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Knowledge and Attitudes towards HIV/AIDS and Associated Current Prevention Practices in the Era of Antiretroviral Therapy (ART) in Rwimi, Uganda Open Access


Other title
antiretroviral therapy attitudes
Type of item
Degree grantor
University of Alberta
Author or creator
Lartey, Nicole N.
Supervisor and department
Saunders, L. Duncan (School of Public Health)
Examining committee member and department
Saunders, L. Duncan (School of Public Health)
Jhangri, Gian (School of Public Health)
Caroll, Linda (School of Public Health)
Alibhai, Arif (School of Public Health)
Department of Public Health Sciences
Global Health
Date accepted
Graduation date
Master of Science
Degree level
Background: The impact of the wide-spread availability of antiretroviral therapy (ART) on the sexual behaviour of the general population who are not on ART in African countries is understudied. Additionally, there are concerns of a return to risky behaviours by people on ART or increased opportunities for the general population to continue to engage in risky behaviours. The purpose of this study was to assess whether the fear of contracting HIV/AIDS had reduced in the era of ART and to describe the culture of HIV prevention among the general population in Rwimi sub-county, Kabarole District, Western Uganda. Methods: A cross-sectional random cluster survey and a focused ethnography were conducted in Rwimi. We administered survey questions to 639 participants between June and August, 2013. We assessed whether the availability of ART has reduced the fear of HIV. In addition, we also assessed participants’ knowledge of and attitudes towards HIV/AIDS and current prevention practices. Logistic regression was used to assess associations for the outcomes general fear and personal fear of HIV with demographic variables and some knowledge measures. We carried out four focus group discussions. Data was collected in the local language, Rutooro, audio-recorded and thereafter translated and transcribed into English and analysed using content analyses. Results: The majority of participants felt that the availability of ART had reduced the fear of contracting HIV/AIDS in the community (89.4%; 95%confidence interval [CI]: 86.9–91.7%). No statistical difference was found for this outcome and any knowledge measures or demographics in logistic regression modelling. In contrast, few participants (22.4%; 95%CI: 17.7-25.6%) mentioned that their personal fear of the disease had reduced with the availability of ART. Participants who had at least a secondary level education had a lower odds (OR=0.29, p=0.022) of reporting a personal reduced fear; but those who were aware of the negative effects of ART had a higher odds (OR= 1.72, p= 0.047) of reporting reduced personal fear of HIV/AIDS. Overall, the majority of participants (94.1%; 95%CI: 93.8-97.1%) were still fearful of contracting HIV/AIDS. Participants generally expressed a positive attitude toward HIV/AIDS prevention practices, but the mode of prevention practiced were influenced by factors such as policy, gender-based perceptions and trust in their relationships. Conclusions: The fear of contracting HIV/AIDS still persists, although participants perceived other people as being less fearful than they were of the disease because of the availability of ART. Additionally, although the community is considerably knowledgeable about HIV/AIDS and the fear of HIV is still present, condom use as a prevention practice remains surprisingly low. There is the need to take into account socio-cultural influences such as gender-based perceptions; relationship dynamics such as power structure and trust; and socio-economic factors that play into HIV prevention in designing sustainable programs that encourage adherence to prevention practices.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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