AIDS/HIV knowledge level and perceived chance of having HIV among rural adolescents

Behaviors that increase the risk of acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) among adolescents living in rural areas have been reported to be as frequent as those of lower socioeconomic minority youth living in large urban areas. Little is known, however, about whether rural adolescents possess adequate knowledge upon which to make responsible decisions to avoid exposure to HIV. In order to address this deficit, we administered the Centers for Disease Control (CDC) 1989 Secondary School Health Risk Survey to 294 sixth, seventh, and eighth grade students (30.2% sample) from a rural county with significant social problems including epidemic sexually transmitted diseases STDs, sex-for-drugs, poverty, and drug abuse. The sample was 65% African-American, 50% female, with a mean age of 12.9 ± 1.3 years. Although 68% reported having received school-based AIDS education, a lower proportion (≥10%) the students were found to correctly answer 8 of 17 AIDS/HIV knowledge questions than those from a national comparison group. The mean was 12.8 ± 3.1 of 17 items answered correct. Lower AIDS/ HIV knowledge was associated with lower school grade (rho = 0.46 p ≤ 0.0001); being African-American, Hispanic, or Native American (p ≤ 0.043); and never receiving school-based AIDS/HIV education (p ≤ 0.0001). Based on multivariate analysis of variance (ANOVA), only school-based AIDS/HIV education was a significant predictor (p ≤ 0.0001) of knowledge. Self-reported behavior change to avoid HIV exposure was associated with previous AIDS education (p ≤ 0.025), and older age (rho = -0.14, p ≤ 0.016). When these variables were analyzed w ith multiple regression, only AIDS/HIV education was found to be a significant predictor (R² = 0.022) of behavior change. Based on regression analysis, AIDS/HIV knowledge level and school grade explained 5.3% (p ≤ 0.004) of the variation in the degree of worry of exposure to HIV. In turn, school grade, degree of worry of HIV exposure, and AIDS/HIV knowledge level explained 10% of the variation in the adolescents' perceived chance of having the HIV infection. These findings indicate that many of these younger rural adolescents lacked adequate knowledge to make responsible decisions about AIDS/HIV risk behavior and possessed beliefs about HIV exposure that may increase their risk.