Using a Condom to Prevent HIV or AIDS - Essay Example

Does knowledge affect attitudes and perceived risks of HIV infection among young adults influencing consistent condom use Table of Contents 2 Introduction 4 Method 5 a.Research design 5 b. Aims, Objectives and Research question(s) 7 c. Sources of information and search strategies 8 d. Inclusion/exclusion criteria 9 e. Quality assessment system. 10 g. Expected outcomes 10 Conclusions 18 References: 19 Bibliography 20 Abstract Use of condoms and the changes in the perceptions are needed to be analysed in the aftermath of an intensified public health information regarding AIDS. Although the view that the use of condoms can prevent HIV is quite high, it remains to be examined whether this is actually translated to an increase in the use of condoms. Adolescents have very few peer-reviewed studies relating to HIV/AIDS-related knowledge, practices beliefs and attitudes. Surveys have been conducted among adolescents subsequent to the apprehension of an increase in HIV infections. Most of these adolescents were typical of those all over the world, having a mixture of correct and incorrect knowledge about HIV transmission and sexually transmitted infections. It was seen that more males than females accounted that they have had sex, having used condoms. They also exhibited an inconsistent use of condoms. Some of the sexual attitudes definitely conformed to machismo ideology; but there were others that provises a scope for interventions and preventions. In many cases it was seen that the stigma attached to HIV was high and it was also seen that many of the adolescents disapproved of same sex relations. Intervention is particularly vital that some intercession is sought against homosexuality-related stigma because it may result in a concentrated HIV epidemic. The surveys showed that personal religious thoughts and beliefs were not a barrier to use of condoms. The multivariate model showed that, being out of school could be significantly correlated to having had sex as well as of insufficient HIV/AIDS-related knowledge. This necessitates that HIV prevention interventions must not be limited to only school going adolescents. For a successful result what is needed is a multi-component approach to prevention. This must include community-based programmes as well as programmes in schools, the mass media and health facilities. Introduction HIV infection is a disease that is caused by the Human Immunodeficiency Virus (HIV). This virus slowly destroys the immune system and as a result, the antibodies within the body find it harder to fight off the infections. There is no cure for HIV infection, precaution being the only way of keeping away from this fatal disease. There has been a rising concern regarding HIV/AIDS infection among young adults globally. The most common way this virus is transmitted from one person to the other is through unprotected sexual intercourse. The statistics on the impact made by HIV/AIDS is overwhelming. According to the estimates made by the United Nations Agency for AIDS, as of 2001 over 40 million people were living under the uncertain dark cloud of HIV/AIDS and from the time the disease was first discovered during the early part of the 80’s around 25 million have died of the disease (UNAIDS, 2001). In the two decades following the identification of the disease, the body of research that delves with the disease has been growing on a steady basis. At present the research on the disease covers a wide plethora of topics ranging from the strict medical studies and experiments on the subject to the social and demographic implications of the epidemic and as well as the research on preventions and interventions that may enable to push back the spread of the fatal and devastating disease of HIV/AIDS. This report forms a systematic literature review proposal on whether the knowledge about HIV/AIDS affects the attitudes and perceived risks of HIV infection among young adults influencing the use of condoms on a consistent basis. The main aim of this report is to examine how effective a role does knowledge play in influencing young adults in taking the necessary precautions as in consistently using a condom, to prevent HIV/AIDS. The use of Condoms is a vital element for an effective and sustained approach to the prevention and treatment of HIV. Since AIDS cure has not yet been found prevention is the mainstay of the response to AIDS. Thus condoms have been and have to be in future too an integral and essential part of any comprehensive prevention programme against AIDS. The promotion of condoms must be accelerated. Method a. Research design There were numerous alternatives available to structure the research. However it was crucial to use a design which will hold the entire research project together. The design used in this context is systematic literature review. Various databases and libraries have been consulted to source already established surveys on HIV/AIDS awareness among the younger generation. The reports of several surveys have been compared in tabular format to compare their findings. The method followed in the survey was the two-stage probability household sample design. The sampling frame used was from the 1997 census. Comprehensive interviews were held with the participants to fully understand their points of view. The deductions were based on sexually experienced participants, both male and female. The female and male samples were not related to each other. Differences between sample estimates were calculated using an average design effect of 1.5. The threat of HIV infection was categorized by the participants as none, small, fair, high or not known. These self-evaluations were then compared with evaluations attributed on the basis of present and past sexual activities so that the perception of risk may be analysed. The number of hazardous factors stated by the participants were reported from among the following: not using a condom at last sex, having a sporadic partner at last sex, have had sex with three or more partners in the past year having more than four cumulative partners, having a record of STIs and, for women who had never been married, the incidence of having been given money or gifts for their latest sexual encounter. Those participants who reported less than two risk factors were classified as having no risk or a low risk of HIV infection; those whose answers indicated two or more risk factors were classified as having a fair or high risk of HIV. Chi-square and t tests were used to evaluate the magnitude of participants. This was done both within and across the subgroups for those participants who appropriately evaluated their HIV risk and those who reported use of condoms at last sex. For investigating the connection between the use of condoms and a correct evaluation of HIV risk, calculating the behavioral, demographic, and HIV-related variables of interest, the probit regression model was used. The outcome variable was use of condoms at last sex. To run the model use of condoms was eliminated from the risk definition variable. All of the variables included in the imputed risk definition on the righthand side of the equation were also removed. Thus each variable comes up only once, in one side of the equation. This solves the problem of endogeneity. Data analysis was executed with Stata 6. Coefficients shown are equal to the change in the probability of use of condoms associated with a change of one unit in the independent variable. All results are given separately for females and males; within each gender, results are disaggregated by marital status. Marital status was coded as ever-married or never-married; the ever-married category includes participants who were married, cohabiting, separated, divorced, widowed, or legally married but not living in the same house as their spouse. b. Aims, Objectives and Research question(s) The main aim of this report is to examine how effective a role does knowledge play in influencing young adults in taking the necessary precautions as in consistently using a condom, to prevent HIV/AIDS. The use of Condoms is a critical element for an effective and sustained approach to the prevention and treatment of HIV. Since AIDS cure has not yet been found prevention is the mainstay of the response to AIDS. Thus condoms have been and have to be in future too an integral and essential part of any comprehensive prevention programme against AIDS. The promotion of condoms must be accelerated. The main research question is how, if at all it does, knowledge helps young adolescents in keeping away from HIV infection. Questions of the surveys conducted were like: a) school attendance and sex education, b) awareness of contraception, c) sexual understanding, knowledge and practice d) present sexual activity, e) attitude to condoms, sexuality f) Attitude to gender issues, g) Knowledge of prenatal care h) maternal morbidity, i) knowledge and attitude to HIV/AIDS, and j) Physical and sexual abuse. c. Sources of information and search strategies There have not been many studies on awareness among young adolescents regarding HIV infection or AIDS. Thus the research was a little challenging in terms sourcing secondary data and published surveys. Mostly used were major online database, library and authoritative websites like PubMed and Guttmacher.org. Journal of the national Medical Association was of great. Some of the Keywords used were: Acquired Immunodeficiency Syndrome Condoms HIV Infections HIV Seropositivity Health Education Health Knowledge, Attitudes, Practice Knowledge Research Risk-Taking Safe Sex Sexual Behavior Students Education d. Inclusion/exclusion criteria Knowledge and greater awareness among young adults regarding HIV infection and AIDS is a topic that has wide scope of research and analysis. However to design an effective research report, it is essential to restrict the research to a specific line and not diverge into too many things. Since the research was done with the help of secondary data, a primary inclusion criterion was the use of authenticate data. Despite Internet being a very helpful pool of information, screening becomes a major issue. This is because more often then not the Internet is over-loaded with fluff. It was thus crucial to distinguish between what data and information to take and what to discard. The second criterion was to use studies published only in the recent years (5-6 years). The third criterion was to conduct the study on young adults. However the other segments of the society was also considered to give it a better picture. e. Quality assessment system. The best way to assess quality of data is by putting it in the form of a table: Table 1: Quality assessment system Parameters Sample size* Recruitment sites** No. of factors explored*** Factors with potential implications on spread of infection? Study 1 NA Database 3 All Study 2 5338 Clinic 1 All Study 3 1438 Slum 3 2nd Study 3 325 Clinic 2 All g. Expected outcomes There have been mixed results in the studies that evaluate these relations. Some studies have found affirmative associations, while there are others that have not found any even after looking into a variety of societal and demographic factors. These studies have often involved diverse population subgroups who are at dissimilar levels of risk (e.g., farmers and commercial sex workers). Besides, they have also used an assortment of questionnaires to compute information and awareness of AIDS, from common knowledge regarding HIV transmission and also from the accuracy of answers given about AIDS, to a broader understanding about this dreaded disease (e.g., how infected is caused or how HIV can be avoided). The present study, which makes use of a national population-based household sample, representative of youth aged 15–24, adds to the body of study on the use of condoms by taking a look at the accurateness of how individuals evaluate their own risk, based on their present and precedent sexual behaviors. It has been found that young adults underestimate their risk of being infected by HIV: 27% women and 80% men who regarded themselves at low or no risk were actually at fair or high risk of HIV contamination. Besides, though on the whole men and women had a fairly accurate knowledge of how HIV is transmitted, 17% and 46%, correspondingly, had no idea how to judge their own threat. Two likely causes for this incongruity are a) women do not always relate their knowledge of HIV transmission to judge their level of risk each time they take part in sexual activity and b) women are generally more unwilling than men to account the self-evaluation of risk that they make. TABLE 2: Title Parameters Sample size Recruitment sites No. of factors explored Factors with potential implications on spread of infection? Use of condoms by adolescents. (Use of condoms by adolescents, National Guideline Clearing house, 2009) Not stated Searches of Electronic Databases 1.Counseling and education regarding the benefits of sexual abstinence (primary prevention) 2.Counseling and education regarding the benefits, availability, and correct use of condoms* (secondary prevention) 3.Collaboration with community resources to decrease restrictions to condom availability All Relationship Between HIV Risk Perception and Use of condoms: Evidence from a Population-Based Survey 5338 females Adolescent clinics The relationship between correct risk evaluation and the likelihood of use of condoms at last intercourse is examined. Individuals knowledge of HIV transmission and accurate evaluation of their own risk Safe Sex Versus Safe Love? Relationship Context and Use of condoms Among Male Adolescents in the Favelas of Recife, Brazil 1438 males Urban slum areas of Brazil Educational attainment, degree of knowledge of HIV transmission and prevention, and use of condoms at first sexual intercourse the analysis revealed that adolescent males in steady relationships were less likely to use condoms, less likely to regard themselves at risk of HIV infection, and more concerned about pregnancy prevention than adolescents in casual relationships Sexually Active Adolescents and Condoms: Changes Over One Year in Knowledge, Attitudes and Use 234 females and 91 males Adolescent clinics knowledge that condoms prevent HIV, value placed on using a contraceptive that prevents one from getting HIV, importance of using a contraceptive that prevents one, from getting HIV; perceptions of their partners wishes, regarding use of condoms; intentions ever to use condoms; and intentions to use condoms most of the time. knowledge that condoms prevent HIV MAJOR OUTCOMES CONSIDERED Rates of use of condoms among adolescents Factors influencing use of condoms Efficacy of condoms in preventing pregnancy, sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV) Effectiveness of school-based condom availability programs Rates of sexual activity, pregnancy, STDs, and HIV among adolescents Solely providing information to adolescents that condoms reduce the risk of contracting HIV may be insufficient to cause an increase in use of condoms. One problem may be that even if adolescents understand in abstract terms that condoms protect against HIV and believe that this is of value, they may not feel personally vulnerable to contracting diseases from their sex partners. Thus, interventions that target perceptions of personal vulnerability may be a way of increasing adolescents motivation to use condoms. A large number of adolescents were interviewed in the above surveys. Their main socio-demographic characteristics were the following: average age: 17.1 years, unmarried: 72%, Muslims :52.8% illiterate 85.4%. Knowledge of HIV was very low ( 4.7% ) and the main source of information on HIV was radio ( 61.5% ). One in 5 participant presented at one time signs suggesting HIV symptoms. HIV/AIDS awareness was high ( 87.7% ) and once more the main source of information was radio. Only 32.8% of the boys and 22% of the girls knew about the condom. Unmarried adolescents had better knowledge of condom than the married ones. First intercourse Use of condoms was very low ( 4.4% ) thought in the last year, 20% of the adolescents had more than one sexual partners. As a way of preventing HIV/AIDS the use of sondoms was revealed by only 32.7%.of the adolescents. There is little doubt that Adolescents have knowledge of HIV, but knowledge and use of condom is very little. Prevention plans should increase adolescents awareness about HIV, and provide them adequate information about the connection between these HIV and HIV/AIDS. The next stage would be the promotion of the use of condom. Accessible literature demonstrates assorted results on the association between risk perception and sexual behavior. The findings show that the use of condom at last sex in this was often related to numerous factors operating both at personal and environmental levels. It was related to most of the demographic and behavioral variables in the analysis. Previous studies demonstrate positive associations between learning and use of condoms. The present study exhibits a similar trend, the only exception being women who have a secondary or higher education. AIDS-related variables such as the following: knowing someone with AIDS, using voluntary counseling and testing services, and Rightly assessing ones own risk— were also certainly associated with use of condoms. However, results differ between gender, and also vary by marital status. Use of condoms at last sex seems to be more strongly connected to accurate evaluation of risk among never-married than among ever-married men and women, and more among males than among females. Similarly, counseling and testing services has been associated with use of condoms, but only among single men and women. Since participants who could use and chose to use these services are a very much self-selected subsample, it is advisable that these results are read cautiously. Factors allied to choosing to obtain services may be the cause of the difference. Sweat et al (Sweat M et al, 2000) found that people who went for voluntary counseling and testing services were much more as likely as those in contrast household likelihood samples to account unprotected sex with nonprimary and commercial partners; following voluntary testing and counseling, use of condoms increased by 66%. Due to low access to and accessibility of voluntary counseling and testing services, participation in counseling and testing is less likely to be allied to an increase in use of condoms of the same scale reported by Sweat et al. in Tanzania and Trinidad. Studies in Sub-Saharan Africa have shown that as many as 90% of individuals of reproductive age would use voluntary counseling and testing services if they were available (Coovadia HM, 2000). It is probable that the Mozambican youth who went for these services were more probable than others to modify their activities. On the contrary, those who used these services might have done so as they found themselves in relatively high-risk situations. It is also possible that they may have had little control over the use of condoms. The intensity of use of condoms at last sex reported in the study (22% among men and 10% among women) characterises significant boost over the levels found in the 1997 DHS (7% and 2%, respectively) (Gaspar MC et al., 1998). The finding that condom use remains lesser among the married than among the never-married individuals is in keeping with findings from previous work (Adetunji J, 2000). With a high HIV prevalence it is imperative to promote use of condoms in all sexual relationships, even in those that are consensual and legal because both married and unmarried individuals are involved in risky sexual behaviors (e.g., multiple partners and unprotected sex with nonregular partners). Moreover, the use of condoms can often be a sign of mistrust (Adetunji J, 1997). A very vital constituent of HIV prevention efforts should include concentrating on these issues in awareness and educational campaigns. It should also include supporting and promoting the HIV testing for both married and regular partners and the sustained use of condoms at least up to the time the couple is able to undergo counseling and testing. Conclusions The AIDS endemic is a complex one. It is certain that in order to successfully limit transmission a combination of medical, social and behavioral approaches is required. There is little doubt that the youth/adolescents should be the focus of policies to control HIV infection. The population-based data from surveys provide knowledge that will help program officials and policymakers to create more effective HIV prevention programs for youth. The reproductive health knowledge of adolescents and young adults and their sexual and contraceptive activities surely have important implications for their wellbeing and welfare, and also for the continuance of their education. In several countries, only very few young people have the necessary information, skills and resources that are absolutely essential to cope with a healthy shift to adulthood. Sufficiently strong and effective programs, including quality sex education and media campaigns, both aimed at in-school and out-of-school youth, would give important information that can enhance young peoples capability to properly judge their own risks of HIV infection and also boost their use of condoms. References: 1. Use of condoms by adolescents, (2009) [Online] Available at: http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=3083&nbr=2309 (27.04.09) 2. Prata, N. et al. Relationship Between HIV Risk Perception and Use of condoms: Evidence from a Population-Based Survey in Mozambique, International Family Planning Perspectives Volume 32, Number 4, December 2006. [Online] Available at: http://www.guttmacher.org/pubs/journals/3219206.html (27.04.09) 3. Juarez, F. & Teressa Martin. Safe Sex Versus Safe Love? Relationship Context and Use of condoms Among Male Adolescents in the Favelas of Recife, Brazil. [Online] Available at: http://www.citeulike.org/user/n0e/article/524585 (27.04.09) 4. Kegeles, Susan M. et al. Sexually Active Adolescents and Condoms: Changes Over One Year in Knowledge, Attitudes and Use. AJPH April 1998 Vol. 78. No. 4. [Online] Available at: http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1349376&pageindex=1 (27.04.09) 5. Sweat M et al., Cost-effectiveness of voluntary HIV-1 counseling and testing in reducing sexual transmission of HIV-1 in Kenya and Tanzania, Lancet, 2000, 356(9224):113–121. 6. 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