Understanding AIDS: A Comparison of Children in the United States and Thailand*
Replicating a prior U.S. study, data were gathered from preschool and school-age children in Thailand (n = 80). Taking a developmental perspective, Thai children's knowledge and understanding of AIDS was assessed, and results were compared with those of the U.S. sample. The findings show that Thai children in each of four designated age groups have higher levels of accurate knowledge of AIDS compared with their U.S. counterparts. The findings of these early studies are discussed in terms of current AIDS infection rates and educational prevention efforts in both cultures.
Key Words: AIDS, child development, children, HIV. Thailand.
In January 2000, the top issue on the agenda of the United Nations Security Council was AIDS. The grave warnings of the worldwide spread of AIDS are now a reality. At the end of 1999, 34.3 million people worldwide were living with AIDS; 1.3 million were children under age 15. Since the beginning of the epidemic, 18.8 million people have died, and approximately one quarter of these deaths were children (Mukwaya, 1999; Joint United Nations Programme on HIV/AIDS [UNAIDS] and World Health Organization [WHO], 2000). The epidemic is most prevalent in sub-Saharan Africa, with South and Southeast Asia ranking second in number of AIDS deaths; the United States reported the highest death rate in the Western world (Mukwaya, 1999; UNAIDS and WHO, 2000).
Given the epidemic nature of this disease, recognition of the problem and early and effective education are top items on the agendas of those working to halt its spread. Educational efforts focusing on children have received attention on several fronts in the past decade. The extent to which children understand concepts related to illness in general, and to AIDS specifically, is of interest as policy makers, educators, and those in the health field attempt to determine how best to increase awareness of the disease and to provide accurate information about it. This task is a pressing one, because children are at risk for contracting the disease themselves, and increasing numbers of them are personally affected as family members and acquaintances become infected. Research is clear in showing that one way of promoting health practices in children, helping them have compassion and understanding for those who are infected, and coping with illness and loss of friends and family members is to provide them with accurate information that is appropriate to their level of cognitive development (e.g., Kappelman, 1990; Koocher, 1973; Speece & Brent, 1984).
The purpose of this study was to replicate our earlier study (Schvaneveldt, Lindauer, & Young, 1990) that measured accurate AIDS knowledge of U.S. children with children in Thailand and to compare responses of the two groups. The goal of both studies was to focus on the neglected area of younger children with respect to AIDS. The underlying assumption is that acquisition of knowledge in the early years can be an effective tool in reducing infection rates in the vulnerable years of adolescence and young adulthood. We placed both studies in a historical perspective and viewed retrospectively how educational efforts targeting children a decade ago may be associated with current rates of HIV infection in both the United States and Thailand.
Data were gathered from the two groups between 1989 and 1992. Both studies are based on Piagetian premises underlying cognitive development in children and their interface with children's understanding of illness and mortality. The earlier study showed a correlation between U.S. children's stage of development and the accuracy of their responses to questions about AIDS (Schvaneveldt et al., 1990); the same trend was expected for Thai children. Because experience also influences children's attitudes and knowledge about illness, and because of the higher prevalence and heterosexual nature of AIDS in Thailand, we assumed that Thai children, compared with U. …