University students' knowledge of, and attitudes towards, hiv and AIDS, homosexuality and sexual risk behaviour: a questionnaire survey in two finnish universities

Summary This study describes Finnish university students' knowledge and attitudes towards HIV and AIDS, homosexuality and sexual risk behaviour. Finnish-speaking students were randomly selected from all registered students at two universities in Finland (N=9715, n=950). The data were collected by using a modified version of the State University of New York at Buffalo School of Nursing AIDS Study Questionnaire on sexual risk behaviour developed by Held and Chng. The total response rate was 35% (n=333). The data were analysed using quantitative statistical methods. Normally distributed data were analysed by t-test and one-way ANOVA, with Bonferroni corrections. Non-normally distributed data were analysed using the Mann-Whitney U-test and Kruskal-Wallis test, followed by a post-hoc test. The majority of students were familiar with HIV and AIDS, including its mode of transmission. However, there were still some misconceptions concerning HIV and AIDS. The oldest students and women had a more positive attitude towards people living with HIV and AIDS (PLWHA). Of patients with HIV or AIDS, intravenous drug users were perceived most negatively. Male students had more homophobic attitudes. Students who reported that religion had an important role in their lives had significantly stricter attitudes towards sexual risk behaviour. Students' knowledge correlated positively with general attitudes towards HIV and AIDS. Knowledge about HIV and AIDS will lead to more positive attitudes towards HIV and AIDS as a disease, towards those infected as well as homosexual people. There is a need to focus on preventive health care and sexual health promotion by educating young people and changing their attitudes towards sexual risk behaviour.     

HIV/AIDS knowledge, women's education, epidemic severity and protective sexual behaviour in low- and middle-income countries

A fundamental public health strategy to reduce the risk of HIV/AIDS is to increase levels of awareness and knowledge about the disease. Although knowledge about HIV/AIDS and protective sexual behaviour are linked theoretically, relatively little is known about their empirical relationship. Using Demographic and Health Survey data from 23 low- and middle-income countries, this study used multilevel logistic regression models: to examine cross-national variability in the relationship between HIV/AIDS knowledge and protective behaviour (condom use and restricted sex); to investigate the moderating influences of women's educational attainment on this relationship; and to test the extent to which severity of the HIV/AIDS epidemic accounts for cross-national variability in the association between HIV/AIDS knowledge and protective behaviour. There was an association between increased knowledge of HIV/AIDS and condom use that varied in strength and form cross-nationally. This cross-national variation was accounted for partially by the socioeconomic characteristics of women resident in the study countries and between-country differences in the severity of the HIV epidemic. While education modified the association between HIV/AIDS knowledge and protective behaviour--stronger associations at lower levels of education--epidemic severity exerted a stronger influence on behaviour than any other characteristic. Finally, this study indicates that protective sexual practices are disturbingly low. In eight of 23 countries, overall levels of condom use to prevent STDs and HIV/AIDS were less than 5.0%. Waiting for the spread of HIV/AIDS infection to change sexual practices in low- and middle-income countries will result in dramatic unnecessary suffering.     

Sexual behaviour of adolescents in Nigeria: cross sectional survey of secondary school students

ObjectivesTo determine whether family structure (polygamous or monogamous) is associated with sexual activity among school students in Nigeria.DesignCross sectional school survey with a two stage, clustered sampling design.Participants4218 students aged 12-21 years attending 39 schools in Plateau state, Nigeria. Responses from 2705 students were included in the analysis.ResultsOverall 909 students (34%) reported ever having had sexual intercourse, and 1119 (41%) reported a polygamous family structure. Sexual activity was more common among students from polygamous families (42% of students) than monogamous families (28%) (χ²=64.23; P<0.0001). Variables independently associated with sexual activity were male sex (adjusted odds ratio 2.52 (95% confidence interval 2.05 to 3.12)), older age (1.62 (1.24 to 2.14)), lower sense of connectedness with parents (1.87 (1.48 to 2.38)), having a dead parent (1.59 (1.27 to 2.00)), family polygamy (1.58 (1.29 to 1.92)), lower sense of connectedness with school (1.25 (1.09 to 1.44)), and lower educational level of parents (1.14 (1.05 to 1.24)). Multistep logistic regression analysis showed that the effect of polygamy on sexual activity was reduced by 27% by whether students were married and 22% by a history of forced sex.ConclusionsSecondary school students in Nigeria from a polygamous family structure are more likely to have engaged in sexual activity than students from a monogamous family structure. This effect is partly explained by a higher likelihood of marriage during adolescence and forced sex. Students'' sense of connectedness to their parents and school, regardless of family structure, decreases the likelihood of sexual activity, and fostering this sense may help reduce risky sexual behaviour among Nigerian youth.

What is already known on this topic

In 2000 Nigeria developed a national health policy aimed at preventing behaviour among adolescents leading to sexually transmitted infections (including HIV), pregnancy, and dropout from schoolEffective interventions in Nigeria have been hampered by inadequate information on contextual factors associated with sexual behaviour of adolescentsIn Western countries adolescents'' sense of connectedness to their parents and to school is inversely associated with risky sexual behaviour, but these effects may differ in countries where polygamy is prevalent and where school attendance is low

What this paper adds

A polygamous family structure is associated with early sexual activity among adolescents, an effect partly explained by a higher likelihood of marriage and history of forced sexual intercourseA greater sense of connectedness to parents and school decreases the likelihood of sexual activity, regardless of family structure     

Sexual behaviour of the genus Equisetum, subgenus Hippochaete

When grown for long periods in axenic single spore cultures, gametophytes of the four European species of subgenus Hippochaete are initially male or female. Females invariably produce antheridia as they get older, but archegonium formation by males is a much rarer event and was only observed in E. hyemale and E. scirpoides. Male gametophytes are smaller, grow more slowly than the females and in E. hyemale and E. variegatum are often short-lived. The proportions of male and bisexual individuals are relatively constant within each species but vary between species. Likewise species differ in the rate at which females later produce antheridia. Gametophytes grow in three ways: activity of antheridial meristems which are totally committed to the formation of male tissues, activity of cushion meristems which may produce archegonia for an indefinite period or switch to antheridium formation, and proliferation from lamellae. Either archegonia or antheridia may arise on the adventitious branches resulting from lamellar proliferation, but the type of sex organ produced is strongly influenced by the culture medium, the sex and age of the parent tissue and the particular species in question. Only by this means are archegonia formed on initially male individuals. The sexual behaviour of the subgenus Hippochaete is compared in some detail with that of the subgenus Equisetum and several subgeneric characteristics are outlined.     

Sexual behaviour of the genus Equisetum, subgenus Equisetum

Gametophytes of five species of Equisetum that were studied in axenic single spore cultures are initially male or female, and the first antheridia appear on the males before the first arche-gonia on the females. The males never produce archegonia, but the females all produce antheridia later in progressively increasing numbers. The proportions of male and bisexual gametophytes are relatively constant within each species but vary greatly between species. Likewise between species there is great variation in the rate at which females later produce antheridia. Male gametophytes are smaller and grow more slowly than females, but individuals of both sexes live for the same length of time. After prolonged culture, growth rates fall to very low levels and there is necrosis of the older parts of the gametophytes; but sex organs are still produced. Initially female gametophytes have much sexually uncommitted tissue, whereas males are composed almost entirely of antheridial branches. The absence of archegonium formation on males may well be related to this lack of sexually undifferentiated tissue and the fact that the growth of the males is intimately connected with antheridium production.     

Sexual risk behaviour among the youth in the era of HIV/AIDS in South Africa

The paper discusses factors associated with sexual risk behaviour, i.e. failure to use condoms consistently during sexual intercourse, among unmarried sexually experienced youths in South Africa. Data from the 'Transitions to Adulthood in the Context of AIDS in South Africa' surveys of 1999 and 2001 were analysed to identify factors associated with high sexual risk behaviour among the youth. The multinomial regression models for male and female youths were fitted separately for the 1999 and 2001 data sets. The results show increasingly consistent use of condoms during sexual intercourse and that high sexual risk behaviour among youths is predominantly determined by social factors such as 'ever-pregnant' or 'ever made pregnant', 'ever given something for sex', age of sexual partner, currently in school, pressured by friends to have sex, peer influence on safe sex and education level for males. There is evidence that availability of contraception information is important in strategic interventions that seek to change the sexual behaviour of the youth in South Africa.     

On knowledge, policy, practice, and fate.

Knowledge of the nation's health and nutritional status is dated, uncertain, incomplete, and complex, whereas politicans demand simplicity and administrators, practicability, and everyone wants more and better information. Rational policy, the unicorn intellectuals hunt, should combine clarity, realism, and conviction, which calls for a touch of passion. Attempts to reconcile these contradictory elements can lead to dangerous political pressures on research; the simplification, exaggeration, and over-generalization of findings; and excessive expectations for humdrum programs that often bear little resemblance to their glorified goals. Inadequate knowledge can justify both action and inaction, which are merely different lays of meeting our fate. The ultimate goal of health and nutrition policy, it may be said, is a long and healthy life and a quick and happy death. That may be desirable, but is it attainable.     

Sexual behaviour of group-living adolescent chimpanzees

This paper reports a study of the heterosexual behavior of three male and four female captive adolescent chimpanzees living a semi-natural life style in a large field enclosure. Observations made with binoculars from an over-head deck were balanced over the daylight hours and the seven weekdays. We recorded 213 copulations in 741.25 hours of observation between February 14 and July 21, 1972. Analysis of the observations suggests that group-living chimpanzees in a large field enclosure behave more like free-living chimpanzees than like other captive chimpanzees paired in small cages. In this group, copulations were non-randomly distributed throughout the day, a finding in agreement with results on wild-living chimpanzees but not previously reported for captive chimpanzees. In this group, moreover, copulations were highly concentrated within each female's period of maximum tumescence, as are those of free-living chimpanzees; and individual differences in sexual attractiveness among females were apparently based on a maturational threshold of swelling size, a phenomenon that has also been reported for wild chimpanzees.     

Sexual Behaviour and AIDS in the Developing World

Sexual Behaviour and AIDS in the Developing World. John Cleland and Benoìat Ferry. eds. Geneva: World Health Organization, 1994. 228 pp.     

Equipoise, knowledge and ethics in clinical research and practice

It is widely maintained that a clinical trial is ethical only if some form of equipoise between the treatments being compared obtains. To be in equipoise between two treatments A and B is to be cognitively indifferent between the statement 'A is strictly more effective than B' and its negation. It is natural to claim that equipoise regarding A and B is necessary for randomised assignment to treatments A and B to be beneficent and non-maleficent and is sufficient for such an assignment to be fair. Cashing this out precisely is difficult, and various forms of equipoise have been discussed which consider whose equipoise is relevant to the decision. This is to make judgement of equipoise something to be managed socially, while its prima facie significance is supposedly cognitive. Recent reconstructions of equipoise-like concepts in epistemology give clues about how to understand equipoise cognitively. In this paper I examine some of this work and discuss how successful it has been. I suggest that while this work is promising, it still has far to go, and that while equipoise remains the best theory we have of the cognitive justification for clinical trials, it is nonetheless incoherent.