HIV/AIDS Behavioral Surveillance Survey (BSS)

Authors/investigators:
Dr Getnet Mitike, Department of Community Health, AAU
Dr Wuleta Lemma, Family Health International, Regional Senior Technical Officer
Dr Frehiwot Berhane, BSS Project - Department of Community Health, AAU
Dr Reta Ayele, Ministry of National Defense
Ato Tamrat Assefa, Jimma University
Dr Tewodros G/Michael, Private Consultant
Ato Fikre Enqusellase, Department of Community Health, AAU
Dr Atalay Alem, Department of Psychiatry, AAU
Dr Yigeremu Abebe, Ministry of National Defense
Professor Dereje Kebede, Department of Community Health, AAU

Table of Contents

Acknowledgements

Definitions of terminology

Operational definitions

Executive Summary

Introduction and methods

Summary of findings

Female sex workers (FSWs)

Between group comparisons

Recommendations

1. Introduction

1.1. Background

1.2. Overview of HIV/AIDS in Ethiopia

1.3 Introduction to behavioral surveillance survey (BSS)

1.4 Objectives of BSS in Ethiopia

2.1 Quantitative survey

2.1.1 Target groups

2.1.2 Sample design

2.1.3 Sample size and sampling procedure for target groups

2.1.4 Data collection and analysis

2.2 Qualitative study

2.2.1 Purpose and objectives

2.2.2 Methods and target groups

2.2.3 Questions

2.2.4 Tools and procedures for data collection

2.2.5 Analysis and write up

2.2.6 Presentation of results

2.3 Ethical considerations

3. Quantitative Results

3.1.1 Socio-demographic characteristics

3.1.2 STI/HIV/AIDS related knowledge

3.1.3 Alcohol and drug use

3.1.4 Sexual behavior

3.1.5 STI and treatment seeking behavior

3.1.6 HIV testing

3.1.7 Exposure to interventions

3.1.8 Relationship between knowledge, behavior, VCT and perception of risk

3.2 Female sex workers

3.2.1 Socio-demographic characteristics

3.2.2 STI/HIV/AIDS and related knowledge

3.2.3 Alcohol and drug use

3.2.4 Sexual behavior

3.2.5 STIs and treatment seeking behavior

3.2.6 HIV testing

3.2.7 Exposure to interventions

3.2.8 Relationships of knowledge, behavior and perception of risk

3.3 Uniformed services, transport workers, the rural population and factory workers

3.3.1 Uniformed services (ground forces and the air force)

3.3.2 Transport workers

3.3.3 Rural population groups (farmers and pastoralists)

3.3.4. Factory workers

3.3.5 Comparisons between the adult groups

4. Qualitative Results

4.1 In- and out–of-school youth in three regional cities (Dire Dawa, Bahir Dar and Jijiga)

4.1.1 Knowledge about modes of transmission and prevention methods for HIV/AIDS

4.1.2 Relationship between HIV infection and other STIs

4.1.3 Misconceptions about HIV/AIDS, its transmission, and condoms and their effects

4.1.4 Stigma and attitudes towards PLWHA

4.1.5 Voluntary counseling and testing (VCT)

4.1.6 Influence of knowledge, education and religion on behavior

4.1.7 Contribution of information sources to increased knowledge and behavioral change

4.1.8 Perception and behavior/practice

4.1.9 HIV risk groups and circumstances/factors contributing to the practice of unprotected sex

4.1.10 Perceived risk behaviors and behavioral change

4.1.11 Participation in anti-AIDS clubs

4.1.12 Suggestions to avert the spread of HIV/AIDS

4.2 Akaki Textile Factory workers

4.2.1 Knowledge about modes of transmission and prevention methods for HIV/AIDS

4.2.2 Relationship between HIV infection and other STIs

4.2.3 Misconceptions about HIV/AIDS, HIV transmission and condom use

4.2.4 Stigma and attitudes towards PLWHA

4.2.5 Voluntary testing and counseling

4.2.6 Influence of knowledge, educational status and religion on behavior

4.2.7 Contribution of information sources to increased knowledge and behavioral change

4.2.8 Perception and behavior/practice

4.2.9 HIV risk groups and circumstances/factors contributing to the practice of unprotected sex

4.2.10 Perceived risk behaviors and behavioral change

4.2.11 Suggestions to avert the spread of HIV/AIDS

4.3.1 Knowledge about modes of transmission and prevention methods for HIV/AIDS

4.3.2 Relationship between HIV and other STIs

4.3.3 Misconceptions about HIV/AIDS, HIV transmission and condom use

4.3.4 Stigma and attitudes towards PLWHA

4.3.5 Voluntary counseling and testing

4.3.6 Influence of knowledge, educational status and religion on behavior

4.3.7 Contribution of information sources to increased knowledge and behavioral change

4.3.8 Perception and behavior/practice

4.3.9 HIV risk groups and circumstances/factors contributing to the practice of unprotected sex

4.3.10 Perceived risk behaviors and behavioral change

4.3.11 Participation in anti-AIDS clubs

4.3.12 Suggestions to avert the spread of HIV/AIDS

4.4 Intercity bus drivers and minibus drivers

4.4.1 Knowledge about modes of transmission and prevention methods for HIV/AIDS

4.4.2 Misconceptions about HIV/AIDS, HIV transmission and condom use

4.4.3 Stigma and attitudes towards PLWHA

4.4.4 Voluntary counseling and testing

4.4.5 Influence of knowledge, educational status and religion on behavior

4.4.6 Contribution of information sources to increased knowledge and behavioral change

4.4.7 Perception and behavior/practice

4.4.8 HIV risk groups and circumstances/factors contributing to the practice of unprotected sex

4.4.9 Perceived risk behaviors and behavioral change

4.4.10 Participation in anti-AIDS clubs

4.4.11 Suggestions to avert the spread of HIV/AIDS

4.5 Pastoralists

4.5.1 Knowledge about modes of transmission and prevention methods for HIV/AIDS

4.5.2 Relationship between HIV and other STIs

4.5.3 Misconceptions about HIV/AIDS, HIV transmission and condom use

4.5.4 Influence of knowledge, educational status and religion on behavior

4.5.5 Contribution of information to increased knowledge and behavioral change

4.5.6 HIV risk groups and circumstances/factors contributing to the practice of unprotected sex

4.5.7 Voluntary counseling and testing

4.5.8 Perception and behavior/practice

4.6.1 Knowledge about modes of transmission and prevention methods for HIV/AIDS

4.6.2 Relationship between HIV and other STIs

4.6.3 Misconceptions about HIV/AIDS, HIV transmission and condom use

4.6.4 Stigma and attitudes towards PLWHA

4.6.5 Voluntary counseling and testing

4.6.6 Influence of knowledge, educational status and religion on behavior

4.6.7 Contribution of information to increased knowledge and behavioral change

4.6.8 Perception and behavior/practice

4.6.9 HIV risk groups and circumstances/factors contributing to the practice of unprotected sex

4.6.10 Factors and circumstances contributing to unprotected sex

4.6.11 Perceived risk behavior and behavioral change

4.6.12 Suggestions to avert the spread of HIV/AIDS

4.7 Female sex workers (bar-based, home-based and street-based)

4.7.1 Knowledge about modes of transmission and prevention methods for HIV/AIDS

4.7.2 Relationship between HIV and other STIs

4.7.3 Misconceptions about HIV/AIDS, HIV transmission and condom use

4.7.4 Stigma and attitudes towards PLWHA

4.7.5 Voluntary counseling and testing

4.7.6 Influence of knowledge, educational status and religion on behavior

4.7.7 Contribution of information to increased knowledge and behavioral change

4.7.8 Perception and behavior/practice

4.7.9 HIV risk groups and circumstances/factors contributing to the practice of unprotected sex

4.7.10 Perceived risk behaviors and behavioral change

4.7.11 Participation in anti-AIDS clubs

4.7.12 Suggestions to avert the spread of HIV/AIDS

5.1 Knowledge about HIV/AIDS

5.1.1 Awareness

5.1.2 Preventive methods

5.1.3 Misconceptions about HIV/AIDS

5.1.4 Comprehensive knowledge

5.1.5 Stigma and discrimination

5.2 General risk and sexual behavior

5.2.1 Drug and alcohol use

5.2.2 Premarital sex

5.2.3 Non-commercial sex partners and numbers of sexual partners

5.2.4 Commercial sex partners and non-regular sex partners

5.2.5 Condom use and unprotected sex

5.2.6 History of STIs and treatment seeking behavior

5.3 HIV testing and exposure to interventions

5.3.1 HIV testing

5.3.2 Media interventions

5.4 Relationships between knowledge, sexual behavior and perception of risk

5.5 Limitations to the study

6. Conclusions and recommendations

6.1 Conclusions

6.2 Recommendations

6.2.1 Policy and advocacy level

6.2.2 Information, education and communication/behavioral change communication (IEC/BCC)

6.2.3 Program level

Additional resources

Annex 1. Sample sizes for study populations (respondents) and sites.

Annex 2A BSS indicators for ISY.

Annex 2B. BSS knowledge indicators and components for ISY.

Annex 2C. BSS indicators for younger OSY.

Annex 2D. BSS knowledge indicators and components for younger OSY.

Annex 2E. BSS indicators for older OSY.

Annex 2F. BSS knowledge indicators and components for older OSY.

Annex 3A. BSS indicators for FSWs.

Annex 3B. BSS knowledge indicators and components for FSWs.

Annex 4A. BSS indicators for uniformed services, transporter workers, factory workers and rural populations.

Annex 4B. BSS knowledge indicators and components for uniformed services, transport workers, factory workers and rural populations.

Annex 5A. Characteristics of the focus group discussants – youth in three regional cities, August 2002.

Annex 5B. Characteristics of the individual in-depth interviewees – youth in three regional cities, August 2002.

Annex 5C. Characteristics of the focus group discussants – adult population groups and female sex workers (FSWs), August 2002.

Annex 5D. Characteristics of the individual in-depth interviewees – adult population groups and female sex workers (FSWs), August 2002.

Annex 6. Definitions of indicators used in Ethiopian BSS.

List of contributors to the BSS round-I