Adolescents and AIDS: Knowledge and Attitude
Steitz, Jean A., Munn, Judith A., Adolescence
Primary prevention of AIDS remains uncoordinated, underfunded, and limited in scope because of public perception that there is no generalized threat of AIDS in the mainstream population (Bowser, 1991). However, as a result of the Magic Johnson tragedy, the public may begin to realize that the demographics of AIDS has changed greatly since its first recognition in 1981. What was thought to be strictly a homosexual disease is now known to be spreading rapidly among the heterosexual population. According to the Centers for Disease Control (CDC), AIDS is presently spreading fastest among the 24- to 30-year-old heterosexual population (CDC, 1989). People who engage in unprotected sexual activities or share needles when taking drugs intravenously are known to be at highest risk. Many adolescents fit this description (DiClemente, 1990; DiClemente, Boyer, & Morales, 1988; DiClemente, Zorn, & Temoshok, 1986).
One question asked is: If adolescents are engaging so actively in AIDS-spreading behaviors, why have only about 1% of the total reported AIDS cases, according to the Centers for Disease Control (1989), been among persons younger than 20? One reason is that AIDS has a long latency period--one to seven years (Curran, Morgan, Hardy, Jaffe, Darrow, & Dowdle, 1985). Hence, many people who develop the disease in their 20s came in contact with the human immunodeficiency virus (HIV) while in their teens. As adolescents continue to engage in unprotected sex and to use drugs intravenously, the problem will grow.
As stated by the National Academy of Science, youth need to be taught how to engage in healthy behaviors and protect themselves against HIV infection in order to prevent the further spread of AIDS (Miller, Turner, & Moses, 1990). Since schools reach 95% of U.S. youth, it makes sense for them to conduct the bulk of preventive AIDS education (Kerr, Allensworth, & Gayle, 1989; Price, Desmond, & Kukulka, 1985). The CDC has established guidelines for AIDS education (Tolsma, 1988), and many school districts have quickly developed and implemented AIDS curricula (Brown & Fritz, 1988; DiClemente, 1989; Remafedi, 1988). However, little research has assessed the effectiveness of these programs (Brown, Nassau, & Barone, 1990; King, Beazley, Warren, Hankins, Robertson, & Radford, 1989). Further, few studies have assessed adolescents' knowledge of AIDS, and almost no studies have looked at the effects on adolescents' attitudes of knowledge gained as a result of an AIDS education program.
Surveys of adolescents' baseline knowledge about AIDS indicate a general increase since 1985 and suggest grade level differences, with older students having more knowledge. However, the surveys also indicate large gaps in information that can place adolescents at continued risk. Price et al. (1985) assessed the level of AIDS knowledge in 256 16- to 19-year-old students in Ohio. They found that only 3 of 19 questions were answered correctly by 75% or more of the participants. The students were most likely to know that people are not born with AIDS, AIDS victims are likely to die, and homosexuals are likely to get the disease. The findings could have been due to the fact that in 1985 the AIDS virus was still largely associated with the homosexual population and that the adolescent population remained unconcerned. It was also found that, for some of the questions, boys were more likely than girls to answer correctly.
In a Massachusetts study using 860 students 16 to 19 years of age, Strunin and Hingson (1987) found that only 2 out of 9 questions on HIV transmission were answered correctly by 75% or more of the participants. The students were misinformed or confused about AIDS, and most had little understanding of the modes of HIV transmission. It was also found that knowledge did not guarantee an effect on behavior; of the 70% who reported being sexually active, only 15% indicated that they had modified their behavior. …