Browsing by Subject "Zimbabve"

This study assesses the relationship between education and HIV-status, and the contribution of HIV-related knowledge, attitudes, and sexual behavior to this association among 15-24 year old population in Zimbabwe. Zimbabwe bears a generalized, sexually transmitting epidemic with a declining HIV prevalence currently estimated at 15 percent. In earlier studies in sub-Saharan Africa, the relationship between education and HIV has been found to change during the epidemic. In mature epidemics, when the knowledge on the transmission mechanisms of the virus increases, education is suggested to become protective of the infection. In addition to increased HIV-related knowledge, more accepting attitudes towards people living with HIV and cognitive skills facilitated by education are argued to influence the behavior protecting from the infection. The aims of this study were two-fold: 1) to describe the trends in the level of HIV-related knowledge, attitudes and sexual behavior by the level of education, and 2) to assess the relationship between education and HIV-status based on the most recent data. This study focused on 15-24 years old only, among whom the acquired infections were assumed to be recent. The trend analyses were based on four cross-sectional, nationally representative Zimbabwe Demographic and Health Survey data sets collected between 1994 and 2010-11. In addition, the association between education and HIV-status was examined by calculating logistic regression models using the 2010-11 data, in which HIV-test results linked with the survey data were available. When trends between 1994 and 2011 were observed, both among women and men the level of education, HIV-related knowledge, and being tested for HIV had become more common, except among men with lower levels of education, who had worse HIV-related knowledge in the end of the periods studied. In 2010 more women in all educational groups, and men with lower levels of education, were married and had started their sex life, when men with higher levels of education, had postponed the onset of their sexual activity compared to 1994. Regardless of the level of education, both men and women had fewer lifetime partners and had less high-risk sex in 2010, though this was considerably more rare among women compared to men. In all other groups condom use in high-risk sex became more frequent during the periods studied, except among women with lower levels of education, who during the final study period were using condoms less often in high-risk sex than during the first study period. When the association between education and HIV status and the contribution of the intervening factors was assessed using the 2010 data, a statistically significant relationship between education and HIV status was found in women but not in men. Among women who had ever had sex having incomprehensive knowledge on HIV also increased the risk of the infection. Both in men and women having risky sexual behavior increased the risk of the infection. In line with earlier studies, the findings of this paper suggest that among young people in Zimbabwe, positive changes in HIV-related knowledge, and changes in high-risk behavior have occurred, though these changes vary according to the level of education and gender. More educated women seem to postpone the onset of their sexual activity, but those who have started their sex life have more often casual partnerships. Women with lower educational level marry and start their sex life early, but have very rarely casual partnerships, though condom use in these partnerships is lower and has even decreases, contrary to all other groups. Men with lower levels of education had most often incomprehensive knowledge on HIV, and had changed their behavior less compared to more educated men. More educated men had been able to alter their behavior more, but having many lifetime partners was still most common in this group. The findings of this study suggest that specific prevention measures are required to address these trends and the needs of different educational groups in both women and men.