Effects of a theory-based audio HIV/AIDS intervention for illiterate rural females in Amhara, Ethiopia.

In Ethiopia the level of illiteracy in rural areas is very high. In this study, we investigated the effects of an audio HIV/AIDS prevention intervention targeted at rural illiterate females. In the intervention we used social-oriented presentation formats, such as discussion between similar females and role-play. In a pretest and posttest experimental study with an intervention group (n = 210) and control group (n = 210), we investigated the effects on HIV/AIDS knowledge and social cognitions. The intervention led to significant and relevant increases in HIV/AIDS knowledge, self-efficacy, perceived vulnerability to HIV/AIDS infection, response efficacy of condoms and condom use intention. In the intervention group, self-efficacy at posttest was the main determinant of condom use intention, with also a significant contribution of vulnerability. We conclude that audio HIV/AIDS prevention interventions can play an important role in empowering rural illiterate females in the prevention of HIV/AIDS.

Correlates of sexual faithfulness among low-literate rural males in the Amhara Region of Ethiopia.

HIV is a major threat to the people of the rural Amhara Region, northwest Ethiopia. To date, numerous studies have focused on condom use for HIV prevention. Using the theory of planned behaviour, this study investigates the psychosocial determinants of intended sexual faithfulness among rural males in the Amhara Region. In February 2008, we conducted a cross-sectional study with 100 males, with an age range of 20-50 years (mean age 38 years), in Dejen Woreda. The participants were illiterate or had a low level of literacy and all were rural farmers. Consequently, 10 literate male data collectors were recruited from the same community to assist in collecting data by means of a structured questionnaire. In the analysis of social cognitions as determinants of sexual faithfulness, attitude to faithfulness emerged as the best predictor of intended faithfulness, with significant contributions from self-efficacy and social norm for faithfulness. Thus, balanced and comprehensive HIV interventions focusing on attitudes, self-efficacy and social norms pertaining to faithfulness, sexual abstinence and condom use are needed to halt the spread of HIV among low-literate males in rural Amhara.

Reaching the hearts and minds of illiterate women in the Amhara highland of Ethiopia: Development and pre-testing of oral HIV/AIDS prevention messages.

In the style of radio programmes, we developed three episodes of audio HIV prevention education for illiterate women in Ethiopia. We used social-oriented presentation formats, such as discussion between women on HIV prevention, and expert-oriented presentation formats, such as an interview with a male doctor. The aim of this study was to assess the relation between evaluation of presentation formats and overall liking of episodes, which is important for persuasive effects. Thirty women from rural Amhara listened to the episodes and, after listening, female data collectors interviewed the women on evaluation of presentation formats, overall liking of episodes, identification with the characters and convincingness. Evaluation of social-oriented presentation formats was strongly related to overall liking of episodes, but evaluation of expert-oriented presentation formats was not. This relation was mediated through convincingness and not through identification. We conclude that social-oriented presentation formats make messages more convincing and, consequently, improve overall liking and persuasive impact.

HIV-prevention knowledge among illiterate and low-literate women in rural Amhara, Ethiopia.

More than 85% of Ethiopia's population lives in rural areas and literacy levels in the country are relatively low. Despite this, little is known about levels of knowledge in regard to HIV/AIDS and condom use among illiterate and low-literate rural individuals. We conducted a cross-sectional study among 200 illiterate to semi-literate women, ages 13 to 24, from two rural communities in the Amhara region of northwestern Ethiopia. Nearly all the women had heard about HIV and AIDS. Among the illiterate individuals (n = 54), 24% did not know that HIV was the cause of AIDS and 48% did not know that HIV could be transmitted by sexual intercourse without a condom with an HIV-infected person. Among the same group, 59% did not know what a condom is. Literacy had a strong positive association with knowledge of HIV transmission and condoms. Thus, due to a generally higher level of literacy (grade 5-8 attainment), very young women (ages 13-20) had better knowledge of HIV transmission and condoms than did women ages 21-24 who by comparison were less literate. Given poor knowledge of HIV transmission and condoms among illiterate and low-literate women in Amhara, targeted HIV-prevention interventions are needed in this region.