Showing papers in "Aids Education and Prevention in 1989"

The Health Belief Model in understanding compliance with preventive recommendations for AIDS: how useful?

Abstract: The Health Belief Model (HBM) has been applied to a variety of health conditions: most are less threatening and require less complex responses than those arising in the case of AIDS. The utility of the HBM in understanding preventive behaviors in AIDS is examined in a cohort of homosexual men at two different time points. Longitudinal analyses estimated the relationship of indices assessing susceptibility, severity, benefits, and barriers, as well as sociodemographic factors, to sexual behavior across the next 18 months. Analyses further defined these associations in specific subgroups of participants, such as those initially at lower or higher risk. In general, measures of severity and socioeconomic advantage had the most consistently beneficial effect on various measures of behavior. Little or no beneficial effect was observed for other components of the HBM, notably a measure of perceived susceptibility. These analyses suggest that the special features of AIDS may require development of more adequate theoretical frameworks.

AIDS fears and homophobia among rural nursing personnel.

Abstract: Attitudes and concerns about AIDS of 144 nursing personnel attending conferences on AIDS in rural central Pennsylvania were assessed. Participants were knowledgeable about AIDS but wished to learn more and wanted additional training. Most were moderately worried about contracting AIDS, and a sizeable percentage showed irrational fears. AIDS fears centered around fear of casual-contact transmission and transmission through intimate contact. Participants held generally negative views of gay men and lesbians, and few had personal knowledge of gay people. Homophobic attitudes correlated significantly with AIDS phobias, suggesting that feelings about gay men may influence the nature of medical care that AIDS patients who are gay might receive.

Development of an instrument to measure attitudes toward acquired immune deficiency syndrome.

Abstract: The AIDS Attitude Scale (AAS) was developed to measure attitudes toward acquired immune deficiency syndrome (AIDS) among college students. In phase one, 67 items, determined by an expert panel to have content validity, were randomly ordered and administered to 164 student volunteers in a large southern university. Fifty-four individual items that correlated significantly (p less than .001) with the total attitude scores were retained for the final version of the scale. In phase two, the revised scale was administered to 135 student volunteers to determine its internal reliability (alpha = .96). Females and older students (21 and over) were significantly more tolerant about AIDS than males and younger students. Preliminary factor analysis revealed three factors explaining approximately 45% of the variance in response patterns; they related to proximity with people with AIDS, moral issues, and social welfare issues. Uses of the instrument in attitudinal studies, program planning, and evaluation are discussed.

Prevention of human immunodeficiency virus infection among adolescents: the interplay of health education and public policy in the development and implementation of school-based AIDS education programs.

Abstract: Adolescents now accounting for less than 1% of diagnosed AIDS cases in the U.S. may need more intensive health intervention to prevent infection. Since HIV infection is not apparent without testing rates of sexual activity teen pregnancy and sexually transmitted diseases are indicators of risk. Data indicate that sexual initiation is occurring earlier numbers of partners are increasing a girls risk of pregnancy by age 20 is 40% and STDs are the most common communicable diseases facing adolescents. Surveys from San Francisco in 1987 found that teens knew that sexual intercourse is the primary route of HIV transmission but only 60% knew that condoms reduce the risk. Few U.S. schools have AIDS education in their formal curriculum and even fewer do evaluations. Standardized AIDS education in schools should be mandatory in intermediate and secondary school; teacher training in knowledge attitudes and value assessment should be included; and results of programs should be evaluated. These education programs must involve students in decision-making resistance training coping strategies and options as well as providing knowledge and dispelling myths and fears. Even thou polls show that 88% of adolescents and 91% of parents favor mandatory HIV/AIDS education in schools the requirement of standardized testable curriculum is controversial. A core curriculum should be universal to provide teens with knowledge they may need if they leave their locale and culture.

Methods for the reduction of AIDS social anxiety and social stigma.

Abstract: A cognitive-social model is proposed for the study of AIDS social attitudes. Features of the ambivalent (fear and compassion) public belief system toward PWAs are outlined and ways to increase altruism and reduce fear are specified. Three studies are reported using cognitive-social methods for the reduction of AIDS social anxiety and social stigma. Study 1 found that cognitive inoculation and abbreviated group desensitization equally reduced AIDS social anxiety measured by a verbal scale. One form of brief group desensitization was superior to basic factual, counterphobic inoculation in reducing desire for social restriction of persons with AIDS (PWAs). In Study 2 subject improvisational role playing of PWAs increased positive attitudes toward PWAs and desire for altruistic actions but did not reduce measured fear. Knowledge of AIDS was negatively correlated with AIDS social anxiety and desire for patient restriction. AIDS social anxiety was negatively correlated with altruism and positively correlated with homophobia. In Study 3, three forms of experimenter-guided mastery imagery reduced AIDS social anxiety and increased AIDS altruism. Results of these studies may have relevance to reducing high-risk contagious behavior, as well as to reducing AIDS social stigma and social anxiety. A componential model of AIDS education is described.

Factors associated with hospital workers' reactions to the treatment of persons with AIDS.

Abstract: This article reports on how the increasing number of AIDS patients is having a significant impact on the delivery of healthcare services. Healthcare workers need to learn how to provide medical care for persons with AIDS as well as how to interact with and relate to them. Workers who have accurate information regarding the transmission of AIDS report more positive responses. In addition to didactic educational efforts hospital workers need explicit education on the psychosocial issues related to AIDS including such issues as fears of contagion, homosexuality, and death anxiety. Ethnic and cultural differences of both the AIDS population and healthcare workers must be addressed to relieve feelings of risk, stress, and discomfort. Each healthcare setting must determine the most effective means to educate all levels of staff on a continual basis.

Mental health care providers: the need for AIDS education.

Abstract: Mental health care providers completed a set of measures assessing their attitudes, knowledge, and beliefs concerning AIDS. Those surveyed were aware of the main transmission routes but were excessively concerned about casual contact. Most indicated that they are not competent to deal with AIDS patients and would prefer not to care for them. The majority favored client testing and segregated programs for HIV-infected persons. Additional AIDS-related education and staff support are needed to overcome irrational beliefs and prejudice.

Who hasn't heard about AIDS?

Abstract: This article analyzes who among the general population has not heard about AIDS despite intensive educational programs and widespread media attention about the syndrome. The data are drawn from a survey of the general public's knowledge, attitudes, and behavior toward AIDS in May-July, 1987 to establish a baseline for future educational interventions and to identify groups in need of special educational efforts. A total of 1540 interviews were conducted in Chicago and the surrounding six-county metropolitan area with adults between the ages of 18 and 60 in a two-stage cluster sample designed to compare blacks, whites, and Hispanics. Of the 1540 respondents, 49 (3.2%) had never heard of AIDS. Contingency table and logistic regression analyses indicated that lower educational levels and being Hispanic or Asian predict not having heard about AIDS. The results suggest the need for programs and intervention strategies that consider the special characteristics of these populations.

A preliminary investigation using drama in community AIDS education.

Abstract: This investigation assessed the impact of drama on AIDS-related knowledge and beliefs of selected individuals in a university community. Subjects were 136 members of the audience attending two performances of "As Is," the award-winning drama by William Hoffman depicting the illness and inevitable death of a homosexual man with AIDS. The investigation used a pretest-posttest design in which subjects completed a survey instrument before and immediately after the performance. No changes in AIDS-related beliefs were detected as a result of the play. However, knowledge decreased slightly. A linear multiple regression analysis determined variables that contributed significantly to variation in pretest knowledge about AIDS. Pretest knowledge scores were high, particularly in terms of modes of transmission. However, some confusion was evident concerning the concept of casual contact. Though subject responses on a pretest tolerance index generally indicated tolerant beliefs toward people with AIDS, substantial concerns were evident among a minority of subjects. More definitive research is needed to examine the impact of drama as a medium for affecting knowledge and beliefs about AIDS and other complex, emotion-laden health education issues.

Designing interventions to prevent HIV-1 infection by promoting use of condoms and spermicides among intravenous drug abusers and their sexual partners.

Abstract: Participants at a 2-day workshop convened by the University of California Los Angeles School of Public Health in May 1988 at the request of the Contraceptive Evaluation Branch of the National Institutes of Child Health and Human Development discussed the feasibility of interventions aimed at promoting use of condoms and spermicides among intravenous drug abusers and their sexual partners. Such interventions are crucial to child survival efforts since the major source of human immunodeficiency virus (HIV) transmission to children is from infected intravenous drug abusers. Although most intravenous drug abusers have casual sexual contacts over 90% are in a long-standing relationship. Contraception is more likely to be used by drug addicts in casual sexual encounters than in their stable sexual relationship. Participants at the workshop reached the consensus that intervention programs should target the couple (even if 1 partner is not an intravenous drug user) use existing value systems to change behavior have a warm and entertaining tone and obtain community support. Among the strategies that have been effective in recruiting intravenous drug abusers and their sexual partners have been advertisements use of sites such as family planning and community health centers use of nonmedical service locations such as day care centers and community organizations involvement of trained volunteers and targeting of a high-risk housing project. Since many intravenous drug abusers are members of poor minority communities with a history of degrading contact with institutions attention must be given to securing the trust of participants. The interventions themselves should use behavioral modification methods that leave existing values and roles intact. In general peer group meetings are most successful in inducing a commitment to initiate and maintain new sexual behaviors.

Pediatric AIDS, developmental disabilities, and education: a review.

Abstract: The increasing incidence and prevalence of pediatric HIV infection and associated morbidity suggest that HIV-related neurological impairments and concomitant developmental disabilities are likely to present major societal problems. This article reviews and discusses (a) issues associated with the variable course and multidetermined nature of the development of children with HIV and (b) contemporary education and policy issues associated with HIV-related developmental disabilities in children. Collaborative service delivery and case management are proposed for organizing social and educational responses to children with HIV and their families.

A bridge to treatment: the needle exchange pilot program in New York City.

Abstract: The needle exchange pilot program in New York City is one element in a spectrum of drug prevention and treatment modalities under way to slow the spread of the human immunodeficiency virus. The program's aim is to help us learn about the addict behaviors that spread the AIDS virus, including whether needle exchange can help reduce the frequency or eliminate those behaviors. Thus far, its primary value for clients lies in drug counseling and referral to treatment. Where an active IV drug user has taken the first step in changing the direction of his or her life by seeking treatment, needle exchange has been a significant means of helping keep that change in focus. Because of its value in helping change, and save, the lives of intravenous drug users and their sex partners and children, it should be expanded, and should be considered for adaption by other communities according to their needs as one relatively small element in a comprehensive AIDS prevention program.

Towards an AIDS information strategy for Zimbabwe.

Abstract: Knowledge about AIDS was surveyed in Zimbabwe before and after the national AIDS awareness campaign in mid-1987 630 teacher-trainees were surveyed before the campaign and 4189 teacher-trainees 1532 adolescents 381 Sindebele-speaking urban adults and 795 Shona-speaking rural adults were surveyed afterward Each subject was given a true- false test to complete with assistance if needed Most subjects knew that HIV is fatal and incurable that condoms reduce risk Many adults believed that HIV is transmitted by toilets cups and mosquitoes Many did not know that HIV can be contracted from a healthy looking person More students after the campaign thought most AIDS victims in Africa are homosexual Teacher-trainees reported a score of 79 out of 10 to show their intention to reduce number of sex partners but 72 for their intention to use condoms Sexual activity was reportedly much higher among teen and student males than females and sex with prostitutes was reported by 385% of male students and 247% of urban male adults Some of the implications of this survey include the need for further education on the high risk of avoidable sexual contacts especially with prostitutes; need for more information on AIDS specifically targeted to rural areas by radio and key organizations This survey points out the nonproductive nature of the argument that condom use among adolescents should not be promoted because this may encourage sexual activity: sexual activity and multiple partners is already prevalent among male adolescents

Responding to AIDS: ten principles for the workplace.

Abstract: The University and the Medical Center have endorsed ten principles for responding to AIDS that were outlined in a report from the campus-based Philadelphia Commission on AIDS. The material entitled Responding to AIDS: Princçolesforthe Philadelphia Workplace is based on a statement developed by the Citizens' Commissionon AIDS forNew YorkCity and Northern New Jersey, and is being widely adopted by Delaware Valley health care institutions. The ten principles are: I. Employment policies should be based on the scientific and epidemiological evidence thatpeople with AIDS or HIV infection do not pose a risk of transmission of the virus to coworkers through ordinary workplace contact. 2. Employment policies must, as a minimum, comply with federal, state, and local laws and regulations. 3. People with AIDS or HIV infection are entitled to the same rights and opportunities as people with other serious or life-threatening illnesses. 4. Therefore, the highest levels ofmanagement and union leadership should unequivocally endorse non-discriminatoryemployment policies and informational and educational programs about HIV infection. 5. Employers and unions have and should recognize the duty of protecting the confidentiality of employees' medical information. 6. Employers and unions should provide employees/members with accurate and up to date information in an understandable and usable form about transmission of HIV, risk reduction, infection control, and the law governing discrimination. 7. Employers and unions should communicate their support of these policies in simple, clear, and unambiguous terms. 8. To prevent work disruption and harassment or rejection by co-workers of an employee with AIDSor HIV infection, employers and unions should undertake education for all employees before such an incident occurs and as needed thereafter. 9. Employers should not require HIV screening as part of general pre-employment or workplace medical examinations. 10. In those special occupational settings where there may be a significant risk ofexposure to HIV (forexample, in health care, where workers may be exposed to blood or blood products), employers should provide specific, ongoing education and training, as well as the necessary equipment and facilities toreinforce appropriate infection control procedures and ensure that they are implemented.

Personal service workers: a critical link in the AIDS education chain?

Abstract: Based on the hepatitis B experience in these PSW occupations, it is possible to transmit HIV through instruments, materials, and equipment used by PSWs. However, PSWs include a group of people that may be overlooked when planning and conducting AIDS education programs because they do not fit into a well defined and apparent risk category as other health care workers. Educators should be cognizant of the need to address this issue in terms of prevention of HIV transmission and proper infection control procedures for PSWs. Educational programs need to be tailored to specific PSW occupations because of their occupational differences. Concern for the potential transmission of HIV through acupuncture, electrology, tattooing, and cosmetology is evident at local, state, and national levels. Anecdotal stories have reported clients purchasing their own electrolysis and acupuncture needles and combs and scissors. Barber shops have declined to shave clients because of their concern over HIV transmission. PSWs need to be concerned with reducing the potential to transmit all infectious diseases, including hepatitis B and HIV. In the current climate of "AIDS phobia," PSWs need to be able to assure their clients that they can provide valued personal services in a safe manner.

The effect of terminology on public consciousness related to the HIV epidemic.

Abstract: Language, as a reflection of culture, not only mirrors the concepts of the society in which it is employed, but also shapes the consciousness of the people who communicate with it. Recently acquired terminology related to AIDS has had a dramatic effect upon American perceptions and traditions. Current suggestions that the term "HIV infection" be used as a substitute for "AIDS" when referring to the epidemic we currently face validly demonstrate the impact that semantics have upon accurately raising consciousness regarding the magnitude of a problem. People involved in AIDS/HIV instruction should take these concerns into consideration when presenting the AIDS issue.

Targeting AIDS through information, education, and communications programs: implications for Africa and the Caribbean.

Abstract: IEC campaigns targeted at acquired immunodeficiency syndrome (AIDS) must seek to achieve the maximum impact within a contest of extremely limited resources. This implies a careful assessment of population groups and behaviors that carry the highest risk. Rather than expending large sums of money on mass media campaigns the approach should be to target IEC activities at the social networks of those most at risk. This may include for example prostitutes homosexual men hotel and tourist employees students and military personnel. Once epidemiologic studies have identified the at-risk population volunteers form these groups should be recruited and trained to reach their peers through the networks available to them. This education component of IEC work takes priority. The second step involves information diffusion to health providers who are likely to come into contact with human immunodeficiency virus (HIV)-infected individuals especially those who have access to pregnant women and mothers. Some of these providers are not aware of the risks involved in the reuse of immunization needles. The third step--communication with the general public--is aimed at making the population aware of the factors that place people at risk of HIV infection. Radio seems to be the media capable of reaching the greatest numbers although traditional means of communication should not be neglected. The IEC effort should consider options at the community institutional and individual levels and address those factors that enable reinforce and predispose appropriate health behaviors.

The impact of AIDS on state public health legislation in the United States: a critical review.

Abstract: This article reviews and analyzes the current public health legislation in 17 states and the District of Columbia in the United States. These states were selected and grouped into high, medium, and low incidence based on their annual AIDS incidence rates. Data were collected through a combination of library research and direct communications with the various state health departments. Four major areas of legislation were reviewed: HIV antibody testing and reporting; confidentiality and partner notification; personal control measures: and AIDS antidiscrimination laws. In general, majority of the states have treated the AIDS epidemic as a public health problem and not as a moral or criminal issue. Some states with higher incidence such as New York and California have developed the least restrictive laws and responded with stronger AIDS antidiscrimination legislation. The states with medium incidence have more restrictive measures and the low incidence states have less legislation and fewer regulations related to AIDS. AIDS educators should be aware of the implications of the varied legislation and regulations on AIDS education and prevention. They should play a strong advocacy role in promoting the development and application of measures that will facilitate the prevention and control of AIDS.