HIV Risk Prevention: Educating Minority Adolescents
Fighting HIV / AIDS involves no less than changing our whole sexual culture." Peter Piot, Executive Director of UNAIDS, feels that what is most vital is that preventive education be stressed into young people's behavior. (UNESCO Courier, October 1999). Around half of all new cases of HIV infection in the whole world involve young people between 15 and 24, and in more and more cases, below age 15. Why is this so? Because everybody knows that it is the age when you begin experimenting with sex and change partners most often which compounds the problem because it multiplies the risk of infection. Studies in Kenya and Zambia show that 23% of the girls between 15 and 19 are HIV-positive compared with only three to four percent of boys. Girls are more vulnerable because of two reasons: the female genitals are more susceptible to infection than those of males (because they have not yet developed) as well as socio-cultural ones (they are most often won by gifts or are the victims of force). They often have as partners adult men who because of their age are more likely to be HIV-positive than boys.
The roots of the problem are most often poverty and male chauvinism. Hence, it is important to educate boys who have to learn that their worth doesn't depend on the number of women they have seduced.
It's been statistically proven that preventive education makes people much more sexually responsible. Youth are more receptive to prevention messages and go on to adopt a more responsible attitude to sexuality than adults.
In countries where there's been a good response to prevention campaign we've seen a very marked drop in the rate of infection among the 15 to 24-year-olds. The rate in Uganda urban areas has dropped 40%. In Zambia it has dropped most markedly among school children.
All this shows that education has an important role to play. While it's true that many children in developing countries don't go to school, the majority pass through school. The opportunity must be grabbed to give them an education about AIDS adapted to their age group, right from the start of primary school. While people feel that this will still encourage children to have sexual relationships, individuals really don't wait for lessons before starting their sexual life.
It has been statistically proven that preventive education makes people much more sexually responsible, namely by having sexual relationships later and using protection. (UNESCO Courier, 1999).
While the highly industrialized world has successfully stemmed the tide of new HIV / AIDS infection and has sharply reduced the number of AIDS deaths through the use of new and more potent anti-HIV drugs, everywhere else in the world the pandemic is still spreading uncontrolled with the sick being treated poorly or left untreated. This is noticeable in South and East Asia and most specially in sub-Sahara, Africa (UNESCO Courier, 1999).
In the United States, HIV/STD infections are prevalent among the African-Americans, and the Latinas in urban and rural areas specially in districts where the unemployment rate is high and impoverished families cannot send their children to school. Out-of-school youth ages 12-19 are most stricken and while efforts are being heightened and the federal government and other funding organizations are helping out, HIV/STD cases still exist and programs don't seem to work out at all. The following glaring statistics stand out in surveys conducted throughout the United States:
as of June 2000, the Centers for Disease Control and Prevention reported that 431,924 individuals are living with HIV infection and AIDS in the United States
There are an estimated 250,000 Americans who are unaware that they are HIV-infected and many of them are young people.
Half of all new HIV infections are thought to occur in young people under 25 years of age.
More than 123,000 young adults in the United States have developed AIDS in their twenties. The delay between HIV-infection and the onset of AIDS means that most of these young people were infected with HIV as teenagers.
Although the total number of youth in the United States who have been infected with HIV is unknown, public health officials believe that 20,000 people between 13 and 24 years of age are infected with HIV every year at the rate of about 2 every hour.
In the United States, more females than males are now being diagnosed with HIV in the 13- to 19-year-old age group.
By 12th grade, 65% of American youth are sexually active and one in five has had four or more sexual partners.
In the United States, 25% of high school students who have had sex said they were under the influence of alcohol and other drugs the last time they had sex.
HIV infections are usually contracted sexually among American young people.
The percentage of high school students who say they have had sexual intercourse decreased from 54% in 1991 to 50% in 1999. The percentage of sexually active high school students who say they used a condom the last time they had sex increased from 45% to 58% during the same period. Their accounts were confirmed when in 1999, births to teenagers fell to their lowest rate in 60 years. (Office of National Aids Policy, Youth and HIV / AIDS 2000: A New American Agenda).
A research system with an objective of applying science, technology, communication should be used to provide alternatives to meeting specific needs of adolescents. Each member included in the team plays a specific and essential role. An active exchange of resources must take place to enable each one to perform his particular task. As each one influences the other, there ensues dynamic interdependence. Interaction is fostered by which the program is able to survive, adapt, maintain itself and grow. The effectiveness of the program is entirely dependent on the communications established within it and between it and others. The successful conduct of the program requires that those responsible for its planning and implementation interact with the other factors in its environment. (Valdecanas, 1983).
The Theory of Reasoned Action (TRA) will be used as a framework for this proposal. First introduced by Fishbein in 1967, it suggests that a person's attitude toward any object is a function of his or her belief about the object and the evaluative aspects of those beliefs (Terry, 1993). The theory is based on the assumption that human are rational and behaviors are under voluntary control. It provides a framework that connects individual beliefs, attitudes, intentions and behaviors as shown in the model below Theory variables are defined by Fishbein and described by Demson (1996).
Behavior: A specific behavior defined by a combination of four components: action, target, context, and time
Intention: The intent to perform a behavior is the best predictor that a desired behavior will actually occur. To be able to measure it accurately and effectively, it should be defined using the same components used to define behavior, action, target, context and time.
Attitude: The individual's positive or negative feelings toward performing the defined behavior.
Behavioral beliefs: A combination of a person's belief regarding the outcomes of a defined behavior and the person's evaluation of potential outcomes. These beliefs differ from population to population.
Norms: A person's perception of the other people's opinion regarding the defined behavior
Normative beliefs: A combination of a person's beliefs regarding other people's views of a behavior and the person's willingness to conform to those views. These beliefs vary from population to population.
The theoretical framework supports a linear process in which the changes in an individual's behavioral and normative beliefs eventually affect the person's actual behavior. The theory forms a causal chain that links belief to behavior. According to the theory, cognitive structures, behavioral and normative beliefs, influence individual attitudes and subjective norms (Fishbein,1994). Consequently attitudes and norms shape a person's intention and remain the best indicator of the desired behavior.
The TRA has been used to successfully influence behaviors involved in the control and spread of STDs and AIDS. Other studies have used the TRA successfully. Ross and McLaus (1992) found that subjective norms were good predictors of intention to use condoms but attitudes were poor predictors of intention. However, research conducted by Fisher, Fisher and Rye (1995) with gay men, and heterosexual college and high school students, suggests that AIDS preventive behavior were predicted by behavioral intention and the behavioral intentions were a functions of attitudes and norms.
In a survey on 12- to 19-year-olds, attitude toward condom use, subjective social norms and self-sufficiency expectations are important determinants of condom use.
The theory has been used successfully as a framework in several AIDS studies. The theory suggests that by providing appropriate knowledge or information, the performance of a given behavior will be influenced. Also, the more one knows about the factors influencing decisions to perform or not to perform a given behavior, the greater the possibility one can develop successful intervention to change…