Predictors of intention to be sexually active among Tanzanian school children.

This paper presents the results from a study of human immunodeficiency virus/AIDS risk behaviour conducted among primary school children in the Kilimanjaro and Arusha regions of northern Tanzania. The study was guided by the theory of reasoned action, and the decision to have or abstain from sexual intercourse was studied. All sixth and seventh grade pupils at eighteen schools were invited to participate. A total of 2,026 pupils (mean age 14.0 years) participated (participation rate of 85%), representing a wide variety of ethnic, socio-economic and urban-rural groups. Sixty-three percent of the boys and 24% of the girls reported having had their sexual debut. Attitudes, subjective norms and self-efficacy were all predictors of intention to have sexual intercourse within the next three months, but prior behaviour emerged as the strongest predictor of intention. Primary schools appear to be an important arena for HIV/AIDS education in Tanzania and it is recommended that such education be directed toward young adolescents.

Hemoglobin concentration in pregnant women. Experience from Moshi, Tanzania.

BACKGROUND: Anemia in pregnancy is common in Tanzania. Previous information on distribution of hemoglobin concentration in total populations is scarce. METHODS: Standard measurement of hemoglobin concentration in consecutive first visit attenders at the antenatal care clinic in Moshi, 1991-1994, for a total of 1800, divided into three series of 600 each. RESULTS: Hemoglobin concentrations ranged from 41 to 146 g/l, mean 96.9 and s.d. 16.3. For international comparison, 74.5% were below 110 g/l and 7.0% below 70 g/l. The median was 97.0; other percentiles were 10th: 75.0, 90th: 116.0. The distribution did not change with mother's age, but in the years 1991 and 1994 there were more low hemoglobin values than in the intervening years. CONCLUSIONS: Low hemoglobin concentrations are prevalent among pregnant women in Moshi, Tanzania. Seven percent were found to have severe anemia, defined as a hemoglobin concentration below 70 g/l.

Condom awareness and use in the Arusha and Kilimanjaro regions, Tanzania: a population-based study.

A cross-sectional study of condom awareness, perceived availability, and use was conducted using a questionnaire in the Arusha and Kilimanjaro regions in northern Tanzania. The questionnaire was administered to a random sample (n = 1,081) of males and females (15-54 years of age) from four localities in the Arusha, Babati, Moshi, and Same districts. Of the 1,081 respondents, 69.9% knew what condoms are and, of these, 31.7% reported having ever used a condom, while 20.7% stated that they used condoms regularly. Furthermore, of the 756 respondents who knew what condoms are, 62.2% stated that condoms were available in their localities and, of these, 44.1% reported having used condoms regularly. The results suggested that, while the majority of the respondents knew about condoms and stated that condoms were available in their localities, reported regular condom use was low. Age, gender, marital status, occupation, and place of residence appeared to be significant determinants of condom awareness and use, while educational status was not. Although barmaids and professional drivers have been shown to practice high-risk sexual behavior, reported condom use among them was low.

PIP: A cross-sectional study of condom awareness, perceived availability, and use was conducted using a questionnaire in the Arusha and Kilimanjaro regions in northern Tanzania. The questionnaire was administered to a random sample (n = 1081) of males and females (15-54 years old) from 4 localities in the Arusha, Babati, Moshi, and Same districts. Of the 1081 respondents 507 were males and 574 females. Overall, 52.3% of the respondents were married and 34.0% were single. The mean age of the population was 29.3 years. 756 (69.9%) knew what condoms were; of these, only 343 (31.7%) reported having ever used a condom, and 224 (20.7%) stated that they used condoms regularly. Respondents in the 25-34 year age group had the highest level of condom awareness and use. Men were significantly more aware of condoms than women (81.9% vs. 59.4%, p 0.0001) and reported more regular condom use than women (27.6% vs. 14.6%, p 0.0001). Unmarried individuals had a significantly higher proportion of reported regular condom use (28.6% vs. 16.1%) compared with married individuals (p 0.001). Furthermore, of the 756 respondents who knew what condoms were, 470 (62.2%) stated that condoms were available in their localities and, of these, 44.1% reported having used condoms regularly. 196 (25.9%) said that they had condoms at home. Significantly more men (80.7%) than women (71.6%) knew where to get condoms (p 0.01). Awareness of condom availability was significantly associated with occupation (p 0.0001), but having condoms at home was significantly lower among farmers and housewives than among people in other occupations (p 0.0001). The results suggested that, while the majority of the respondents knew about condoms and stated that condoms were available in their localities, reported regular condom use was low. Age, gender, marital status, occupation, and place of residence appeared to be significant determinants of condom awareness and use, while educational status was not. Although barmaids and professional drivers have been shown to practice high-risk sexual behavior, reported condom use among them was low.

Scale reliability and construct validity: a pilot study among primary school children in Northern Tanzania.

Based on the World Health Organization's standardized survey inventories assessing AIDS-related knowledge, attitudes, beliefs, and practices (KABP) for adolescents, a written questionnaire was developed and pilot tested among primary school children in Northern Tanzania. Subjects included 472 fifth and sixth graders at four schools in Arusha and Kilimanjaro regions. Results indicated that the large majority of the students understood the questions and were able and willing to complete the survey. Non-response patterns did not seem to be related to the sensitivity of included questions. AIDS-related knowledge and attitudes toward engaging in sexual behavior had acceptable reliability and construct validity when compared with similar surveys in Western countries, while perceived social norms and self-efficacy need further development. KABP questionnaires may serve as a useful method in AIDS-related surveys and evaluation studies among school children in Tanzania if survey instruments are adapted to reflect the local social and cultural context.

AIDS education for primary school children in Tanzania: an evaluation study.

OBJECTIVE: To test the effects of an HIV/AIDS education program. DESIGN: A quasi-experimental, nested cross-sectional design including baseline and 6-month follow-up surveys. Schools, stratified according to location, were randomly assigned to intervention (n = 6) or comparison conditions (n = 12). SETTING: Public primary schools in Arusha and Kilimanjaro regions, Tanzania. PARTICIPANTS: A total of 2026 sixth and seventh grade pupils (average age, 14.0 years) participated at baseline (85%) and 1785 at follow-up. INTERVENTION: The program was designed to reduce children's risk of HIV infection and to improve their tolerance of and care for people with AIDS. Local teachers and health workers attended a 1-week training workshop before implementing the program over a 2-3-month period (averaging 20 school hours per class). MAIN OUTCOME MEASURES: Self-reported exposure to AIDS information, communication regarding AIDS; AIDS knowledge, attitudes towards people with AIDS, attitudes towards having sexual intercourse, subjective norms regarding sexual intercourse, and intention to engage in sexual intercourse. RESULTS: Following this program, intervention pupils reported significantly higher scores for the following outcome measures than pupils attending the comparison schools: AIDS information (13.1 versus 10.5; P = 0.0001), AIDS communication (10.9 versus 7.8; P = 0.0001) AIDS knowledge (14.5 versus 11.5; P = 0.0001), attitudes towards people with AIDS (9.0 versus 6.7; P = 0.0008), subjective norms (45.5 versus 43.9; P = 0.011), and intention (1.3 versus 1.4; P = 0.020). No program effect was seen for attitudes towards sexual intercourse (47.0 versus 46.3, P = 0.44). CONCLUSIONS: These results indicate that it is feasible and effective to provide AIDS education for Tanzanian primary school children.

PIP: In the adjacent regions of Arusha and Kilimanjaro in Tanzania, researchers conducted a quasi-experimental, nested cross-sectional design to evaluate the Ngao (shield) HIV/AIDS education program for public primary school children, a culturally specific program. The baseline survey and the 6-month follow-up survey included 2026 and 1785 6th-7th grade children, respectively. Teachers of the participating schools and health workers participated in a 1-week training workshop before they implemented the program over 2-3 months. Its intent was to reduce the pupils' risk of HIV infection and to improve their acceptance of and care for people with AIDS. At baseline, the pupils in intervention and comparison schools tended to be comparable. At follow-up, however, intervention pupils had been exposed to more AIDS information (scores, 13.1 vs. 10.5), had discussed AIDS more often (10.9 vs. 7.8), and had a higher increase in AIDS knowledge (14.5 vs. 11.5) than did the comparison pupils (p = .0001 for all the above). They also had significantly more positive attitudes towards people with AIDS than the comparison pupils (9 vs. 6.7; p = .0008). Pupils in the intervention had more restrictive subjective norms regarding sexual intercourse (45.5 vs. 43.8; p = .011) and less intention to engage in sexual intercourse over the next 3 months than at baseline. Yet, they were not significantly different from comparison pupils, because the comparison pupils also had a change in attitude. These findings show that teachers in primary schools and health educators can implement a workable and effective HIV/AIDS education program for school children.

Exposure to HIV/AIDS information, AIDS knowledge, perceived risk and attitudes toward people with AIDS among primary school-children in northern Tanzania.

An AIDS survey based on WHO's KABP survey instrument for adolescents was implemented with sixth and seventh grade students attending one of 18 randomly selected primary schools in the Arusha and Kilimanjaro regions of Northern Tanzania (n = 2,026). While students reported having been exposed to several sources of AIDS information, overall knowledge level was low, particularly with respect to risk associated with causal contact, and the fact that a person can be infected and show no signs of the disease. Students who reported frequent exposure to AIDS information or who frequently talked to others about AIDS, were more knowledgeable regarding AIDS than students who reported less frequent exposure to AIDS information or communication. Furthermore, students with high scores on AIDS knowledge were more likely to report AIDS as a very severe disease. Also, they perceived themselves as less susceptible to AIDS, and were more likely to have a positive attitude toward spending time with and taking care of people with AIDS than did less knowledgeable students. It is recommended that primary schools be utilized as an arena for AIDS education in Tanzania.