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Misconceptions, denial and folk beliefs - obscuring the risk perceptions among young Zambians

Worldwide, an estimated 11.8 million people aged 15 to 24 are infected with HIV, most of whom (77%) live in sub-Saharan Africa. In Zambia, 21% of the population fall within this age group. How much do young Zambians know about HIV and how does it affect their behaviour? Researchers from Population Services International put these questions to young men in Lusaka, Zambia.

Many young Zambians still engage in several high risk behaviours such as:

having sex at an early age
multiple sexual partners
inconsistent condom use.

Their knowledge and beliefs about infection stem from their education, culture, socialisation and personal experience. Can high-risk behaviour be attributed to a lack of knowledge about HIV and its transmission? Or do misconceptions, folk beliefs and denial play a role?

Researchers interviewed 30 out-of-school males aged 15 to 19 years in Lusaka. They found that although overall awareness of sexually-transmitted infections (STIs) and HIV/AIDS is high, specific knowledge about transmission, prevention, symptoms and risk factors is limited. For example:

Most youth view promiscuous, careless and unhygienic individuals, especially women, as likely transmitters of STIs/HIV.
Although most know that STIs and HIV are sexually transmitted, they also reported that infection could be spread by mosquito bites, kissing and biting.
Folk explanations linking infection to blood strength, menstruation and sorcery are common.
Despite knowing that a healthy-looking person can be infected, most participants still rely on outward appearance to spot people who are likely to be HIV-positive.

Young people receive information about sex, STIs and HIV from a variety of sources including personal contacts, ‘information, education and communication’ programmes and the mass media. Most inaccurate information seems to come from peers and adults. Few of the participants believe that they are at risk from STIs and HIV/AIDS. Denial appears to be the result of the stigma attached to STIs and the conflict between local values discouraging sex among young people and their own perceived need for sex.

Misconceptions, folk beliefs and denial compete with correct information. They reduce youth's personal risk perception and slow the adoption of safer behaviour. Improving young people’s knowledge about STIs and HIV/AIDS could help to change their attitudes about risk behaviours, improve their ability to negotiate safer sex and decrease stigma. The researchers recommend that youth-targeted programmes should:

develop more peer-based interventions
present science-based message that work within a local health belief framework
make mass media messages more accessible to populations with limited education and distribute them in local languages
publicise the availability of HIV and STI testing and the importance of knowing one’s status
work with communities to decrease stigma linked to HIV/AIDS and talk openly about sexual activity amongst young people
help create long-term strategies for increasing youth's access to educational and economic opportunities.

Source(s):
‘Misconceptions, folk beliefs and denial: young men’s risk for STIs and HIV/AIDS in Zambia’, PSI Research Division Working Paper 53, by K. Longfield, R. Cramer and N. Sachingongu, 2003 Full document.

Funded by: USAID; UK Department for International Development

id21 Research Highlight: 17 November 2003

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