID S d is e a s e .T h e U n iv e rs ity o f Bophuthatswana w as taken as a case study because it offered con v en ien t and easily accessible sam ples for the researchers w ho are both lecturers in social sciences at the relevant campus.U niversity students w ere selected for the study because studies have indicated that older adolescents and young adults are likely to be sexually active and potential for multiple sex partners and could be a high risk AIDS population group.M oreover, by being better educated than the general public, and mostly single and concerned with sex, they are more attuned to the problem o f AIDS, and therefore more likely to change their sexual practices.Social science students were selected because the inter-disciplinary and generalist nature of their studies could make them an im portant s o u rc e o f A ID S in fo rm a tio n fo r o th e r m em bers o f society, especially in the rural areas w here the majority o f them originate.

M E 'n iO D O L O G Y
The study involved First and Final Year social science students.The tw o groups o f students were selected in order to investigate whether there w as a difference in know ledge and attitudes tow ards the AIDS disease and sexual practices related to it between those students w ho have newly arrived at the cam pus and those w ho have been there for more than three years.M ore than 1/3 o f both First Year students (87 students) and Final Year students The study w as descriptive and sought to describe the level o f know ledge of, attitudes tow ards and sexual practices related to AIDS and H IV infection among the social science students.

GENER AL KNOW LEDGE OF TH E RESPONDENTS A BO U T AIDS
All the respondents, both First and Final Years indicated that they had heard about the AIDS disease, although most o f them did not know what the letters A ID S or HIV meant.Table 1 below show s the main sources o f information about A ID S for the First Year respondents.Concerning the country from w hich AIDS originated, 72% o f the First Y ears stated Africa, 12% America, 6% Europe and the rest did not know or w ere not sure.In the case o f the Final Years, 63% stated A m erica, 31 % Africa and the rest did not know or w ere not sure about the origin o f the disease.A s regards the question w hether the original country o f the disease w as im portant, 63% o f the First Years and 76% of the Final Y ears thought it w as not im portant but 24% o f the First Years and and 20% o f the Final Y ears said that it was important.The rest w ere not sure.Forty eight per cent of the First Years and 52% o f the Final Years who indicated that the origin o f the disease w as not im portant argued that AIDS w as a w orldw ide problem now, therefore, people should be concerned with fighting it.The rest did not indicate any justification for their position.Those w ho indicated that the country o f origin w as im portant justified their position by the comm on argum ent that the source of the disease w ould give a picture of the extent of its spread to the rest o f the world.The common sym ptom s o f AIDS, according to the Final Year respondents, w ere loss o f body w eight, fatigue, sw ollen glands and neck, diarrhoea, sores in arm pits, mouth, private parts etc. and skin rash respectively.T he pattern w as alm ost the sam e as that indicated by the First Y ear respondents.

Radio
The majority o f both First Y ear (89% ) and Final Year (93% ) respondents indicated that there w as no cure available for the A ID S disease.Eight per cent (8% ) o f the First Y ear and 2% of the Final Year respondents stated that there were traditional w ays o f curing the disease.The rest of the respondents in both groups either did not know or were unsure.
The study wanted to establish the ideas the re sp o n d e n ts had co n ce rn in g the ty p e o f activities or behaviours w hich present a risk for HIV infection including their attitudes towards those who had contracted the disease.Most First Year (86% ) and Final Year (91% ) respondents i ndicated the followi ng activities;      A s these tables show, both First and Final Year respondents i ndicated very sim ilar ideas about the best w ays o f protection from HIV.
The respondents w ere asked the extent to w hich they feared the disease AIDS.Forty five o f the First Y ear and 48% o f the Final Year respondents w ere 'very scared'.The rest were either m oderately scared, not so scared or did not bother about the disease.T his could be attributed to ignorance.T his w as established by the question " I feel I know very little about AIDS"; 94% o f the First Year and 93% o f the Final Y ear respondents adm itted that they knew little about A IDS.The rest w ere either n o t su re or th o u g h t they knew en o u g h .M oreover, w hen asked w hether A ID S should be discussed in class or not, the majority o f them responded positively.This indicated that there w as definite need for more inform ation on AIDS.

R E S P O N D E N T S ' S E X U A L
Studies on A ID S have suggested that reducing the num ber o f sex partners is one w ay of low ering the risk o f HIV infection b u t this should take into account the sexual behaviour or the risk level o f the partners.This is because the p artn ers w ill reduce the risk o f H IV infection only if they are them selves HIV negative and practice safe sex (Boffey, 1988).
T he stu d y w as, th erefo re, in terested in investigating the num ber ofsexual partners the respondents in both groups o f students had before and after know ing som ething about the A ID S disease.T ab le 7 below sh o w s the picture for the First Y ear respondents.Table 7 show s the majority o f the First Year respondents had at least one sexual partner before and after know ing som ething about the A ID S disease.T he m ost alarm ing notion derived from Table 7 is the number o f students (32% ) w ho bravely indicated that they had tw o o r m o re sex u al p artn ers even a fte r know ing som ething about the A ID S disease and the way it spreads rapidly through sexual intercourse.Table 8 show s the situation for the Final Year respondents.There are a number o f reasons given for this attitude w hich include association with illicit sex and prostitution, loss o f sensitivity for the m ale d u rin g se x u a l in terco u rse, vaginal irritation for the fem ale and loss o f spontaneity in the sexual encounter.Certain people are a g a in st the use o f condom s for religious reaso n s; o th e rs fail to use condom s not because they are against them but, because they might not be readily available when they decide to have sex.T his is a comm on situation in the rural areas o f most developing countries and especially in A frica.M oreover, others fear breakage, slippage or rem aining in the vagina during sexual intercourse (Tanner, 1987).
M ore than 90% o f the respondents in each category o f the students did not use condoms d u rin g sex u al in te rc o u rse .T he com m on reasons given w ere that it w as not necessary since they trust each other and that "condoms dull the beauty o f sex".Some expressed that they felt shy to go to a shop and buy condoms either for their own use or that of a partner.T hey justified their situation by stating that condom s are associated with sex, therefore, buying them publicly might give people a bad im pression about the buyer; A s regards who sh o u ld buy condom s, the majority o f the respondents in both cases stated that it w as a m an 's responsibility to buy condom s because it w as men w ho put them on during sexual in te rc o u r s e .W h e n a sk e d w h e th e r they preferred having sexual intercourse with a partner w earing a condom or not, the majority o f the respondents in both groups thought the c ondom good for personal safety against pregnancy and sexually transmitted diseases and that it had nothing to do with w hether one partner loved the other or not.Those who were against condom use justified their position by a rg u in g that ad eq u ate sexual satisfaction d u rin g se x u a l in te rc o u rs e c o u ld not be obtained if condom s w ere used.

A
decade or m ore has passed since the discovery of the H uman Im munodeficiency Virus (HIV) as the cause o f the Acquired Im m une D e fic ie n c y S y n d ro m e (A ID S ).Inspite o f the avai lability o f therapeutic agents that can slow the replication o f the virus, there is still neither a cure for A ID S nor a vaccine for HIV infection.The A ID S epidem ic has touched all segm ents of society, both in the in d u s tria liz e d and d e v e lo p in g c o u n trie s including the rich and poor, the young and old, rural and urban people.Thousands o f people are either them selves infected w ith H IV or have lost friends and relatives due to the AIDS disease.
(2 6 stu d e n ts) p a rtic ip a te d in th e stu d y .S e v en ty -fiv e per cen t o f the F irst Y ear respondents and 71% o f the Final Y ear respondents w ere females.The age range for the First Y ears w as 17 to 33 years.For the Final Years it w as 21 to 3 8 years o f age.Eighty nine per cent o f the First Years and 83% o f the Final Y ears originated from rural areas o f B ophuthatsw ana and other South A frican Homelands.A four page questionnaire containing 23 questions divided into three parts w as the instrum ent used to collect data.The first part provided background biographical data on the respondents such as age, sex, marital status, place o f origin (rural or urban), year o f study etc.; the second part w as concerned with assessin g the general know ledge o f the respondents about AIDS and attitudes towards people w ho w ere already afflicted with the disease; the third part sought to investigate the respondents' present sexual practices such as the number o f sexual partners and attitudes and practices regarding the use o f condoms.T h e q u e s t io n s w e re b o th c lo s e d a n d open-ended.A sociology class w as used to adm inister the questionnaire because it is an inter-disciplinary course in which most of the social science students, both first and final years, meet.Participation in the study was voluntary.
b ec a u s e the respo ndents w e re allo w ed to state a s m any sou rc es of inform ation a s possible.
ta l e x c e e d s 1 0 0 % b e c a u s e respo ndents w ere a lk iw e d to state as m an y s o u rc es of inform ation a b o u t A ID S /H IV infection a s possible.T ab le 2 sh o w s th at the m ain sources of in fo rm a tio n a b o u t A ID S for Final Y ear respondents were radio, television, printed media and friends.Compared to the First Year respondents, television played an important role for them as a source o f inform ation because inspite o f their rural background, all had been in M m abatho, w here the University o f B ophuthatsw ana is located for 3 or more years.As in the case o f First Year respondents, f r ie n d s w e re an im p o r ta n t s o u r c e o f information about AIDS for the Final Year respondents and lecturers and parents were a poor source.A s regards the am ount o f knowledge the two groups o f students had about AIDS and HIV infection, the m ajority o f the respondents (85% o f First Years and 87% o f the Final Y ears) knew that AIDS was a condition which had to do with the w eakening of the body's immune system.Paradoxically most of them did not know w hat A IDS and HIV stood for.When asked about the causes of AIDS, 56% o f the First Years and 62% of the Final Years knew that it w as due to HIV infection.The rest could not specify the virus causing AIDS.Eighty seven per cent o f the First Years and 91% o f the Final Years knew the different m odes by w hich HIV w as transmitted.The comm on m odes o f transm ission stated were sexual intercourse, blood transfusion and sharing unsterilized needles and razors.
W h en a s k e d to in d i c a te th e c o m m o n sym ptom s of A ID S the follow ing responses shown in Table3w ere given by the First Year respondents.The majority o f the First Y ear respondents listed loss of body w eight as the most common symptom of the A ID S disease, followed by fatigue, swollen glands and neck, skin rash re s p e c tiv e ly .T a b le 4 b e lo w sh o w s the responses of the Final Y ear respondents on the sam e issue o f com m on sym ptom s for the AIDS disease.
allow ed to list as m an y sym p to m s of A ID S as possible.
-c a s u a l s e x , p r o m is c u ity , s h a r in g o f u n s te r iliz e d n e e d le s , r a z o r s , s y r in g e s , to o th b ru s h e s ; b lo o d tr a n s fu s io n a n d a p reg n an t m o th er w ith H IV infectin g her unborn child.The majority o f respondents in b o th g ro u p s knew th at H IV c a n n o t be transm itted by casual contact with people around them , w itchcraft, kissing, sharing toilets or telephones.Sixty five per cent o f the F irst Y ear an d 55% o f th e F in al Y ea r respondents, however, w ere unsure w hether the risk of contracting HIV w as increased by sharing a bed or eating with som eone already su fferin g from the disease, including the latter's sneezing, coughing and spitting; this uncertainty also applied to insect bites such as those o f the mosquito, bed-bug and louse.
ta l e x c e e d s 1 0 0 % b e c a u s e th e respo ndents w e re allo w ed to In d icate a s m an y w a y s of H IV prtevention a s possible.
the First Year respondents, the majority o f the Final Y ear students had one or more sexual partners before and after know ing so m eth in g a b o u t the A ID S d isease.T his in d ic a te s th a t sex u al b e h a v io u r has not c h a n g e d m u ch .W hen a sk ed a b o u t the p re c a u tio n s w h ich they to o k to p rev en t th em selv es and th eir p artn ers from H IV infection, the com m on answ ers w ere that either the respondent trusts his/her partner or they trust hini/her.Knowing o n e's HIV antibody status and that o f o n e's partner is one way o f preventing HIV infection and this study w as interested in know ing the w illingness of the respondents to undergo an HIV antibody test.When asked which w as the best way to determ ine w hether o r n o t o n e h a s c o n tr a c te d H IV , m o st re s p o n d e n ts in b o th g ro u p s o f stu d e n ts indicated that it w as through a medical test.M ore than 60% o f the respondents in each category o f the students, however, w ere not sure w hether they should undertake an HIV antibody test.The hesitation w as attributed to th e so c ia l, p sy c h o lo g ic a l and eco n o m ic consequences o f the results o f the test.There w as much concern about the manner in w hich test resul ts could be taken by relatives, friends, health insurers and other acquaintances.This is supported by studies w hich have tried to explain the attitude o f those w ho are reluctant to undergo an HIV test.They argue that there are m any co n tro v ersies su rrounding HIV antibody testing.Positive tests bring feelings o f guilt, anxiety and depression(M acklin,  1988;).The study also sought to investigate attitudes held by respondents tow ards condom s and their use.V arious studies have indicated that condom s, if used consistently and carefully, are an effective method o f reducing the risk o f HIV infection; however, research in different countries o f the w orld has shown that the use o f condom s is an unpopular strategy am ong th e g e n e ra l p u b lic in c lu d in g th e y o u th(H epw orth, 1989).

C
O N C L U S IO N S A N D R E C O M M E N D A T IO N S T h e m a in f i n d in g s o f th e s tu d y a re sum m arized as follows:-First, the majority o f the respondents in both g r o u p s o f s t u d e n ts s h o w e d a g e n e ra l know ledge about A ID S such and its main sym ptom s, com m on m odes o f transmission, the non-availability o f either a western or a trad itio n al m edical cu re and m ethods o f personal prevention against the disease.The m ajority o f both groups o f students, however, adm itted that they did not know much about A ID S and they expressed the need for more in fo rm a tio n a b o u t th e d ise a se .L ack o f sufficient kno w led g e w as show n both by negative attitudes tow ards those w ho were H IV p o sitiv e and the n u m b er o f sexual partners respondents had even after knowing s o m e th in g a b o u t th e d ise a se .T h e r e is, th e r e fo re a n e ed f o r A ID S e d u c a tio n a l p ro g ra m m e s to c le a r aw ay som e o f th e m isco n cep tio n s a b o u t th e tran sm issio n o f th e v iru s.O ne interesting aspect o f the flndings w as the lim ited role teachers and lecturers played as sources o f i nforrnation about AIDS.There is a great need for teaching staff to be involved a c tiv e ly in the d is s e m in a tio n o f A ID S information.T his is because students spend a substantial proportion of their time w ith them.Furthermore, despite their positive attitude towards the necessity o f using condom s as protection against H IV infection, the majority o f the respondents did not use them during se.xual intercourse.G iven this discrepancy between attitude and behaviour, s a fe r sex practices, especially th e use o f co n d o m s need to be highly em p h asized in ed u ca tio n a l p ro g ram m es.R E F E R E N C E S ARNOLD, B. (1989) : Public Knowledge o f A ID S .C o m m u n ity H e a lth in N e w Zealand, 4 (2), 3-15 BEDFORD, R. (1992): AIDS: Knowledge and Attitudes o f a group of South African Health P rofessionals.S o u th A fric a n Journal o f Psychology, 22(1), 17-20 BETE, C. (1989): AID S; The Silent Killer, Atlanta, Syndistar.BOFFEEY, P.M. (1988) : Researchers List Odds o f G etting A ID S in Heterosexual Intercourse, A^ew York Tim es, P. A-1 FRIEDM AN, S.R. (1987): Public A wareness o f AIDS and C ondom s in Rwanda.Social Science and M edicine, 24 (2), 97-100 FU RLEY, K.E.(1989): Public A w areness Survey on A IDS and C ondom s in Uganda.AID S, 3(3) 147-154 HEPW ORTH, J. (1989) Strategies fo r A ID S Education and Prevention.Haworth Press.I lUNSON, B. (1991): The Com plete G uide to Safe Sex, San Fransisco A ID S Foundation M ACKLIN, E.D. (1988): AIDS: Im plications fo r F a m ilie s.F a m ily R ela tio n s, 3 7 , 141-149 SIM BAYI, L.C. AND NOM BE (1993) : A Survey o f the K nowledge, A ttitudes and Sexual Practices o f College o f Education Students in B ophuthatsw ana R egarding AIDS and C ondom U se. U niversity of B o p h u th a ts w a n a ( U n p u b li s h e d Manuscript).TA N N ER , W. (1 987): The Effect o f Condom U se and Sensuous Instruction on A ttitudes tow ards Condom s.Paper presented at the A nnual M eeting o f the Society for the Scientific Study o f Sex, A tlanta, G.A. V AN D EV ENTER, A. (1990) : Community H e a lth in S o u th A frica , U n iv ersity o f O range Free State.TA W A N D A , M. (1 9 9 0 ): M ale Knowledge o f and A ttitudes and Practices Tow ards AIDS in Zimbabwe.A ID S, 4(3) 245-250 W O L F G A N G , F. (1 9 9 1 ) : D o n 't b e a C asualty o f C asual Sex, A ichtal, M agraf Publishers.

Table 1
concerned the small role teachers and lecturers played as sources o f inform ation.V ery rarely did they discuss the A ID S problem with the students.The im p a c t o f h e a lth w o rk e rs as so u rces of inform ation about A ID S for the students also seem ed v ery lim ited in that only 8% o f respondents named health w orkers as sources o f information.T able 2 show s the sources of information about AIDS for the Final Year respondents.
source o f information because rural people may not be able to buy a television set.The T able also reveals the minimal role parents play as sources o f information about AIDS.T his could be attributed to lack of information on th e ir p art a b o u t th e disease and the influence of tradition whereby parents rarely discuss sexual issues with their children.The most interesting finding

Table 5
below show s the responses o f the First Y ear respondents concerning best w ays to protect oneself from HIV infection.