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  • Title: Trends in attitudes and behaviour relevant to AIDS in Ugandan community.
    Author: Konde-Lule JK, Tumwesigye MN, Lubanga RG.
    Journal: East Afr Med J; 1997 Jul; 74(7):406-10. PubMed ID: 9491169.
    Abstract:
    Behaviour-related preventive measures are still the main weapon against the spread of AIDS. Intensive AIDS prevention and control activities conducted over the last ten years need to be evaluated on the basis of their impact on attitudes and behaviour relevant to AIDS. The main objective of this study was to document and evaluate trends in attitudes and behaviour relevant to AIDS in a Ugandan community over a seven year follow up period. The study was a longitudinal community-based closed cohort. Periodic surveys were conducted on the study group and data on condom use, attitudes about condoms, rates of sexual partner change and reported frequency of sexually transmitted diseases were collected in all surveys. Data reported are from surveys conducted during 1987, 1992 and 1994 in which similar questions were asked and emerging trends identified. Reported condom use ever, increased from 3.9% in 1987 to 10.1% in 1992 and to 27.2% in 1994. This is a 7.3 fold increase over seven years. In females, reported use of condoms increased from 1.2% in 1987 to 18.2% in 1994 while in males it increased from 6.9% to 35.3% over the same period. In this study group there are still more people opposed to the ongoing intensive condom campaign than there are those supporting it. The percentage supporting the campaign was 28% in 1987, 26% in 1992 and 40.8% in 1994. This is a rising trend. The rate of sexual partner change has declined. During the baseline survey, 26.5% of the respondents reported that they had intercourse with two or more sexual partners in the six months period before the interview. This proportion decreased to 6.8% in 1992 but then increased to 17.1% in 1994. During the baseline survey, 2.6% of the study group reported that they had sexual intercourse with six or more partners during the six months period before the interview but during the 1992 and 1994 surveys, no one reported sexual intercourse with more than five partners during a similar period. The reported frequency of sexually transmitted diseases during a twelve month recall period, reflecting STD incidence, decreased from 3.5% in 1992 to 1.9% in 1994. In conclusion during the seven year followup period of this community-based closed cohort, we have identified a sharp increase in condom use, a reduced rate of sexual partner change and a decline in the reported frequency of sexually transmitted disease. The percentage of people supporting the condom campaign is rising. These are some of the outstanding outcomes of the AIDS prevention activities conducted in the country over the last 10 years. Over the past decade, the Government of Uganda has implemented health education campaigns aimed at preventing the further spread of HIV infection and AIDS. A 7-year (1987-94) longitudinal closed cohort study (n = 1990) conducted in Kasangati evaluated the impact of these campaigns on condom attitudes and use, rates of sexual partner change, and sexually transmitted disease (STD) incidence. Kasangati is a semirural subcounty north of Kampala. Most encouraging was a 7.3-fold increase in condom use over the 7-year study period. Ever use of condoms rose from 4% in 1987 (baseline) to 10% in 1992 and to 27% in 1994. Support for campaigns that urge condom use outside of regular relationships rose from 28% in 1987 to 26% in 1992 and to 40.8% in 1994. The proportion of respondents reporting 2 or more sexual partners in the previous 6 months fell from 26.5% in 1987 to 6.8% in 1992, then increased to 17.1% in 1994. It is unclear whether the higher rate of sexual partner change in 1994 than 1992 represents an underreporting in 1992 or is related to increased rates of condom use. In the 1987 survey, 20.2% of respondents reported an STD episode in the preceding 5 years. In 1992 and 1994, when the recall period was reduced to 12 months before the survey, these rates were 3.5% and 1.9%, respectively. The numerous AIDS prevention campaigns in Uganda, combined with easier access to condoms, appear to have had a significant impact on AIDS-related attitudes and behaviors in Uganda.
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