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APRIL 2002 UNICEF

ADOLESCENTS’ KNOWLEDGE, ATTITUDE AND PRACTICE CONCERNING HIV/AIDS IN SIERRA LEONE

Survey Report

APRIL 2002

GoSL

Adolescents’ Knowledge, Attitude and Practice concerning HIV/AIDS in Sierra Leone

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ADOLESCENTS’ KNOWLEDGE, ATTITUDE AND PRACTICE

CONCERNING HIV/AIDS IN SIERRA LEONE

Survey Report

(Conducted by Central Statistics Office with financial support from UNICEF, Sierra Leone)

GoSL APRIL 2002


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Acknowledgements

pecial thanks the Ministry of Development and Economic Planning and to all survey respondents and enumerators for their cooperation through out this survey exercise; to the staff of the Central Statistics Office who provided leadership and managed all

aspects of the survey, serving as Directors, Coordinators and Supervisors ;the data entry and editing personnel and secretarial staff; the technical support provided by Dr. Joseph Kamara of the Department of Mathematics, Fourah Bay College. The technical assistance was provided by UNICEF Sierra Leone through the following officers Mr. Keith Wright, SPC, Mr. Paul Sengeh, M&E Officer, Mr. Aiah Mbayo Education Officer, UNICEF Sierra Leone and Dr. James Pilot. Special thanks go to all the community leaders and guides in the surveyed areas without whose cooperation and understanding this coverage survey would not have been completed The 2001 Adolescents HIV/AIDS KAP Survey was funded entirely by UNICEF Sierra Leone

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TABLE OF CONTENTS PAGE

EXECUTIVE SUMMARY iii 1.0 INTRODUCTION 1

1.1 HIV/AIDS 1 1.2 Impact of HIV/AIDS pandemic 1 1.3 HIV/AIDS and Adolescents 2 1.4 Plans to arrest spread of HIV/AIDS 2 1.5 Status of HIV-AIDS in Sierra Leone 3

2.0 OBJECTIVES OF THE KAP SURVEY 4

2.1 Background 4 2.2 General Objective 4 2.3 Specific Objectives 4

3.0 METHODOLOGY 5

3.1 Study Areas 5 3.2 Study Population 5 3.3 Sampling Methodology 5 3.4 Training of Interviewers and Supervisors 7 3.5 Data Collection 7 3.6 Distribution of Adolescents in Sampling Frame and completed interviews 8 3.7 Data Processing 8

4.0 RESULTS 10

4.1 Background Characteristics 10 4.2 Sexual History: Numbers and Types of Partners 14 4.3 STIs and STDs 16 4.4 Knowledge of HIV/AIDS 18 4.5 HIV/AIDS Testing 22 4.6 HIV/AIDS Attitude and Practices 22 4.7 Access to communication preference of communication channels 26 4.8 Acceptance and Credibility 27

ANNEXES

Technical Team Questionnaire Tables


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Executive summary

Objectives

he key objective of the survey was to ascertain adolescents HIV/AIDS knowledge, attitude and practice, determine their access to the media in so far as getting vital information on HIV/AIDS, and ascertain their acceptance and credibility of the information they receive. The

responses were to be analyzed by differentials of age, sex and spatial variations. The survey results will be presented to decision-makers for strategies and interventions that will help to significantly reduce the spread of HIV/AIDS in Sierra Leone The Survey Methodology The 2001 Adolescents’ HIV/AIDS Knowledge, Attitude and Practices (KAP) Survey used a sample size of 3019 adolescents aged 12-21 years in both rural and urban areas from four administrative districts of the country; the Western Area in the West, Port Loko district in the Northern region, Bo district in the Southern region and Kenema district in the Eastern region. Data was also collected from adolescents in four Internally Displaced Persons (IDPs) camps one from each region and a category of people with no fixed abode, the floating population. The four regions chosen provide general contrasts in socioeconomic and cultural environment required for a comprehensive analysis of adolescents’ HIV/AIDS knowledge, attitude and practice. In this light, different numbers of clusters were chosen from both the rural and urban areas of these regions based on their adolescents population as reflected in the 1985 population census figures. For the Western area, 40 urban and 5 rural clusters were chosen; for Port Loko district, 5 urban and 22 rural clusters were chosen; for Bo district, 7 urban and 14 rural clusters were chosen and for Kenema district, 10 urban and 17 rural clusters were chosen. A total of 120 clusters were covered from the four regions. Twenty adolescents were interviewed from each cluster. Since the country has gone through a ten-year rebel war, a good number of the population may be residing in IDP camps and some others in makeshift abodes or floating on the streets in the capital and provincial head quarter towns. With this in mind, 100 IDP and 50 floating adolescents were targeted in each of the four regions

Data collection using an internationally tested structured questionnaire was undertaken between 19th November and 2nd December 2001.

Survey Results

The summary result shows that more than 55% of the respondents were 16 years and above. School attendance is high as 62% of the respondents had attended school, but literacy level in the rural areas is low estimated at 22.3%. Less than 36% of the respondents earn income, with Bo district recording the highest percentage. A very high percentage of the respondents lived with family or relatives. The level of drugs use among adolescents is quite low. Over 86% do not drink alcohol; less than 7% have tried marijuana; and less than 2% have ‘shot’ drugs. In general the floating population are more vulnerable with higher rates of having had sex (80%); higher prevalence of STIs (three times more that the urban adolescents); 35.6% use drugs or consume alcohol every day. The adolescents in IDP populations display a similar pattern to that of their rural counterparts for the majority of indicators. About 58% of the adolescents have had sex with 44.8% having had their sexual debut by the age of 18 years and 1.8% having had their sexual debut by the age of 13 years. There is little difference between female (58.9%) and male (56.4%) respondents who had had sex. Significantly only 4 % used a

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condom during their first sexual intercourse. Generally females had older partners than did males but normally within 4 years of their age at sexual debut. The survey results show that the HIV/AIDS is not considered a real risk and thus there is unwillingness to change behaviour and a high level of stigmatism and discrimination towards people living with HIV.AIDS. By contrast the respondents showed a certain degree of pragmatism. The majority of the adolescents believe that people should know their HIV/AIDS status, although only 2% had actually had an HIV/AIDS test. However nearly two-thirds are willing to do the test. Overall knowledge and understanding of HIV, AIDS and related issues is very low throughout the country, with significant differences between urban and rural areas, but no substantial differences between the sexes. Although 72.3% of the adolescents had heard of the term HIV or AIDS, only 7.7% could show that they had an adequate understanding. There are similar low levels of knowledge concerning other STIs. Only 56.8% could state an STI with Gonorrhoea (34.5%), Syphilis (11.1%) and HIV/AIDS (3.9%) the most commonly stated types, albeit by few of the respondents. There is a considerable range in levels of knowledge across the country e.g., 90% of adolescents had heard of the terms HIV or AIDS in Western Area as compared to 58.4% in Port Loko; 14.7% of adolescents in Western Area know the difference between HIV and AIDS and only 1.6% in Port Loko. Misconceptions are common. 55.1% do not know that healthy people can carry the HIV and an equally high number did not know that everyone is vulnerable to HIV infection. Negative attitudes towards people living with HIV/AIDS are widespread, (60.2%). For example, 67.6% of the respondents stated that a teacher or workers should not be allowed to work; 67.7% stated that a student should not continue at school; 81% stated that they would not buy food from a trader who is HIV positive or a PLWA; 78% would not share a meal with a person who is HIV positive or a PLWA. The main source from which they first heard about HIV/AIDS is the mass media (45%) and only 10% heard about if from their peers. Less than 10% of the respondents have contracted an STI/STD, and only 49% would go to a hospital/ health centre/clinic for treatment. If they were to contract an STI only 34% of the rural adolescents would do the same, compared with 61% in the urban areas. Overall, there is limited knowledge of condoms and their advantages and there is little access. In general, there is a negative attitude to condoms. An alarming 37.3% had not heard of a condom. Only 4% used a condom on their first sexual intercourse and currently 13.5% use a condom. Knowledge of the use of a condom as a contraceptive was higher than that to prevent HIV infection. A mere 10.5% of adolescents knows that a condom is an important means to prevent HIV infection and 27% would use a condom to prevent an unwanted pregnancy. Access is limited, especially in the rural areas. Three-quarters of adolescents do not know where to obtain condoms in their locality. On the whole there is an unwillingness to change sexual practices to avoid HIV infection or an unwanted pregnancy. Less than 50% of adolescents would abstain from sex in order not to contract HIV/AIDS, ranging from 61% in the Western area to 31% in Kenema district would ‘stick to one partner’ in order to prevent HIV/AIDS. Also above 45% of the urban and floating adolescents would not stick to one partner as compared with only 34% in the rural areas. Only one-third knows how to prevent an unwanted pregnancy. 27% of the respondents knew the use of condoms; 21% knew family planning pills, and 14% knew sexual abstinence as methods for preventing unwanted pregnancies. More females use contraception than their male counterparts. Regarding communication channels, adolescents have greater access to the radio than for any other source including television, video/cinema and newspapers. The radio is the most preferred source of information on HIV/AIDS. Nearly all the respondents in all survey areas listen to church/mosque and more than 95% accept messages from sermons.


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1.1 HIV AIDS

ore than two decades after its identification, acquired immune deficiency syndrome (AIDS) has become far more widespread and devastating than initially predicted. It affects men, women and children in all parts of the World. According to the Joint United Nations

Programme on HIV/AIDS (UNAIDS), approximately 22 million people have died from the disease, 36 million people live either have the virus (HIV) or the disease (AIDS). In the year 2000 alone, it was predicted that 5.3 million people including 600, 000 children were newly infected with HIV and over 90% of this statistics was from developing countries among which are those south of the Sahara. Since the late 1990s, the epidemic increased rapidly in the Southern African countries with record high prevalence of 20% in Namibia and Zambia and South Africa, 24% in Lesotho, 25% in Swaziland and Zimbabwe, almost 36% in Botswana, 16% in Malawi, and about 13% in Mozambique (UNAIDS 2001; Ntozi, 2001). In East Africa - Djibouti, Ethiopia and Kenya; for example - prevalence rates are still in double digits. In West Africa, at least five countries - Burkina Faso, Cameroon, Côte d’Ivoire, Nigeria and Togo - are experiencing serious epidemics with adult HIV prevalence exceeding 5% (UNAIDS – 2001) Uganda has showed that the spread of HIV/AIDS can be reversed. Through an extraordinary effort of national mobilisation reduced the adult HIV prevalence rate from around 14% in the early 1990s to 8% in 2000. HIV prevalence in pregnant women in urban areas have fallen for eight years in a row, from a high of 29.5% in 1992 to 11.5% in 2000 (UNAIDS - 2001). 1.2 IMPACT OF THE PANDEMIC 1.2.1 Impact on Growth, Income and Poverty

The AIDS epidemic has had a profound impact on growth, income and poverty. It is estimated that the annual per capita growth in Sub-Saharan countries with the HIV prevalence rate of more than 20% in falling by 0.5 – 1.2% as a direct result of AIDS. People at all income levels are vulnerable to the economic impact of HIV, but the poor suffer most acutely. AIDS pushes people deeper and deeper into poverty as households lose their breadwinners to AIDS, livelihoods are compromised, and savings are consumed by the cost of health care and funerals. In the most affected countries, estimates indicate that the number of people living in poverty has already increased by 5% as a result of the epidemic (UNGASS - 2001). 1.2.2 Impact on Fertility Because the main mode of transmission of HIV in Sub-Saharan Africa is through sexual intercourse, women and girls who form about 55% of the population are more vulnerable to HIV/AIDS. (Ntozi, 2001). The impact of HIV/AIDS on fertility could be serious since the disease is prevalent within the reproductive age group of women; HIV infected women experience reduced pregnancy rate and rising levels of induced and spontaneous abortion. HIV/AIDS induces sterility, increases foetal mortality and decreases frequency of sexual intercourse and production of spermatozoa. Examples of data from Tanzania, Uganda and Zambia indicate that fertility has declined in populations hard hit by HIV/AIDS epidemic (Ntozi - 2001). In rural areas, as in cities, the epidemic further adds to the already formidable burdens women bear - as workers, caregivers, educators and mothers (UNGASS, 2001).

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Introduction 1.0


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The UNAIDS estimates that across the globe, 34.3 million people have AIDS, of these 24.5 million are in Africa. Also, out of the 19 million AIDS deaths in Africa, some 3.8 million are children under age 15. Over the years the infection rates have been alarming. In 1990 there were 5.4 million new infections world-wide with 4.5 million in Africa; 2.8 million deaths due to AIDS, 85% which are in Africa; 13.2 million children orphaned by AIDS, with 12.1 million in Sub- Sahara Africa. The estimated net effects of this pandemic will be a reduction in life expectancy in Sub-Saharan Africa from 59 years to 45 years between 2005 and 2010. 1.3 HIV/AIDS and Adolescents1 Physical, psychological, and social attributes of adolescence make young people particularly vulnerable to HIV and other sexually transmitted infections (STIs). Adolescents often are not able to comprehend fully the extent of their exposure to risk. Societies often compound young people’s risk by making it difficult for them to learn about HIV/AIDS and reproductive health. Moreover, many youth are socially inexperienced and dependent on others. Peers pressures easily influence them – often in ways that can increase their risk. Recent declines in incidence of HIV/AIDS in a few countries, accompanied by signs that young people are changing their risk-taking behavior, give hope. AIDS today is widely seen as a social crisis as well as a problem of individual behavior. The AIDS epidemic is complex, and thus only a combination of approaches can succeed. It is increasingly clear, however, that youth must be at the center of strategies to control HIV/AIDS. Young people need help to become aware of risks of HIV/AIDS and how to avoid them. Education and communication programmes must go beyond merely offering information to fostering risk-avoidance skills as well, such a delay of sexual debut, abstinence, and negotiation with sex partners. HIV/AIDS education should begin early, even before children become sexually active. While not recognized at the onset, the HIV/AIDS epidemic is now clearly worst among youth. Over a period of 20 years, more than 60 million people have been infected with HIV; half of them became infected between the ages of 15 and 24 (153,432). An estimated 11.8 million people between the ages of 15 and 24 are living with HIV/AIDS (432). In some African countries more than one young woman in every five is living with HIV/AIDS. 1.4 Plans To Arrest Spread Of HIV/AIDS In most heavily affected countries, efforts are being made to prevent the spread of the disease (UNAIDS – 2001). But despite such efforts, huge challenges remain. Millions of young African women remain dangerously ignorant about HIV/AIDS. According to UNICEF, more than 70% of adolescent girls (aged 15 – 19) in Somalia and more than 40% in Guinea Bissau and Sierra Leone, have never heard of AIDS. In countries such as Kenya and Tanzania, more than 40% of adolescent girls harbour serious misconceptions about how the virus in transmitted (UNAIDS – 2001).

The vast majority of Africans living with HIV do not know they have acquired the virus. One study has found that 50% of adult Tanzanian women know where they could be tested for HIV, yet only 6% have been tested. In Zimbabwe, only 11% of adult women have been tested for the virus. Moreover, many people who agree to be tested prefer not to return and discover the outcome of those tests. A study in Abidjan, Côte d’Ivoire, shows that 80% of pregnant women who agree to undergo a HIV test return to collect their results. But of those who discover they are living with the virus, less than 50% return to receive drug treatment for the prevention of mother-to-child transmission of the virus (UNAIDS – 2001).

1 Population Reports, Volume XXIX,, Number3, Fall 2001


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1.5 Status of HIV/AIDS in Sierra Leone Sierra Leone ranks last among the 174 countries surveyed globally in the 2000 United Nations Human Development Index with a per capita GDP of about US$ 136, a life expectancy of 38 years and an adult literacy rate of 30 percent. The most recent household survey (in 1989/90) showed that about 82 percent of the population lived below the poverty line, and about 49 percent lived in severe poverty. The effects of the rebel war have significantly reduced the standard of living, which has led to a massive brain drain that has already severely depleted the human resources base of the country. Available statistics on HIV/AIDS portray a bleak future for all developing countries including Sierra Leone. The identified factors contributing to the spread of HIV/AIDS including poverty, ignorance (about reproductive health and sexuality), literacy, prohibitive cost of AIDS drugs, an aversion to discussing sex in some communities, and to some extent unsafe sexual practices are all prevalent in Sierra Leone. Much more worrying is the consequence of the ten years war among which sexual violence and drug abuse were common occurrences in both rebels occupied and government controlled areas. In 1998 about 317 AIDS cases were reported. Knowledge levels are low and access to appropriate information and services are severely limited. The MICS-2 Survey (2000) showed that about 54% of women aged 15-49 at national level have never heard of HIV/AIDS. Twenty one percent of women aged 15-49 know of all three of the main ways to prevent HIV transmission. Nineteen percent of the women correctly identified three misconceptions about HIV transmission, 19 percent of women of reproductive age in Sierra Leone know a place to be tested for HIV and only 2 percent have ever been tested. The preliminary results of the HIV Sero-prevalence survey (April 2002) show a national HIV prevalence rate of 4.9% with a range from 4.0% in areas outside Freetown to 6.1% in Freetown


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2.1 Background/Problem Statement

n spite of the interventions by government and other non-governmental organizations (NGOs) the pandemic marches forward. As a result of AIDS, people are dying in the years when they are supposed to be most productive.

For any successful intervention to curb the debilitating effects of this scourge, the necessary information must be at hand. Such information should depict the general knowledge, attitude and practice of high-risk members of the entire population like adolescents who have been noted to be sexually hyperactive. To a large extent, previous programmes have not been that successful because of the paucity of accurate and reliable national statistics in terms of coverage and content. Information on adolescents’ level of awareness and perspectives on HIV/AIDS will immensely reduce the alarming prevailing rates, as the adolescents are both principal agents and beneficiaries of such development programmes. It is against this background that the survey was undertaken.

2.2 General Objective

The broad objective of this survey was to ascertain Adolescents (aged 12 – 21 years) Knowledge, Attitude and Practices on HIV/AIDS in the Western Area and three other districts in the country.

2.3 Specific Objectives

� Target between 2,500 and 3,000 adolescents (aged 12-21 years) so as to determine their

knowledge, attitude, and practices regarding HIV/AIDS. � Determine the adolescents’ access to communication channels in so far as getting vital

information on the transmission of HIV/AIDS is concerned. � Administer a structured questionnaire to the targeted groups drawn from

rural /urban settlements, both in-school and out of school. � Analyse responses by such differentials as sex, age and region (spatial) variations.

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Objectives of the KAP Survey 2.0

Objectives of the KAP Survey

2.0


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3.1 Study Areas The data which form the basis for this study was obtained from single round samples of about 3,000 adolescents aged 12 – 21 years, in both rural and urban populations of four (4) regions of Sierra Leone: the Western region in the West, Port Loko district in the Northern Region, Bo district in the Southern Region and Kenema district in the Eastern Region. The four regions are in different administrative areas and provide the general contrasts in socio-economic and cultural environments Although the physical geography of the four regions is broadly similar, there are noticeable differences in their local economies. In the urban parts of the Western Area, the main economic activities are Government jobs, and trading. In the rural areas, the main economic activities are predominantly fishing with some petty trading and small scale farming. In the urban areas of Port Loko, Bo and Kenema districts, there are fewer government jobs compared to the Western Area. Market centres and business enterprises are also established and petty trading is common. In the rural areas, more emphasis is Loko district and upland rice in both Bo and Kenema districts. There is extensive diamond mining activity in Bo and Kenema districts. In Port Loko, there is considerable river transportation which facilitates internal trade and cross border interaction with the neighbouring Republic of Guinea.

The choice of these four districts was largely influenced by the fact that the administrative capitals for their respective regions are located in the districts. However in the case of the Northern Region, Bombali district was replaced by considerations. 3.2 Study Population The 1985 census data reveals that, in the four regions (Western Area, Port Loko, Bo and Kenema districts), the total population was 1,489,313. The population in those four constituted 42.3% of the total population of 3,515,812 persons enumerated in 1985. The percentage distribution of the population in urban areas (2000+ persons) in 1985 was 89% in the Western Area, 17% in Port Loko and 32% each in Bo and Kenema districts. 3.3 Sampling Methodology The sampling unit of the survey is the household. The recently updated sampling frame recommended by the Central Statistics Office (CSO), used in recent surveys, was used for this survey. The Central Statistics Office has a list of Enumeration Areas (EAs) that covers the entire country. The EAs served as clusters and the households as sampling units. The strata to be used in the sampling process are derived from the administrative structures of the country with special reference to the following administrative areas: Western Area in the West, Port Loko district in the North, Bo district in the South, and Kenema district in the East. First stage of sampling The list of EAs were ordered and stratified according to the following variables: location (rural/urban), District, Chiefdom, and Population size. In each of the four regions, one displaced camp was selected at random and added to the list of EAs in the area of existence. About 5% of the floating population was also targeted.

Methodology

3.0


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Second stage of sampling In the second stage of sampling, the EAs were classified as urban and rural, and listed accordingly for each district. The actual number of EAs selected, for each district, within the urban/rural areas was proportional to the population sizes of these urban/rural areas. An every nth systematic sampling was used to select one hundred and forty (140) EAs all in all. The number of urban and rural EAs selected in the sample are listed in Appendix 1 Third stage of sampling In each of the EAs chosen in each district a locality was randomly selected and twenty (20) households in turn randomly chosen from this locality. In the few cases where the chosen locality had less than the required number of twenty (20) households, locality was then immediately replaced by a bigger one that was randomly selected from the same EA. For the purpose of cost reduction and efficiency, the sample design just described is simpler and more convenient than the more tedious method of first dividing each EA into equal segments of twenty (20) households and thereafter, selecting at random one segment from the EA. The choice of either sampling design is a matter of preference, but in any case, the over all conclusions remain unchanged. One adolescent (alternating between male and female), chosen at random was interviewed in each household. In households where large extended families or groups of people live together in different units within the same compound, the recommended procedure was to randomly choose a study subject from among those found in a given unit and complete the interview for only that respondent. The list of EAs and the corresponding localities from which the twenty (20) households were chosen are given in Appendix II. The population of each IDP camp was ascertained from the UNOCHA database of IDP populations. The database is updated monthly, and considered to be reasonably accurate. One displaced camp was randomly selected in each district and hundred (100) individuals interviewed in the selected camp. For the floating population, two hundred (200) individuals (50 per district) were targeted and interviewed. The list of the chosen displaced camps is also given in Appendix II Sample size Decisions regarding sample size were made based on a number of factors that included;

(i) The probability of making Type 1 error that the survey was willing to accept. This

probability “r” generally set at 0.05 (or 5%), is the probability that the true population value for a given indicator might fall outside of confidence limits (in this case the 95% confidence limit), that surround the estimate of the indicator;

(ii) The design effect (or deff) of the survey. This provides a correction for the loss of sampling efficiency resulting from the use of a more complex (cluster) sampling design, instead of simple random sampling. The default value of 2 is commonly used. Assuming that cluster sample sizes can be kept moderately small, the use of a standard value of deff = 2.0 should adequately compensate for the use of cluster sampling in most cases;


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(iii) The average number of people per household (nh). Available data suggest that the

average household size in rural areas of Sierra Leone was seven (7), whilst in urban areas it was approximately six (6). An average value of nh = 6.5 was accepted;

(iv) The estimated non-response rate (nr) was 10% and 1.1 was the factor necessary to

raise the sample size by 10% for non-response;

(vi) The desired precision “d” of the estimate of key variable, set at d = 0.05;

(vii) the proportion “p” of the total population that the target population group 12 – 21 years comprise; set at p = 0.2 (or about 20%); and

(viii) the predicted or anticipated prevalence for the key indicator, set at v = 0.01 (or 1%).

The formula used in estimating the sample size is given in Appendix III. 3.4 Training of Interviewers and Supervisors The training of interviewers and supervisors took place in the Sierra Leone Girl Guides Association building next to the Central Statistics Office (CSO). The training lasted for one week; Monday, 12th to Saturday, 17th November 2001. The participants comprised mainly of the co-ordinators, the supervisors and the enumerators. Information on the objectives of the survey was followed by discussions on the sampling design and above all, the sampling techniques that supervisors and enumerators should employ in the field. The greater part of the first two days was focused on the questionnaire. The study Director from CSO, and representatives from UNICEF, explained and clarified all the one hundred and fourteen (114) questions in the core questionnaire to all participants. The participants in turn were given the opportunity to ask questions related to the questionnaire and thereby make vital contributions. In the next two days, the supervisors and interviewers were divided into four (4) groups, and test interviews were conducted. Each member of a group had the opportunity to interview one of four (4) adolescents aged between 12 – 21 years who were randomly selected from the streets of Freetown. The test interviews were followed by discussions, and reports were submitted by supervisors of the four (4) groups. The co-ordinators made their assessment of the exercise. On the final day of the training a pre-test of the questionnaire was conducted using localities in Freetown which were not included in the selected sample. The overall experience gained by interviewers and supervisors during the one-week training period enabled a few modifications to the questionnaire. The final selection of the enumerators was carried out, and four teams each having a supervisor and a co-ordinator were selected for the actual fieldwork. 3.5 Data Collection The four groups of enumerators had a supervisor and a co-ordinator. The supervisors distributed the questionnaires to be used by enumerators in the field, facilitated the work of the co-ordinator. The co-ordinator made on the spot checks to each of the areas to ensure that the field work was properly done. In order to ensure effective supervision on the field, all four groups did a combined exercise for one week in the Western Area. The next one-week of the fieldwork was conducted in the provincial districts (Port Loko, Bo, and Kenema districts). As a way of expediting the exercise, Port Loko district was divided into two sub-regions. Each enumeration region had one supervisor and a co-ordinator. The supervisors secured and edited all questionnaires after the fieldwork and returned them to the Head Office of the Central Statistics Office in Freetown.


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The data collection lasted for two weeks from 19th November and to 2nd December 2001. 3.6 Distribution of Adolescents in Sampling Frame and Completed Interviews The distribution of adolescents in the sampling frame for the survey was based on the 1985 census figures of the four (4) survey districts; Bo, Kenema, Port Loko and Western Area. The weights given to the survey districts hinged on percent urban figures (1985). This meant in effect, that 42% of the respondents would be from urban areas; 38% rural; 13% and 7% displaced and floating population respectively. The latter being treated as a separate enumeration area/strata for the survey. A total of 3000 (three thousand) were targeted as the distribution shows in Table 3.1. below. The completed interviews exceeded target by 0.6% or approximately 1%, over- enumeration in rural areas (11.3%) and under-enumerations in the urban areas (1.1%), displaced population (22 %) and (4.5%) of the floating population produced a variant of 1 percent above target The fact that only 25 adolescents were interviewed from the displaced population in the Western Area with so many densely populated displaced camps compared to 108 for Kenema with a fewer number of camps may be attributed to the possible use of the wrong locality type codes which remained unnoticed by the data entry operators until after analysis. Or, that the codes for displaced camps and rural areas may have been inadvertently interchanged, which may be manifested in the difference between targeted and completed interviews for rural areas. 3.7 Data Processing

Data coding, entry and analysis was carried out at the Central Statistics Office in Freetown. Microsoft Access was used for Data entry and with SPSS to make the data analysis.


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Table 3.1 Distribution of Adolescents in Sampling Frame and Completed Interviews

Sampling Frame

District % Urban

1985

Urban Rural

Displaced

Floating

Total

Bo 32.0% 150 280 100 50 580

Kenema 32.0% 200 340 100 50 690

Port loko 17.0% 100 430 100 50 680

Western Area 89.0% 800 100 100 50 1050

Total

1250 1150 400 200 3000

Completed interviews

Urban

Rural Displaced Floating Total

160 280 81 50 571 185 363 108 51 707

118 422 98 52 690

773 215 25 38 1051

1236 1280 312 191 3019


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4.1 Background Characteristics

he data obtained from the survey have been analysed and the results are shown in tables 4.1.1 to 4.8.1 of this section, and are illustrated in Figure 1 to Figure 29 of Annex IV

4.1.1 Age at Last Birthday For this survey, an adolescent was considered to be somebody aged between twelve (12) and twenty-one (21) years old. Adolescents’ ages were recorded in completed years, (age at last birthday).

22% of those interviewed in the Western Area were between 16 &19 years compared to about 16% for the same age cohort in Port Loko and Kenema districts. More 12-13 year olds (25.8%) were interviewed in Port Loko district than any other survey district; the lowest of this group being from the Western Area, 12.2%.

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Age group distribution of respondents

12-13 yrs

14-15 yrs

16-17 yrs

18-19 yrs

20-21 yrs

17.5%13.3%

20.0%

19.3%

18.7%

Results

4.0


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There were more males (20.3%) than females (19.8%) in the age band 14-15 years, the age at which many youths are presumed to be at the prime of their puberty. Recall lapse is a normal phenomenon in reporting ages. Overall, the recall lapse was 8.2% for all respondents. It was highest in Kenema district where 17% did not know their ages and lowest in the Western Area, 4.3%. A higher proportion of those in the rural areas (11.4%) could not tell their ages compared to a mere 4.8% of their urban counterparts. And a few more females (9.3%) over males (7.1%) did not also know their ages. 4.1.2 Educational Characteristics The level of school attendance is quite high with 62.0% stating that they had attended school. The level is much higher for the Western Area (79.3%) and urban areas (79.4%) compared to the rural areas (46.0%) as expected. Also evident is the differential between males (67.2%) and females (57.0%) The level of completed schooling in the “none” category course includes all those who have never attended school as well as those who are still in school at all levels. The parameters used to ascertain the level of literacy among the adolescents canvassed during the survey were the level of completed schooling and the adolescent’s ability to read and/or write in the English Language. Of the 3019 adolescents interviewed, only 42.3% indicated they can read and/or write in English. Although 46.4% of the males can read and/or write in English only 3.3% completed secondary school. This unfavourably compares with a lower percentage of literacy level for females estimated at 38.2%. This disparity in levels of literacy between the two sexes, estimated at 8.2 percentage points may be associated with sex preference in terms of retaining children in school when family resources are low.

Educational Characteristics of Youths 12-21 years o f age

66.5

46.148.4

79.3

62.0

26.323.8

20.7

57.8

35.4

0.9 1 2.66.5

3.2

72.975.2 76.7

35.5

61.3

41.3

27 26.2

63.7

42.3

0

10

20

30

40

50

60

70

80

90

100

Bo Kenema Port Loko W estern Area ALL

Ever Attended School Primary Secondary None Literate in English


12

Across the four (4) survey districts, 63.7% and 26.2% of the respondents are literate in the Western Area and Port Loko Districts respectively. This observed difference could be attributed to the relative peace, which the Western Area enjoyed, as compared to all other regions of the country during the course of the war, the preponderance of private schools as a more stable and guaranteed avenue for schooling, to name but a few. Literacy levels are higher in the urban areas than in the rural areas: 64.6% of adolescents in the urban areas are literate as compared to 22.3% in the rural areas. 4.1.4 Income, Religion and Ethnic Group Status The level of economic activity and the number of persons engaged in some form of income earning activity at whatever level determines to a large extent peoples’ standard of living. Of all the adolescents in the survey districts 35.6% were engaged in income earning activities. Also, 49.2% and 26.6% of the respondents earned an income in Bo and Western Area respectively. Again, more adolescents are engaged in income earning activities in the rural areas (42.7%) than those in the urban areas (24.8%). These differences likely occur because more adolescents in urban areas are in educational institutions than their counterparts in rural areas. It is noted that more males (38.4%) than females (32.9%) earn income in all the survey districts. The two major religious groupings (Christians and Muslims) account for over 95% of religious affiliations. Although Muslims dominate overall (66.7%), the disparities are widest in rural areas and Kenema and Port Loko districts.

The distribution of adolescents by ethnic group largely follows the expected pattern with Mendes (38.4%), Temnes (33.5%) and Limbas (5.7%) forming the main ethnic groups. The distributions also largely follow expected regional patterns and concentrations of ethnic groups.

Religious groupings of adolescents

29.6

68.8

1.6

33.8

64.7

1.50

10

20

30

40

50

60

70

80

90

100

Christian Muslim others

Per

cent

male female


13

4.1.5 Living Arrangements An adolescent’s living arrangement may be a contributory factor in the risk of exposure to both Sexually Transmitted Infection (STIs) and/or HIV/AIDS. The information is also useful for messages about HIV AIDS prevention and care. A substantial number(81.2%) of adolescents interviewed lived with family or relatives. The next highest category were those living with sexual partners (8.7%) and those with no fixed abode (3.3%) Whereas 91.8% lived with relatives in the urban areas, a lower percentage of 80.8% is reported in the rural areas. The preponderance of early marriages in the rural areas may explain this as shown by the highest percentage (13.8%) living with a sexual partner. Of the special category of floating population, 49.2% had no fixed abode and only 0.6% of respondents in displaced camps lived with friends. More males (83.2%) than the females (79.3%) lived with family/relatives. The disparity of 3.9 percentage points underpins the earlier explanation of early marriages for females.

4.1.6 Alcohol and Drug Use The use of drugs of various kinds (alcohol, ‘shooting’ drugs, and marijuana) can be a contributory factor in increasing risk of HIV infection. Overall the level of alcohol and drug use among adolescents is quite low. Eighty-six percent do not drink alcohol, 92.8% have never tried marijuana and 99.2% have never “shot” drugs. It is only the Floating Population that stands with as 35.6% who drink alcohol everyday, 53.4% have tried marijuana and 6.3% have “shot” drugs.

Living arrangements of youths

3.5

83.2

2.8 1.8 3.3 4.50.70.9

79.3

0.3

15.5

0.9 2.2 0.50

10

20

30

40

50

60

70

80

90

Alone FamilyRelatives

Employer Sexual Partner Friends No FixedAbode

Other

Percent

Male Female


14

4.2 SEXUAL HISTORY 4.2.1 Sexual History: Number and Types of Partners Sexual intercourse is one of the major means of HIV/AIDS transmission in Sierra Leone. Fifty-eight percent of the 3019 adolescents interviewed had had sexual intercourse. Sexual activity is highest among the floating population (79.6%) compared to 46.8% in Internally Displaced Persons’ (IDP) camps; 19.4% of the floating population had had at least three (3) sexual partners in the three months prior to the survey. There is an insignificant difference between urban and rural areas, in sexual activity between sexes with 58.4% and 56.3% of males and females respectively having had sexual intercourse. Significantly a very low percentage (3.7%) had used condoms during their first sexual intercourse.

4.2.2 Age at First Sexual Intercourse The age of first sexual intercourse is a significant factor in contracting HIV/AIDS and/or other STIs. The earlier the age the greater the vulnerability. The results show that 44.8% of the adolescents had had sex before they were eighteen.

Ever had sexual intercourse and use of condom during the first sex

58.056.0 56.0

59.0

5.7

2.2 3.1 4.2

0

10

20

30

40

50

60

70

Urban Rural Male Female

Ever Had Sex Condom Use During First Sex


15

Less than 4% (3.6%) of respondents reported to have had sexual intercourse for the first time at ages ten and eleven years. More males (4.0%) than females (3.3%) reported to have had sexual intercourse at that same age. The percentage is higher in rural areas (4.0%) than in urban areas (2.6%). This may be in line with a higher level of early marriages and/or forced marriage in the rural areas. In Port Loko District, 4.4% of the adolescents reported to have had sexual intercourse at about 10 – 11 years old compared to only 2.7% of adolescents of the same age group in the Western Area.

Cummulative percentage of adolescents who had sexua l intercourse by age and by gender

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

10 11 12 13 14 15 16 17 18 19 20 21

Male Female

Age at First Sexual intercorse by male and female y ouths

0

2

4

6

8

10

12

10 11 12 13 14 15 16 17 18 19 20

Age at First intercourse

Per

cent

age

Female Male


16

There is no significant difference in age at first sexual intercourse between the sexes throughout the ages. For example 9.0% of males had had sex by age 15 while 10.1% of females had had sex by that same age. 4.2.3 Age Status of First Sexual Partner The age status of the first sexual partner shows that 24.5% of respondents had sexual partners who were 0-4 years older and 13.4% of respondents had sexual partners who were younger. In general females had older sexual partners while that of males were younger. More than 40% did not answer the question.

4.3 STIs AND STDs 4.3.1 Knowledge of STDs and STIs Ascertaining adolescents’ knowledge of Sexually Transmitted Infections (STIs) is the first and crucial step in the fight against the spread of HIV/AIDS. In this survey knowledge of STDs and STIs means having heard of the diseases. Across the survey area 56.8% know something about STIs. The highest percentage (74.3%) is in the Western Area and the lowest (36.8%) is in the Port Loko district. The disparity in adolescents’ knowledge about STDs/STIs by sex is not great with 58.3% and 55.3% of males and females respectively. Of particular interest is the fact that three-fourths of the floating populations have some knowledge of STDs and STIs. There a distinct urban--rural difference. In urban areas, 68.4% of adolescents have some knowledge compared to 44.4% of those in the rural areas. Understandably, the high percentage of knowledge in

Age status of first sexual partner of adolescents

0 10 20 30 40 50

10+ Years Older

5-10 Years Older

0-4 Years Older

Younger

Don’t Know

Percentage

Urban Rural Male Male Female


17

the Western Area may be closely related to the access of newspapers and FM radio stations as compared to the paucity of such communication channels in other parts of the country. The three most commonly names STI/STDs were Gonorrhoea (34.5%), Syphilis (11.1%) and HIV/AIDS (3.9%)

4.3.2 Having contracted an STI An average of only 8.6% of all respondents reported to have contracted an STI with the floating population recording the highest percentage of 31.4%. More adolescents (13%) in Bo district reported to have contracted an STI than their counterparts in other districts; Kenema 5.8%, in Port Loko 7.5%, in Western Area 8.8%. The high prevalence of STDs in the floating population suggests the risky sexual behavioural patterns in such communities. In terms of the course of action after contracting an STI, the majority (47.8%) of respondents indicated that they would go to the hospital/health centre/clinic for treatment. In the Western Area 67.8% preferred Hospital/Clinic/Health Centre treatment compared to a lower percentage of 23% in Port Loko. Only 34.3% of rural adolescents would go to a hospital, compared to 60.7% in urban areas and 63.9% of the floating population.

Knowledge of three different types of STIs by adole scents

13.8

6.99.0

25.7

42.0

27.228.8

45.0

5.2

2.75.1

1.0

0

5

10

15

20

25

30

35

40

45

50

Urban Rural IDP Camp Floating

Per

cent

age

Syphilis Gonorrhoea HIV/AIDS


18

4.4 HIV/AIDS KNOWLEDGE 4.4.1 Information about HIV/AIDS Although 72% of all adolescent respondents had heard about either HIV or AIDS, this leaves an alarming 28% who have never heard of HIV/AIDS. There is considerable difference between the regions. A substantial percentage (90%) in the Western Area had heard whilst about only 58% of the adolescents knew the terms in Kenema District. There is also a high differential in the level of information of about 26 percentage points between urban and rural adolescents. 4.4.2 Source of Information Information about preventing HIV/AIDS depends on the source and credibility of information. Adolescents first get information from a number of sources including peers, sexual partners, parents, teachers, and mass media including radio, TV and newspapers. Most adolescents (45%) reported that they get information on HIV/AIDS from the mass media, particularly from the radio. Several of the respondents get information from their peers 9.5%. This is in sharp contrast to the percentage (2.5%) that receive information of HIV/AIDS from their parents.

4.4.2 Major facts about HIV/AIDS While the knowledge of the term is well over 50% there is very little understanding of HIV or AIDS. Very few adolescents (7.7%) know the difference between HIV and AIDS; 8.3% of the male respondents know the difference compared to 7.0% females. There is a considerable geographical difference in levels of understanding. In the Western Area 14.7% know the difference between HIV and AIDS whilst 1.9% and 14.1% in the rural and provincial urban areas respectively know the difference between the virus and the disease.

Source of Information on HIV/AIDS to adolescents

Sexual Partner

Parents

Other

Teacher

PeersMass Media

0.7%

2.5%

6.5%

6.9%

9.5%

45%


19

On average more than 60% did not know any one living with AIDS, although 13.6% of the floating population know somebody living with HIV/AIDS. The condom is one of the means of protection from HIV/AIDS. However only 38% of the respondents considered the use of condoms during sex as a protection against HIV infection. This overall figured varied from 58.4% in the Western Area to 22. 8% in Port Loko district. A similar pattern is exhibited between the urban and rural areas with 54.0% and 21.6% respectively. Other variables investigated include determining whether the adolescents know that AIDS can affect anyone, and if, a healthy looking person can carry the virus. Close to half (48.6%) of all respondents believe that HIV/AIDS can affect any one (64.7% and 34.1% in the Western Area and Port Loko district). A lower percentage of adolescents in the rural areas (35.3%) than those in urban areas (62%) and approximately 60% of the floating populations have similar beliefs. Misunderstandings about HIV/AIDS are very common . 55.1% of all the respondents (38.7% in Western Area and only 72.8% in Kenema district) hold the view that a healthy looking person does not carry the virus. Between urban and rural areas, there is a considerable differential of 27.3% points. More than 50% of either sex believes that a healthy looking person does not carry the virus (53.6% and 55.6% for males and females respectively)

Percentage of Adolescents who know major informatio n on HIV/AIDS

0

10

20

30

40

50

60

70

Knows differencebetween HIV and

AIDS

Believes there is nodifference between

HIV and AIDS

Knows someone withHIV/AIDS

Knows condom canprotect from HIV

during sex

Knows HIV can affectanyone

Knows a healthylooking person cancarry the HIV virus

Per

cent

Urban Rural IDP Camp Floating


20

4.4.3 Knowledge about HIV/AIDS - Transmission HIV/AIDS can be transmitted through several means. Adolescents were questioned on the various methods of transmission. These included, blood transfusion, use of infected needles, mother to child/foetus, and breast-feeding. A little more than half of the adolescents (52.8%) know that the virus can be transmitted through blood transfusion. The figure for Port Loko district is about half that reported for the Western Area (35.8% and 74.4% respectively) with a similar pattern replicated between urban and rural areas (70.2% and 34.5% respectively). The difference in knowledge between males and females is not that wide with a difference of 5%. Of striking note is the fact that 41.4% of rural adolescents could not respond to the question. This may be due to the paucity of detailed health information on HIV/AIDS and the high level of illiteracy in these areas. The use of infected needles is another mode of HIV transmission. Many respondents do not know this fact (54%). 4.4% more females and males did not know this basic fact.. A substantial difference exists among adolescents in the Western Area and Kenema District and those in Urban and Rural areas. 25.2% of adolescents in Western Area do not know of this method of transmission as compared to 61.5% in the Kenema district. The number of adolescents living in rural areas who do not know of this mode of transmission is approximately double that of those living in urban areas. Transmission of the virus through breastfeeding is not common knowledge with only 56.8% unaware of this fact. In all the survey districts knowledge was highest in the Western Area with 53.4%, and lowest in Kenema district with 33.8%. More adolescents in the urban areas (51.5%) than their rural compatriots (34.6%) know that the virus can be transmitted through breastfeeding. Between the sexes, a little over 40% of the females know of the fact as compared to 43.9% for males.

Percentage of Adolescents who correctly identify t ransmission modes of HIV/AIDS

An Infected Pregnant Woman

can transmit HIV to Unborn Child

HIV can be Transmitted through Blood Transfusion

HIV can be transmitted through

breast milk

A Person can get HIV by using

Infected Needle

Did not know any specific way

43.2%

53.8%

40.3% 44.7%

52.8%


21

4.4.4 Knowledge of Protection Methods

Knowledge of protection methods is vital to arrest the spread of HIV/AIDS. The adolescents were asked to state any protection methods that they know. The graph below shows the four main methods quoted and the general low level of knowledge.

Only 7.2% of the respondents stated all three methods (sticking to one partner, abstinence and condom use) as means of protection from HIV/AIDS. Very importantly, a large percentage of 47% of the respondents did not know any method of protection. Sticking with one partner was a relatively common stated method. A high percentage 61.3 % of respondents was recorded in the Western Area and about half that figure (31%) in the Kenema district. Once again the floating population has more overall knowledge with 54.5% know that sticking to one partner can protect against HIV/AIDS. Whether this knowledge is translated into practice remains to be ascertained. These is little difference between male and female knowledge on this topic Significantly, 55% of the adolescent respondents would not abstain from sex in order to protect themselves from HIV infection This ranges from nearly 40% in the Western Area to 69% in Port Loko district. Adolescents in the rural areas are less likely to abstain (34%) but the urban is not a great deal better at 55%. Similarly less than 20% of respondents are willing to abstain from sex to avoid unwanted pregnancies (section 4.4.2). Very importantly only 10.5% of the respondents would use a condom as the protection method of choice. There was a significant difference between the urban and rural population (17.4% and 4.2%) who respectively prescribed condom use as a protection method. There was no significant difference between male and female respondents.

Percentage of adolescents who know three HIV protec tion methods

45.6 44.8

10.57.2

52.6

47.4

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Protection bysticking to one

uninfectedpartner

Protectionthrough Sexual

Abstinence

Using a condomevery time

Knows all threeways

Knows at leastone way

Doesn't knowany way


22

4.5 HIV/AIDS Testing Testing for HIV is crucial in the fight against HIV/AIDS. Despite the low levels of basic knowledge the adolescents show an openness to testing and knowledge one's HIV status. The majority of the adolescents (71.8%) believe that people should know their HIV/AIDS status. The figures were 82.3% in Western Area, 77.9% in Bo district, 62.4% in Kenema district, and 61% in Port Loko district. More respondents in urban areas (79%) believe people should know their HIV/AIDS status as compared to 66.5% in rural areas. That about 62% of those interviewed are willing to do the test but only 1.6% had actually done the test. Given the limited testing sites in the country it is not surprising that a small percentage of adolescents know where to have an HIV test. The highest such knowledge, 28.7% is in the Western Areas and lowest of 11% in Kenema district. 4.6 HIV/AIDS ATTITUDES AND PRACTICES

4.6.1 Personal Feelings about People With HIV/AIDS The adolescents displayed some contradictory attitudes to People living with AIDS (PLWA). While 69% strongly sympathise with the PLWA and barely 1% consider PLWAs as immoral, 60.2% of the adolescents feel that PLWAs should be discriminated against. A large number of the respondents (68%) stated that an infected employee must not be allowed to continue work or an infected student must be sent away from school. A significantly high percentage (78%) stated that they would not share a meal with a PLWA and worse still, 81% would not buy food from a trader who is a PLWA. 73.3% of the respondents stated they would not keep it a secret when a family member is known to be HIV positive or has AIDS. Nonetheless 29% of the respondents stated they would care for either a male or female relative with HIV/AIDS. Western Area has the highest proportion of respondents that would care for either a male or female relative, 37.4%, and Kenema recorded the least, at 22.9%. This pattern is similar to that in urban and rural areas, 35% and 27% respectively and, between males and females, 31% and 27%.

Adolescents' attitude and practice to HIV/AIDS testing

Believe people should Know their HIV AIDS StatusWilling to be Tested for HIV/AIDSKnow where to get an HIV TestEver had an HIV Test

61.5%

19.7% 1.6%

71.9%


23

4.6.2 HIV/AIDS and Condom Use A high percentage of respondents (60.5%) indicated that they were at risk of getting HIV/AIDS. It was only in the Port Loko district where 58% consider that they are not at risk. Condom use remains a very important means of protection against HIV/AIDS. About sixty-three percent of the respondents stated to have heard of condom as a method of protection against HIV/AIDS. However less than 50% of the respondents in Kenema and Port Loko districts have the same knowledge. Significantly, although more than 60% of the respondents had actually heard about condoms, only 29% know where to obtain condoms in their communities. Knowledge of where to obtain condoms varies from 42.5% in the Western Area to 14.5% in Port Loko district. Only 13.5% of the adolescents use a condom for sex to prevent HIV infection. The results of knowing where to get condoms and its use for sex have a close relationship. For instance, 14.5% of respondents in the Port Loko district know where to get a condom but only 8% use a condom in a sexual encounter. A similar pattern is exhibited between urban and rural areas, and between male and female respondents. About one quarter of the adolescents who know about condoms actually use a condom. 4.6.3 Discussing Personal Behaviour and HIV/AIDS Discussing sex and reproductive health related issues, particularly HIV/AIDS, is traditionally viewed as a taboo to most parents, more so between parents and adolescents. Although this is an important way for adolescents to receive information only 32.1% of the respondents discuss personal behaviour related to HIV/AIDS with either their parents or teachers. More adolescents in Western Area (40.3%)

Adolescents' attitude to people living with HIV/AID S

60.2

67.6

81.078.0

67.7

26.7

0

10

20

30

40

50

60

70

80

90

100

Believe people withAIDS should be

discriminatedAgainst

Believe an infectedTeacher/ W orker

should not beallowed to work

Believe one shouldnot buy food fromTrader with HIV

AIDS

Believe on shouldnot share Meal with

an HIV/AIDSInfected Person

Believe a studentwith HIV but no

AIDS should not beallowed Class

Can keep Secretthe HIV/AIDS Status

of Family Member

Per

cent

age


24

discuss with their parents or teachers than in Kenema and Port Loko with 27.9% and 22.2% respectively. More females (34.5%) than males (29.6%) discuss HIV/AIDS issues with their parents or teachers.

Just as fewer discussions take place between parents or teachers and adolescents, so it is between sexual partners. Again more adolescents in the Western Area (40.9%) talk to sexual partners about HIV/AIDS than they do in Port Loko district (24.5%). The situation is the same between urban and rural areas, and there is only a marginal difference between males and females. These figures should be compared with the low levels of knowledge and understanding of HIV/AIDS and related issues (Section 4.4). The quality of the discussions is questionable. This is underlined by the fact that less than 1% heard of the disease from their sexual partners. 4.6.4 Willingness to change About 52% percent of the adolescents stated that they are unwilling to change sexual practices in order to avoid HIV infection. This varied from 49.4% in urban areas to 56.3% in rural areas. There was no significant difference between male and female respondents on this issue. This is probably related to low levels of knowledge and currently it is a cause for concern. A substantial percentage (94.1%) cautiously use skin piercing instruments such as blades, needles and knives. However it was not clear if the caution was due to fear of HIV infection or far of pain and injury. 4.6.5 Prevention of Unwanted Pregnancy Teenage and/or unwanted pregnancy is a critical challenge. Questions were asked about the adolescent's knowledge of contraceptive methods. Only three (3) methods were commonly mentioned, significantly with low percentages. The three most common methods are condom use

HIV/AIDS and Condom Use

At Risk of Getting HIV AIDS

Ever Heard of Condom

Know Where to get a Condom

Use Condoms for Sex

62.7%

29.2%

13.5%

60.5%


25

(27%); family planning pills (21.3%) and sexual abstinence (14%). Condom use is rated high in the Western Area (41.4%) compared to the Kenema figure of 20.5% and even lower in Port Loko

District. In urban areas, 37.4% consider condom use as a preventive method whereas only half this percentage thinks the same in rural areas. The difference between males and females is about 12.3 percentage points suggesting that more males than females may use condoms to avoid unwanted pregnancies. This fact should be compared with the finding that 13.5% of adolescents would use a condom (Section 4.6) and only 10.5% know that condoms is a HIV infection protection method (Section 4.4). The use of family planning pills is not popular. In all surveyed districts, less than 30% may use the pill, with Port Loko and Kenema districts recording the least, 15.5% and 16.0% respectively. Abstinence is extremely unpopular method. Of all the different strata used for the analysis, it was only in the Kenema district that 21.6% adolescents would abstain from sex. Otherwise, below 20% would abstain from sex to avoid unwanted pregnancy. Of more concern is that 33% of the respondents do not know how they can avoid unwanted pregnancies. This fact can be added to the fact that a large percentage of 47% of the respondents did not know any method of protection from HIV infection (Section 4.4.4).

P e rc e n ta g e o f a d o le s c e n ts w i th k n o w le d g e o f p re v e n t in g u n w a n te d p r e g n a n c y

23 .1

2 8.5

14.4

2 .8

29.2

1 .9

20 .5

16.0

21.6

0 .3

38 .0

3 .5

14 .9 15 .5

1 0.1

4 .6

5 0.9

3 .9

41.4

2 4.7

11.1

1 .1

18.5

3 .1

0

1 0

2 0

3 0

4 0

5 0

6 0

7 0

8 0

9 0

1 0 0

B y U s ing C o nd o m s F a m i ly P la nning P i lls A b s ta ining fro m S e x O the r D o n’ t K no w N o R e sp o ns e

B o K e ne m a P o rt L o ko W e s te rn A re a


26

4.7 ACCESS TO COMMUNICATION AND PREFERENCE OF

COMMUNICATION CHANNELS 4.7.1 Access to communication The communication plays a key role in the fight against HIV/AIDS. It informs and educates people so that people can make informed judgements on HIV/AIDS related issues. Access to the commination is therefore of paramount importance for the success of programmes geared toward HIV/AIDS.

Adolescents’ access to radio, television, visit to video/cinema house and the reading of local newspapers were all investigated by the survey. Radio access is the highest with 78.6%, compared to only 26.0% for television (TV), 41.2% who visit video/cinema houses and just 24.4% who read local newspapers. More respondents had access to radio in the Western Area (85.8%) than in Kenema and Bo districts, with 70.2% and 78.3% respectively.

Visits to video/cinema houses are relatively low at 41.2% but still higher than access to TV and those who read local newspapers (24.4%). A large proportion of the floating population (69.9%) for example, visits video/cinema houses. Such visits are highest in Bo district (56.2%) and very low in Port Loko, 15.7%. More males 47.2% than females 35.4% visit video/cinema houses.

Reading local newspapers is closely associated with literacy levels and access. The results indicate that a mere 24.4% read local newspapers; 46.4% in the Western Area compared to 11.2% in Kenema district. Literacy levels aside, the distribution networks and the readership of majority of the local tabloids is mostly limited to Freetown and some provincial towns. More males (27.1%) than females (21.8%) read local newspapers.

Percentage of Adolescents w ith access to different communication channels

78.6

26.0

41.2

24.4

19.422.1

0

10

20

30

40

50

60

70

80

90

100

Access to Radio Access to Television Visit to VideoCinema House

Read Local Newspapers

Read Magazines Access to FlyersPosters


27

HIV/AIDS information dissemination through outreach materials such as magazines, and flyers/posters; membership of social/youth groups and, attendance at drama performances is equally low among adolescents. Only 19% adolescents read magazines, 22.1% have access to flyers/posters, 20.6% belong to youth groups. More adolescents in the Western Area (39.7%) read magazines than those in Kenema (7.9%) and Port Loko districts (8.0%). Access to flyers/posters is highest in the Western Area (41.8%) and very low in the Kenema and Port Loko districts, 6.9% and 9.1% respectively. Attendance (37.5%) at performances by drama groups compares closely with the numbers that visits video halls and more than those that have access to TV or read newspapers.

Communication through the church and mosque is important. At least 90% of all adolescents listen to church/mosque sermons. More than 95% accept messages from sermons although only 34.3% and 31.6% of those in the Western Area, and urban areas respectively had ever listened to sermons that include issues relating to HIV.AIDS.

Although attending drama performances is popular and common, watching a play with a HIV/AIDS theme is not a common occurrence among youths/adolescents. Only 16% of adolescents have ever watched such plays. The situation is no better in the Western Area (25.6%) and urban areas (23.2%) where one expects that anti-HIV campaigns may be intensive. It is even worse in Kenema district (6.4%) and rural areas (5.8%) compared to what obtains in the other areas.

4.7.2 Source Preference for Information on HIV/AIDS

Adolescents’ preferred source for information on HIV/AIDS is the radio with 63.3% compared to that of Television (7.6%) and newspapers (1.4%). With all the number of radio stations in the Western Area, only 58.9% adolescents prefer it compared to higher percentages in Bo, Kenema and Port Loko districts of at least 60% each.

It would seem understandable then that more adolescents in the Western Area (17.8%) prefer TV than their counterparts in other areas, as the TV coverage is still limited to some parts of the Western Area.

But with over forty (40) newspapers published weekly in Freetown and only 2.6% of adolescents preferring this source may be a pointer to the fact that either youths do not read newspapers much or they have little confidence in materials in newspapers, a view shared by majority of the reading public.

4.8 ACCEPTANCES AND CREDIBILITY

4.8.1 Sources of Messages Believed Best

The radio is the most credible source of messages for youths/adolescents with 59.4% of adolescents believing messages aired on the radio, and messages from churches and mosques being the most credible at 18.0%. Of those that believe messages on radio, Port Loko district recorded the highest percentage, 70.6% and Western Area the lowest, 50.5%. The Western Area situation may be explained by the availability of other sources of information including TV and newspapers compared to the other areas where such facilities hardly exist. Again, more rural youths (63.3%) believe best messages on radio than their urban counterparts. Of interest is that only 3.7% of adolescents stated that they have confidence in what they hear from their peers. This may be put down to the fact that adolescents know that their peers also have limited knowledge on HIV/AIDS.


28

References Ainsworth M., D. Filmer and I. Semali 1996. The impact of AIDS mortality on individual fertility:

evidence from Tanzania. Paper presented at a workshop on: “The links between infant and child mortality and fertility”, organized by the committee on Population, National Research Council, Washington, D.C., November 6-7, 1996.

Cleland J. G., M.M. Ali and V. Capo – Chichi 1999. Postpartum sexual abstinence in West Africa:

implications for AIDS – control and family planning programmes. AIDS vol 13 (1): 125 – 131.

Cochran, W. G. (1997) Sampling Techniques. Third Edition PP 428 John Wiley and Sons, Inc. New

York, New York 10016. Census Report of Sierra Leone (1985) – Central Statistics Office – Freetown. Desgrees du Lou, A., P. Msallati, R. Ramon, V. Noba, I Viho, F. Dabis, L. Mandelbrot, C. Welffens –

Ekra and the Ditrame Project 1998. HIV – I infection and reproductive history: a retrospective study among pregnant women, Abidjan, Cote D’Ivoire, 1995 – 1996. Journal of STD & AIDS vol 9:452-456.

Desgrees du Lou, A., P. Msallati, A.Yao, V. Noba, I Viho, R. Ramon, C. Welffens – Ekra and F.

Dabis 1999: Impaired fertility in HIV – I infected pregnant women: a clinic based survey in Abidjan Cote D’Ivoire 1997. AIDS vol. 13: 517-521.

D’Ubaldo C., P. Pezzotti, G.Rezza, M. Branca, G. Ippolito and the DIANAIDS collaborative study

group 1998. Associatiobn between HIV-I infection and miscarriage: a retropesctive study. AIDS vol.12(9): 1087-1093.

Family Health International (FHI) (1998), ‘Preventing Mother-to-Child Transmission of HIV’. Impact

on HIV Vol.1, No. 1 Foreman,M; eds. (1998). Aids and Men: Taking Risks or Taking Responsibility? (London Panus/Zed

Books). Gomez,A;Meacham,D. eds. (1998) Women, Vulnerability and HIV/AIDS. A Human Rights

Perspective (Santiago, Chile: Latin America and Caribbean Women’s Health Network),vol. 2.

Glynn J.R., A. Buve, M.Carael, M.Kahindo, I.B. Macauley, R.M. Musonda, E. Jungmann,F Tembo

and L. Zekeng 2000. decreased fertility among HIV-I infected women attending antenatal clinics in three African cities. Journal of Acquired Immune Deficiency Syndromes(JAIDS) vol. 25(4); 345-352.

Gray R. H., M. J. Wawer, D. Serwadda, N. Sewankambo, C. Li, F. Wabwire – Mangen, L. Paxton, N.

Kiwanuka, G. Kigozi, J. Konde – Lule, T. C. Quinn, C. A. Gaydos and D. McNairn 1998. Population based study of fertility in women with HIV infection in Uganda. Lancet 1998. vol 351: 98 – 103.

Gregson S. 1994. Will HIV become a major determinant of fertility in Sub – Saharan Africa? The

Journal of Development Studies. Vol. 30 (3) 605 – 679.


29

Gregson S., T. Zhuwau, R. M. Anderson and S. K. Chandiwana 1997. HIV and fertility change in rural Zimbabwe. Health Transition Review vol 7 Supplement 2:89-122.

Hamblin, J.; Reid,E (1991). ‘Women, the HIV Epidemic and Human Rights: A Tragic

Imperative’.(New York:UNDP.HIV and Development Programme) : 5. Jennings,C; (1990). Understanding and Preventing AIDS: A book for Everyone.( Cambridge;MA:

Health Alert Press). Joint United Nations Progrme on HIV/AIDS (UNAIDS), ‘AIDS Epidemic Update. December 2000’(

Genrva:UNAIDS; December 2000): 3 Kamali A., L. M. Carpenter, J.A.G. Whitworth, R. Pool, A. Ruberantwari and A. Ojwiya 2000. Seven

– year trends in HIV – 1 infection rates and changes in sexual behaviour among adults in rural Uganda. AIDS vol 14 (4) 427 – 434.

Leroy V., J. Ladner, M. Nyiraziraje, A. Buzubagira, P. Van de Perre, E. Karita and F. Dabis 1998.

Effects of HIV – 1 infection on pregnancy outcome in women in Kigali, Rwanda, 1992 – 1994. AIDS vol 12 (6): 643 – 650.

Martin P. M. V., G. Gresenguet, V. M. Herve et al. 1991. Decreased number of spermatozoa in HIV –

1 infected individuals. AIDS vol 6: 130 – 131. Mukiza – Gapere J. and J. P. M. Ntozi 1995. Impact of AIDS on marriage patterns, customs and

practices in Uganda. Health Transition Review vol 5 supplement: 201 – 208. Okeibunor J. C. 1999. Threat of AIDS and condom use in a Nigerian urban community: implications

for fertility regulation in Nigeria. A study report for Union for Africa Population Studies (UAPS). Dakar, Senegal.

Population Reference Bureau (PRB). The World’s Youth 2000. (Washington: PRB, 2000): 1 Ross A., D. Morgan, R. Lubega, L. M. Carpenter, B. Mayanja and J. A. G. Whitworth 1999. Reduced

fertility associated with HIV: the contribution of pre – existing subfertility. AIDS vol 13 (15): 2133 – 2141.

Ryder R. W., V. L. Batter, M. Nsuami, N. Badi, L. Mundele, B. Mutela, M. Utshudi and W. L.

Heyward 1991. Fertility rates in 238 HIV – 1 seropositive women in Zaire followed for 3 years Postpartum. AIDS vol. 5: 1521 – 1527.

Thackway S. V., V. Furner, A. Mijch, D. A. Cooper, D..Holland, P. Martinez, D. Shaw, I. Van Beek,

E. Wright, K. Clezy and J. M. Kaldor 1997. Fertility and reproductive choice in women with HIV – 1 infection. AIDS vol 11 (5): 663 – 667.

UNAIDS, (1998). ‘ AIDS 5 years since ICPD: Emerging Issues and Challenges for Women, Young

people, and infants’, (Geneva: UNAIDS): 6. UNAIDS, Report on the Global HIV/AIDS Epidemic. June 2000(Geneva: UNAIDS, June 2000): 11 UNAIDS,December 2001, AIDS epidemic update. UNAIDS, Peter Piot intervention at the 12th International Conference on AIDS and STIs in Africa,

Ouagadougou, Burkina Faso, December 2001. UNGASS, June 2001, HIV/AIDS Fact Sheets: Global crisis-Global action.


30

UNGASS, June 2001, HIV/AIDS Fact Sheet: HIV/AIDS AND Development. United Nations (1995). Platform for Action and the Beijing Declaration. Fourth World Conference on

Women. Beijing, China.( New York: United Nations, 1996): 60. United Nations Educational, Scientific and Cultural Organisation (UNESCO) and UNAIDS. (2000).

Migrant Population and HIV/ AIDS (Geneva: UNESCO and UNAIDS): 1. World Bank Group, Press Release. (2000). ‘ AIDS Blunts Economic Growth; Worsens Poverty in

Hard-hit countries.’(Durban, 2000). WHO, Fact Sheet No. 242, ‘ Women and HIV/AIDS’ (Geneva: WHO, June 2000). World Health Organisation (WHO) (2001). Fact Sheet 6, ‘HIV/AIDS: Fear, Stigma and Isolation’. Zaba B and S. Gregson 1998. Measuring the impact of HIV on fertility in Africa. AIDS vol. 12

supplement 1: S41 – S50.

ANNEXES


32

1985 Pop % Urban Urban Rural Displaced Floating Total

Bo District 268,671 32 150 280 100 50 580

Kenema District 337,055 32 200 340 100 50 690

Port Loko District 329,344 17 100 430 100 50 680

Western Area 554,243 89 800 100 100 50 1050

Total 1,489,313 170 1,250 1,150 400 200 3,000

ENUMERATION AREAS District Urban Rural Displaced Floating Total

Bo District 7 14 5 26

Kenema District 10 17 5 32

Port Loko District 5 22 5 32

Western Area 40 5 5 50

Total 62 58 20 0 140

Distribution of Adolescents and Enumeration Areas for Sampling Frame

Annex 1


33

Technical Team

PROJECT DIRECTOR H.B.S. Kandeh Director, CSO

CENTRAL STATISTICS OFFICE

J.S. N. Pessima Asst. Project Director M.V. MacCormack Survey Co-ordinator S.A.T. Rogers Asst. Survey Co-ordinator M.G. Gegbe Supervisor P. Amara Supervisor G. Musa Supervisor M. H. Soko Supervisor UNIVERSITY OF SIERRA LEONE L. Kamara Sampling Consultant UNICEF, SIERRA LEONE

K. Wright UNICEF Senior Project Co-ordinator E. Mbayo UNICEF Project Officer P.Sengeh UNICEF Project Officer J. Pilot UNICEF Consultant

ENUMERATORS Charles B. Boye- Pyne Augustine .B.Macarthy Sheik Issa Koroma Jannie Taylor

Philip Foday Kargbo Fatmata Macarthy Mohamed Bob - Mansaray Gabriel J Jonnie Emmanuel Musa Sama Gamanga. Khadie Gamanga (Mrs) Mathew Momoh Mary Rogers (Miss) Abu Bakarr Kamara Mohamed A. Mohai Joseph Lamboi Mary Sidikie-Lahai Yandie S.K. Brima Andrew M.Saffa Henry B.W. Samu SUPERVISORS M.A.B. Gegbe P.S. Amara Malicky Soko G.B. Musa DATA ENTRY H. Sesay (CSO) Data Entry Operator C. Davies (CSO) Data Entry Operator A. Sillah (CSO) Data Entry Operator E. Bangura (CSO) Data Entry Operator O. Allieu (CSO) Data Entry Operator DATA EDITING G. Katta (CSO) Editor P. Macauley (CSO) Editor


34

001 QUESTIONNAIRE IDENTIFICATION NUMBER |___|___|___| 002 REGION……………………………………. 003 DISTRICT…………………………………… 004 LOCALITY………………………………….. 005 HOUSEHOLD NUMBER …………………… HOUSEHOLD LISTING

Age Group Total Male Female 0-4 5-11 12-21 22+

TOTAL Introduction: “My name is…………………………….. I’m working for the Central Statistics Office… We’re interviewing people here in [name of district/town] in order to find out about…[describe purpose of study]. Have you been interviewed in the past few weeks [or other appropriate time period] for this study? IF THE RESPONDENT HAS BEEN INTERVIEWED BEFORE DURING THIS ROUND OF KAP, DO NOT INTERVIEW T HIS PERSON AGAIN. Tell them you cannot interview them a second time, thank them, and end the interview. If they have not been interviewed before, continue: Confidentiality and consent: “I’m going to ask you some very personal questions that some people find difficult to answer. Your answers are completely confidential. Your name will not be written on this form, and will never be used in connection with any of the information you tell me. You do not have to answer any questions that you do not want to answer, and you may end this interview at any time you want to. However, your honest answers to these questions will help us better understand what people think, say and do about certain kinds of behaviours. We would greatly appreciate your help in responding to this survey. The survey will take about XX minutes to ask the questions. Would you be willing to participate?”

___________________________________________________________

(Signature of interviewer certifying that informed consent has been given verbally by respondent) Interviewer visit

Visit 1 Visit 2 Visit 3 Date Interviewer Result Result codes: Completed 1; Respondent not available 2; Refused 3; partially completed 4; Other 5. 005 INTERVIEWERS: Code [____|____] Name__________________________ 006 DATE INTERVIEW: __\ ____ \ _____

Sierra Leone Adolescents Knowledge, Attitude and Practice (KAP) Survey 2001

Annex 1I


35

CHECKED BY SUPERVISOR: Signature ____________________ Date ___________ SIERRA LEONE ADOLESCENTS KNOWLEDGE, ATTITUDE AND PR ACTICE (KAP)

SURVEY 2001

Section 1: Background characteristics THIS SURVEY ONLY INTERVIEWS ADOLESCENTS AGED 12—21YE ARS OLD. NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

TO Q 01

RECORD SEX OF THE RESPONDENT

MALE 1

FEMALE 2

Q 02

In what month and year were you born?

MONTH [__|__] DON’T KNOW MONTH 8

NO RESPONSE 9

YEAR [__|__] DON’T KNOW YEAR 8

NO RESPONSE 9

Q 03

How old were you at your last birthday? (Compare and correct Q 02 if needed)

AGE IN COMPLETED YEARS [__|__]

MUST BE BETWEEN 12 AND 21 YRS OLD

DON’T KNOW 8 NO RESPONSE 9

ESTIMATE BEST ANSWER

Q 04

Have you ever attended school?

YES 1 NO 2

NO RESPONSE 9

→→→→ Q 8

Q 05

What is the highest level of school you completed: primary, secondary or higher?

CIRCLE ONE

(List locally appropriate categories) PRIMARY 1

SECONDARY 2 HIGHER 3

NO RESPONSE 9

Q 06

How many total years of education have you completed up to now?

# YEARS COMPLETED [__|__]

NO RESPONSE 9

Q 07 Can you read, write and speak in English YES 1 NO 2

NO RESPONSE 9

Q 08

Do you work to earn money for yourself?

YES 1 NO 2

NO RESPONSE 9

→→→→Q 10

Q 09

What do you do to earn money?

MULTIPLE ANSWERS ARE POSSIBLE.

YES NO

BUSINESS 1 2 FARMING 1 2 CIVIL SERVANT 1 2 SELF EMPLOYED 1 2

NO RESPONSE 1 2 OTHER (SPECIFY)…………………15


36

Q 10

How long have you lived here in (NAME OF COMMUNITY/TOWN NEIGHBORHOOD/ VILLAGE)?

NUMBER OF YEARS [__|__]

RECORD 00 IF LESS THAN 1 YEAR DON’T KNOW 8

NO RESPONSE 9

Q 11

What religion are you?

CIRCLE ONE

CHRISTIAN 1 MUSLIM 2

BAHAI 3

OTHER 4 NO RELIGION 5 DON’T KNOW 8 NO RESPONSE 9


37

SIERRA LEONE ADOLESCENTS KNOWLEDGE, ATTITUDE AND PR ACTICE (KAP) SURVEY 2001

Section 1: Background Characteristics

NO.

QUESTIONS AND FILTERS CODING CATEGORIES SKIP TO

Q 12

To which ethnic group do you belong? CIRCLE ONE

MENDE 1 TEMNE 2 LIMBA 3 LOKO 4 FULA 5

CREOLE 6 NO RESPONSE 9

OTHER …………………………………. 15

Q 13

Do you live:

ALONE 1 WITH FAMILY/ RELATIVES 2

WITH EMPLOYER 3 WITH SEXUAL PARTNER 4

WITH FRIENDS/COWORKERS/STUDENTS 5 NO FIXED ABODE /HOME 6

NO RESPONSE 9 OTHER ……………………………………..15

Q 14

During the last 4 weeks how often have you had drinks containing alcohol? Would you say………….READ OUT

CIRCLE ONE

EVERY DAY 1 AT LEAST ONCE A WEEK 2

LESS THAN ONCE A WEEK 3

DOES NOT DRINK 4 DON’T KNOW 8 NO RESPONSE 9

Q 15

Some people have tried a range of different types of drugs. Which of the following, if any, have you tried?

READ LIST

YES NO DK NR MARIJUANA 1 2 8 9

BROWN BROWN 1 2 8 9 COCAINE 1 2 8 9

CRACK 1 2 8 9 CAPSULE 1 2 8 9

Q 16

Some people have tried injecting drugs using a syringe. Have you injected drugs in the last 12 months? DRUGS INJECTED FOR MEDICAL PURPOSES OR TREATMENT OF AN ILLNESS DO NOT COUNT

YES 1 NO 2



38

SIERRA LEONE ADOLESCENTS KNOWLEDGE, ATTITUDE AND PR ACTICE (KAP)

SURVEY 2001

Section 2: Sexual History: Numbers and Types of Partners Now I am going to ask you some personal questions about sex. Remember we are asking these questions to learn more about how young people like yourself feel, in order to help you make your life safer. We know that some young people have had sexual intercourse and some have sexual intercourse with more than one person. Please answer the following questions honestly. Remember, your name is not written on this questionnaire. NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP TO Q 17

Have you ever had sexual intercourse? [For the purposes of this survey, “sexual intercourse,” is defined as vaginal or anal penetrative sexual intercourse.]

YES 1 NO 2

NO RESPONSE 9

→→→→Q 23 →→→→Q 23

Q 18

At what age did you first have sexual intercourse? RECORD IN COMPLETED YEARS

AGE IN YEARS [__|__]

DON’T’ KNOW 8 NO RESPONSE 9

Q 19

How much older or younger was the person with whom you had your first sexual experience? READ OUT ANSWERS:

MORE THAN 10 YRS OLDER 1 5 - 10 YRS OLDER 2

LESS THAN 5 YRS OLDER 3 YOUNGER 4


Q 20

Was a condom used during this first time you had sexual intercourse?

YES 1 NO 2


Q 21

Have you had sexual intercourse in the last 12 months?

YES 1 NO 2

NO RESPONSE 9

→→→→Q 23

Q 22

How many sexual partners have you had in the last one-month?

ONE 1 TWO 2

THREE 3 MORE THAN THREE 4



39


Section 3: STIs/ STDs

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP TO Q 23

Have you ever heard of diseases that can be transmitted through sexual intercourse?

YES 1 NO 2

NO RESPONSE 9

→→→→Q28 →→→→Q28

Q 24

Can you describe any symptoms of STIs/STDs? Any others? DO NOT READ OUT THE SYMPTOMS CIRCLE 1 FOR ALL MENTIONED. CIRCLE 2 FOR ALL NOT MENTIONED. MORE THAN ONE ANSWER IS POSSIBLE.

Yes No

ABDOMINAL PAIN 1 2

GENITAL DISCHARGE 1 2

FOUL SMELLING DISCHARGE 1 2

BURNING PAIN ON URINATION 1 2

GENITAL ULCERS/SORES 1 2

SWELLINGS IN GROIN AREA 1 2

ITCHING 1 2

DON’T KNOW 8

NO RESPONSE 9

OTHER _________________________15

Q 25

Name two types of sexually Transmitted Infections (STIs) in your community. (CIRCLE ANY TWO)

SYPHILIS 1

GONORRHOEA 2 HERPES 3

CHLAMYDIA 4 TRICHOMONAS 5

HIV/AIDS 6 DON’T KNOW 8 NO REPSONSE 9

Q 26

Have you contracted any STI/STD?

YES 1 NO 2


Q 27

If you contract a STI what would you

do?

GO TO HOSPITAL/ HEALTH CENTRE 1

SELF TREATMENT 2 HERBALIST 3


OTHER …………………………… 15


40


Section 4: KNOWLEDGE

NO.

QUESTIONS AND FILTERS

CODING CATEGORIES SKIP TO

Q 28

Have you ever heard of HIV or the disease called AIDS?

YES 1 NO 2

NO RESPONSE 9

��Q 53

Q 29

From which source did you first hear of, or know about HIV/AIDS?

MASS MEDIA 1

TEACHER 2 PARENTS 3

PEERS 4 SEXUAL PARTNER 5


OTHER (SPECIFY)…………….. 15

Q 30

What is the difference between HIV and AIDS?

HIV IS THE INFECTION AND 1

AIDS IS THE DISEASE

NO DIFFERENCE 2

HIV IS THE DISEASE AND 3 AIDS IS THE INFECTION


Q 31

Do you know anyone who is infected with HIV or has AIDS?

YES 1 NO 2


Q 32

Do you know anyone who has died of AIDS?

YES 1 NO 2



41



NO.

QUESTIONS AND FILTERS

CODING CATEGORIES SKIP TO

Q 33

Do you have a close relative or close friend who is infected with HIV or has died of AIDS?

YES, A CLOSE RELATIVE 1 YES, A CLOSE FRIEND 2

NO 3 DON’T KNOW 8 NO RESPONSE 9

Q 34

Can people protect themselves from HIV, the virus that causes AIDS by using a condom correctly every time they have sex?

YES 1 NO 2


Q 35 Do you know that HIV/AIDS can affect any one?

YES 1 NO 2


Q 36 Can a healthy looking person carry the HIV virus?

YES 1 NO 2


Q 37 Can a pregnant woman infected with HIV or AIDS transmit the virus to her unborn child?

YES 1 NO 2


Q 38 Can HIV be transmitted from one person to another through blood transfusion?

YES 1 NO 2


Q 39

Can a person get HIV by getting injections with a needle that was already used by someone else?

YES 1 NO 2


Q 40

Do you think a person can get infected with the AIDS virus through supernatural means

YES 1 NO 2


Q 41 Can mosquitoes transfer AIDS from one person to another by biting an infected person and then going to bite an uninfected person?

YES 1 NO 2


Q 42

Can people protect themselves from getting infected with the AIDS virus by having one uninfected sex partner who also has no other partner?

YES 1 NO 2


Q 43

Can people protect themselves from getting infected with the AIDS virus by not having sex at all?

YES 1 NO 2



42

SIERRA LEONE ADOLESCENTS KNOWLEDGE ATTITUDE AND PRA CTICE (KAP) SURVEY 2001

Section 4: Knwledge

Q 44

What can a pregnant woman do to reduce the risk of transmission of HIV to her unborn child? DO NOT READ LIST CIRCLE ALL THAT ARE MENTIONED.

TAKE MEDICATION 1

HAVE AN ABORTION 2 SEEK MEDICAL ADVICE 3

SEE A TRADITIONAL HEALER 4 DON’T KNOW 8 NO RESPONSE 9

OTHER ………………………….15

Q 45

Can a woman with HIV or AIDS transmit the virus to her newborn child through breastfeeding?

YES 1 NO 2


Q 46

Is it possible in your community for someone to get a confidential test to find out if they are infected with HIV? By confidential, I mean that no one will know the result if you don’t want them to know it.

YES 1 NO 2


Q 47

I don’t want to know the result, but have you ever had an HIV test?

YES 1 NO 2


→→→→Q 51 →→→→Q 51

Q 48

Did you voluntarily undergo the HIV test, or were you required to have the test?

VOLUNTARY 1

REQUIRED 2 DON’T KNOW 8 NO RESPONSE 9

Q 49

Please do not tell me the result, but did you find out the result of your test?

YES 1 NO 2


Q 50

When did you have your most recent HIV test?

WITHIN THE PAST 3 MONTHS 1 BETWEEN 3 - 6 MONTHS 2 BETWEEN 6 - 4 MONTHS 3

MORE THAN A YEAR AGO 4 DON’T KNOW 8 NO RESPONSE 9

Q 51

What sexual behaviour do you think promotes HIV/AIDS?

(CIRCLE ALL ANSWERS GIVEN)

HAVING TOO MANY PARTNERS 1

UNPROTECTED SEX 2 ANAL SEX 3


YES 1

NO.



43

Q 52 Do you know where one can be tested for HIV infection?

NO 2 DON’T KNOW 8 NO RESPONSE 9

Q 53

Would you like to be tested for HIV infection

YES 1 NO 2


→→→→Q 55 →→→→Q 57 →→→→Q 57


44



NO. QUESTIONS AND

FILTERS CODING CATEGORIES SKIP

TO

Q 54

Why would you like to be tested?

WANTING TO BE TREATED 1

JUST TO KNOW 2 SO I DON’T PASS IT TO OTHERS 3


OTHER ………………………………15

→→→→Q 56 →→→→Q56 →→→→Q 56

Q 55

Why would you not want to be tested?

DON’T WANT TO KNOW 1 FEAR OF STIGMATISATION/REJECTION 2

FEAR OF COPING WITH BEING HIV POSITIVE 3 IT DOES NOT HELP (NO CURE) 4

IT DESTROYS RELATIONSHIPS 5 NEVER HAD SEX 6


Q 56

Under what conditions would you consider getting tested?

IF THERE IS COUNSELLING 1 IF THERE IS SOME MEDICAL THERAPY 2

IF IT IS CONFIDENTIAL 3 IF IT THERE IS NO NEGATIVE IMPACT ON MY LIFE 4

WHEN GETTING MARRIED 5 BEFORE HAVING SEX WITH PARTNER 6

WHEN PARTNER IS UNFAITHFUL 7 DON’T KNOW 8 NO RESPONSE 9

OTHER………………..………………..15

Q 57

Do you think people should be tested for HIV before marriage?

YES 1 NO 2


Q 58

Do you think it will help if an HIV/AIDS counselling and testing service was set up in this area?

YES 1 NO 2

ALREADY THERE 3

Q 59

Do you think it will be important for people to know their HIV status?

YES 1 NO 2


Q 60

Why is it necessary for adolescents to know their HIV status?

SO THEY DO NOT INFECT OTHER PEOPLE 1 SO THEY CAN GET TREATMENT 2

JUST TO KNOW 3 SO THEY CAN MAKE PLANS FOR THEIR FUTURE 4

NO RESPONSE 9 DON’T KNOW 8

OTHER-----------------------------------------15


45

IERRA LEONE ADOLESCENTS KNOWLEDGE, ATTITUDE AND PRA CTICE (KAP) SURVEY 2001

Section 5: ATTITUDE

NO.


Q 61

How do you feel about people with

HIV/AIDS?

SYMPATHIZE 1 THEY DESERVE IT 2

NOTHING 3 THEY ARE IMMORAL 4

HELPLESS 5 DON’T KNOW 8 NO RESPONSE 9

OTHER--------------------------------15

Q 62

Should people with AIDS be discriminated against?

YES 1 NO 2


Q 63

If a worker/teacher is HIV infected but not sick should he/she be allowed to continue working?

YES 1 NO 2


Q 64

If a shopkeeper or food seller has HIV or AIDS would you buy food from him/her?

YES 1 NO 2


Q 65

Can a person get HIV by sharing a meal with someone who is infected?

YES 1 NO 2


Q 66

Would you be willing to share a meal with a person you know had HIV or AIDS?

YES 1 NO 2


Q 67

If a male relative of yours became ill with HIV, the virus that causes AIDS, would you be willing to care for him in your household?

YES 1 NO 2


Q 68

If a student has HIV but is not sick, should he/she be allowed to continue attending school?

YES 1 NO 2


Q 69

If a female relative of yours became ill with HIV, the virus that causes AIDS, would you be willing to care for her in your household?

YES 1 NO 2


Q 70

If a member of your family became ill with HIV, the virus that causes AIDS, would you want it to remain secret?

YES 1 NO 2



46

SIERRA LEONE ADOLESCENTS KNOWLEDGE, ATTITUDE AND PR ACTICE (KAP) SURVEY

2001

Section 5: ATTITUDE NO.


Q 71

What can result from a sexual encounter?

YES NO

GETTING A STIs 1 2

GETTING HIVAIDS 1 2

FEELING OF REGRET 1 2

PREGNANCY 1 2

FEELING PROUD 1 2


OTHER (SPECIFY)-------------------- 15

Q 72

How can adolescent girls/boys prevent unwanted pregnancies?

BY USING CONDOMS 1 BY USING FAMILY 2

PLANNING PILLS ABSTAINING FROM SEX 3 DON’T KNOW 8 NO RESPONSE 9

OTHER (SPECIFY)--------------------15

Q 73

Do you consider yourself at risk of the following? READ EACH ONE OUT AND CIRCLE ONE FOR YES AND TWO FOR NO.

YES NO

( F) GETTING PREGNANT 1

2

(M) MAKING A GIRL PREGNANT

1 2

GETTING HIV/AIDS 1 2

GETTING STIs 1 2 SEXUAL ABUSE 1 2

Q 74 Have you ever heard of a condom? (Show sample of one) (I mean a rubber object that a man puts on his penis before sex)

YES 1 NO 2


Q 75 Has your sexual partner ever used a condom? (Show picture or sample of one.) (I mean a rubber object that a man puts on his penis before sex.)

YES 1 NO 2



47

Q 76 Do you know where one can get (or buy) condoms?

YES 1 NO 2

NO RESPONSE 9

Q 77

Do you use condoms for sex?

YES 1 NO 2

NO RESPONSE 9

→→→→Q79

Q 78

Why don’t you use condoms for sex?

PARTNER DOES NOT LIKE IT 1 REDUCES MY SATISFACTION 2

IT FASTENS AFTER USE 3 NOT AVAILABLE IN COMMUNITY

4 EXPENSIVE 5 DON’T KNOW 8 NO RESPONSE 9

OTHER ……………………….15

Q 79

Do you insist on the use of condoms each time you have sex?

YES 1 NO 2

NO RESPONSE 9


48


Section 5: ATTITUDE

NO.


Q 80

Do you consider HIV/AIDS a big threat to

youths in your community

YES 1 NO 2


Q 81

Do you discuss HIV/AIDS and RH issues

with your parents/guardians/teachers?

YES 1 NO 2

NO RESPONSE 9

Q 82

Do you discuss HIV/AIDS issues with your friends (Peers)?

YES 1 NO 2

NO RESPONSE 9

Q 83

Do you talk to your sexual partner about HIV/AIDS?

YES 1 NO 2

NO RESPONSE 9

Q 84

Are you willing to change your sexual practices in order to avoid HIV/AIDS?

YES 1 NO 2


Q 85

Do you take the necessary care/ prevention when using blades/knives/shooting needles?

YES 1 NO 2


Q 86

Do you believe that there is HIV/AIDS in

Sierra Leone?

YES 1 NO 2



49


Section 6: ACCESS TO MEDIA AND ACCEPTANCE OF MESSAGE

NO.


6.1 ELECTRONIC MEDIA Q 87

Do you have access to a radio?

YES 1 NO 2

NO RESPONSE 9

Q 88 Do you have access to Television? YES 1 NO 2

NO RESPONSE 9

Q 89 Do you visit a Video house/ cinema house? YES 1 NO 2

NO RESPONSE 9

Q 90 How often do you visit the Video house/ cinema house to watch tapes/cassette?

DAILY 1 WEEKLY 2

MONTHLY 3 SELDOM 4


OTHER………………………. 15

6.2 PRINT MEDIA Q 91

Do you read local newspapers? YES 1 NO 2

NO RESPONSE 9

Q 92

Do you read magazines? YES 1 NO 2

NO RESPONSE 9

Q 93

Do you have access to materials such as, leaflets, flyers, posters and books on HIV/AIDS?

YES 1 NO 2

NO RESPONSE 9

6.3 OTHER MEDIA

Q 94 Do you belong to any social group/youth group/peer group/health club in this community?

YES 1 NO 2

NO RESPONSE 9

Q 95

Are there drama groups/theatre in your community?

YES 1 NO 2


Q 96

Do you attend drama/theatre, folk theatre, street plays?

YES 1 NO 2

NO RESPONSE 9

Q 97

How often do you watch plays/concerts?

WEEKLY 1 MONTHLY 2

SELDOM 3 DON’T KNOW 8 NO RESPONSE 9

OTHER…………………………… 15

Q 98 Have you ever watched a play with HIV theme?

YES 1 NO 2

NO RESPONSE 9


50


Section 6: ACCESS TO MEDIA AND ACCEPTANCE OF MESSAGE

NO.


Q 99

Do you listen to sermons/speeches in your church, Mosque or place of worship?

YES 1 NO 2

NO RESPONSE 9

Q 100

Do you accept messages you get from sermons at your place(s) of worship?

YES 1 NO 2

NO RESPONSE 9

Q 101

Have you ever listened to HIV related sermons?

YES 1 NO 2

NO RESPONSE 9

Q 102

How often do you listen to such sermons/speeches?

DAILY 1 ONCE A WEEK 2

MONTHLY 3 DON’T KNOW 8 NO RESPONSE 9

Q 103

Which religious body do you get your messages from?

CHURCH 1 MOSQUE 2

NO RESPONSE 9

Q 104

Which source do you prefer to get information on

HIV/AIDS from?

RADIO 1 TELEVISION 2

NEWSPAPER 3 STICKERS 4 THEATRE 5

NO RESPONSE 9 OTHER………………………….15


51


SECTION 7: ACCEPTANCE/ CREDIBILITY

NO.


Q 105 Which radio station do you like to listen to?

(CIRCLE ALL THE OPTIONS MENTIONED)

SLBS FM 99.9 1 FM 98.1D 2

BBC 24 HRS FM 94.3 3 VOH FM 96.2 4

UNAMSIL FM 103 5 BO KISS 104 6

KENEMA FM 96.5 7 BBNFM 93 10

RFI FM 89.9 11 BBC DIRECT 12

BFBS 13 OTHER ------------------------15

Q 106

At what time(s) do you listen to radio? (CIRCLE ALL THE OPTIONS MENTIONED)

6 - 9 A.M 1 9 - 12 A.M 2 12 - 3 P.M 3 3 - 6 P.M 4 6 - 9 P.M 5

10 P.M ONWARDS 6

Q 107

During the last 4 weeks, how often have you listened to the radio?

EVERYDAY 1 AT LEAST ONCE A WEEK 2 LESS THAN ONCE A WEEK 3 DID NOT LISTEN TO RADIO 4 IN LAST 4 WEEKS


OTHER ...………………. 15

Q 108

Do you think that the messages/discussions aired on the radio you listen to are credible?

YES 1 NO 2

NO RESPONSE 9

Q 109

Do you watch television?

YES 1 NO 2

NO RESPONSE 9

→→→→Q 113

Q 110

Which TV station do you like to watch? (CIRCLE ALL THE OPTIONS MENTIONED)

SLBS TV 1 BFBS 2 CNN 3

GUINEA TV 4


52


SECTION 7: ACCEPTANCE/ CREDIBILITY

NO.


Q 111

During the last 4 weeks, how often have you

watched the SLBS TV?

EVERYDAY 1

AT LEAST ONCE A WEEK 2

LESS THAN ONCE A WEEK 3

DID NOT WATCH TV IN LAST 4

FOUR WEEKS

SELDOMLY 5

DON’T KNOW 8

NO RESPONSE 9

Q 112

What is your most favoured

programme/insertion on SLBS TV?

YOUTH IN PERSPECTIVE 1

MUSICAL MIX 2

WAN POT 3

MEMORY LANE 4

HEALTH WAYS 5

DON’T KNOW 8

NO RESPONSE 9

OTHER ………………... …… 15

Q 113

Do you always accept inserted messages on

the Videotapes you watch?

YES 1 NO 2

NO RESPONSE 9

Q 114

What is the source of the messages you

believe best?

DRAMA GROUP 1

STREET THEATRE 2

PEER GROUP 3

RADIO 4

TELEVISION 5

NEWSPAPER 6

CHURCH/MOSQUE SERMON 7

DON’T KNOW 8

NO RESPONSE 9


53

TABLES


54

Table 4.1.1 Age at Last Birthday

12-13

Yrs 14-15 Yrs

16-17 Yrs

18-19 Yrs

20-21 Yrs

Don’t Know

Total

Bo 14.0 23.1 18.4 19.2 17.9 7.4 571 Kenema 14.7 19.2 17.0 16.5 15.5 17.0 707 Port Loko 25.8 21.0 17.8 14.8 14.8 5.8 690 Western Area

12.2 18.2 22.4 22.4 20.5 4.3 1051

Urban 12.6 19.8 21.7 22.1 19.1 4.8 1236 Rural 19.9 19.4 17.7 13.4 17.1 11.4 1280 IDP Camp 20.9 25.3 16.4 17.7 9.9 9.9 312 Floating 7.9 17.3 18.8 27.7 22.5 5.8 191 Male 15.3 20.3 19.2 19.7 18.3 7.1 1499 Female 17.1 19.8 19.4 17.7 16.8 9.3 1520 ALL 13.3 20.0 19.3 18.7 17.5 8.2 3019

Table 4.1.2 Educational Characteristics

Level of Completed Schooling

Ever Attended School

Primary

Secondary

None

Literate

in English Bo 66.5 26.3 0.9 72.9 41.3 Kenema 46.1 23.8 1.0 75.2 27.0 Port Loko 48.4 20.7 2.6 76.7 26.2 Western Area

79.3 57.8 6.5 35.5 63.7

Urban 79.4 57.1 6.1 36.7 64.6 Rural 46.0 18.7 1.0 80.2 22.3 IDP Camp 62.5 19.9 80.1 39.1 Floating 56.5 32.5 5.2 62.3 36.6 Male 67.2 37.2 3.3 59.4 46.4 Female 57.0 33.6 3.2 63.1 38.2 ALL 62.0 35.4 3.2 61.3 42.3


55

Table 4.1.3

Income Earning Status, Religion And Ethnicity

Income earning Status

Religion

Ethnicity

Yes Christian Muslim Mende Temne Limba Loko Fula Creole Other

AREA

Bo 49.2 47.3 51.7 67.8 6.8 2.8 1.2 1.4 0.4 19.6 Kenema 40.0 15.7 81.5 83.7 5.8 1.3 1.0 1.1 - 7.1 Port Loko 33.6 14.1 83.8 3.2 83.2 2.5 2.2 1.7 0.1 7.1 Western Area

26.6 45.6 53.9 14.9 34.1 12.4 6.0 4.9 7.6 20.2

TYPE

Urban 24.8 40.2 59.5 29.9 30.0 9.9 3.4 4.5 5.8 16.5 Rural 42.7 22.0 76.5 49.5 36.8 2.7 2.7 1.0 0.9 6.4 IDP Camp 29.8 34.9 64.7 30.1 32.4 1.3 1.0 1.3 - 34.0 Floating 68.1 36.1 51.8 31.9 36.1 5.8 6.8 3.1 - 16.2

SEX

Male 38.4 29.6 68.8 37.2 35.2 5.9 3.1 2.1 2.7 13.9 Female 32.9 33.8 64.7 39.5 31.9 5.5 3.0 3.2 2.8 14.1

ALL 35.6 31.7 66.7 38.4 33.5 5.7 3.0 2.6 2.7 14.0

Table 4.1.4 Living Arrangements

Location

Alone Family Relatives

Employer Sexual Partner

Friends No Fixed Abode

Other

AREA Bo 4.9 75.7 1.9 9.8 3.5 2.6 1.6 Kenema 1.0 70.9 3.4 16.5 1.4 6.1 0.1 Port Loko 1.7 83.8 0.4 8.1 2.5 2.3 0.7 Western Area 1.7 89.5 0.9 3.2 1.5 2.6 0.4

TYPE Urban 0.7 91.8 1.6 4.0 1.1 0.2 0.4 Rural 0.5 80.8 2.0 13.8 2.0 0.3 0.6 IDP Camp 0.3 87.8 10.6 0.6 0.6 Floating 25.7 4.7 0.5 1.6 11.5 49.2 2.1

SEX Male 3.5 83.2 2.8 1.8 3.3 4.5 0.7 Female 0.9 79.3 0.3 15.5 0.9 2.2 0.5

ALL 2.2 81.2 1.6 8.7 2.1 3.3 0.6


56

Table 4.1.5 Alcohol Consumption and Drug use

Alcohol Consumption Drug Use

Every Day

Weekly

Less than once a week

Don’t Drink

Other Tried Marijuana

Drug Injection


TYPE Urban 1.0 3.5 2.5 89.1 4.0 2.9 0.7 Rural 2.5 4.7 2.1 89.1 1.7 3.9 0.2 IDP Camp 1.9 2.2 1.0 93.6 1.3 3.8 Floating 35.6 16.2 4.7 41.9 1.5 53.4 6.3

SEX Male 5.9 5.4 2.6 84.2 1.7 9.9 1.0 Female 2.0 3.9 2.0 88.9 3.2 3.4 0.6

ALL 3.9 4.7 2.3 86.6 2.6 6.6 0.8


57

Table 4.2. 1 Sexual History

Ever

Had Sex

Condom Use

During First Sex

Sex in Last

Twelve Months

Sexual Partners in Last One Month

1 2 3 3+ Don’t know

No Response

AREA Bo 58.5 2.8 48.5 27.3 12.4 4.2 3.9 0.5 51.7 Kenema 59.8 2.4 50.8 34.1 10.6 3.7 2.0 0.6 48.4 Port Loko 49.9 2.3 37.7 22.5 7.0 4.6 3.3 0.3 62.3 Western Area

60.9 5.9 43.0 31.5 5.5 2.1 2.7 0.1 57.9

TYPE Urban 58.4 5.7 42.2 30.7 7.0 2.0 1.9 0.1 58.3 Rural 56.3 2.2 45.2 31.5 8.5 3.0 1.8 0.2 54.7 IDP Camp 46.8 1.0 36.5 24.4 6.7 2.9 1.3 0.3 63.8 Floating 79.6 4.7 69.6 12.6 18.8 16.2 19.4 3.1 29.8

SEX Male 56.4 3.1 42.6 22.7 9.9 4.8 4.5 0.2 57.7 Female 58.9 4.2 46.7 35.7 6.8 2.1 1.3 0.5 53.4

ALL 57.7 3.7 44.7 29.2 8.3 3.4 2.9 0.3 55.5

Table 4.2.2 Age at First Sexual Intercourse

10-11

Yrs 12-13 Yrs

14-15 Yrs

16-17 Yrs

18-19 Yrs

20-21 Yrs

Don’t Know

No Response

AREA Bo 3.3 6.5 21.8 13.0 4.5 0.7 8.2 41.2 Kenema 3.8 13.8 19.1 11.4 5.2 0.4 5.9 40.3 Port Loko 4.4 10.0 18.7 5.4 2.3 0.4 9.0 49.9 Western Area 2.7 5.9 18.0 19.8 8.8 0.9 5.8 38.2

TYPE Urban 2.6 6.0 17.9 18.4 8.3 0.7 5.3 40.6 Rural 4.0 10.0 18.7 9.7 3.9 0.5 8.5 43.8 IDP Camp 4.3 10.2 16.0 7.7 2.9 0.6 5.1 52.9 Floating 6.3 16.8 35.1 5.7 4.7 0.5 11.0 19.9

SEX Male 4.0 8.8 18.9 11.5 5.9 0.9 6.9 43.2 Female 3.3 8.8 19.4 14.9 2.2 0.4 7.1 40.7

ALL 3.6 8.8 19.1 13.3 2.7 0.6 7.0 41.9


58

Table 4.2.2a Age at First Sexual Intercourse; Males

Current Age 10 11 12 13

14

15 16

17 18 19 20 Don’t Know

No N

12 2.0 3.9 1.0 93.1 102 13 0.8 0.8 3.9 2.3 4.7 87.5 128 14 4.1 1.4 5.4 7.5 4.1 6.8 70.7 147 15 3.8 1.3 7.0 4.5 6.4 8.3 8.9 59.9 157 16 3.3 1.3 5.9 7.9 16.4 10.5 5.9 8.6 40.1 152 17 3.6 0.7 5.8 2.2 18.2 19.0 15.3 2.2 4.4 28.5 137 18 3.5 0.7 3.5 4.2 14.8 18.3 15.5 11.3 3.5 7.0 17.6 142 19 4.6 2.6 2.0 5.2 4.6 14.4 12.4 11.1 11.1 5.9 8.5 17.6 153 20 2.9 0.7 5.7 3.6 3.6 17.9 10.7 12.1 12.1 7.9 3.6 5.0 14.3 140 21 0.7 1.5 4.4 5.9 9.6 23.7 9.6 10.4 9.6 8.1 5.9 7.4 3.0 135 Don’t Know 0.9 1.9 3.8 4.7 0.9 1.9 0.9 1.9 20.8 62.3 106 ALL 43 16 67 65 116 165 100 69 53 33 13 112 647 1499 2.9 1.1 4.5 4.3 7.7 11.0 6.7 4.6 3.5 2.2 0.9 7.5 43.2

Table 4.2.2b Age at First Sexual Intercourse; Females

Current

Age

10

11

12

13

14

15

16

17

18

19

20

Don’t Know

NO

N

12 3.3 3.3 2.4 0.8 90.2 123 13 1.5 0.7 2.2 2.9 2.9 89.8 137 14 3.0 2.2 6.7 5.9 5.2 6.6 70.4 135 15 1.8 3.6 6.1 10.3 9.1 9.7 5.4 53.9 165 16 3.3 2.0 5.3 6.7 16.7 16.0 6.7 8.7 34.7 150 17 0.7 0.7 3.5 5.6 12.5 20.8 16.7 8.3 8.4 22.9 144 18 2.2 2.9 2.2 9.6 8.8 15.4 16.2 15.4 6.6 7.4 13.2 136 19 1.5 1.5 3.7 14.9 13.4 19.4 21.6 6.0 4.5 5.2 8.2 134 20 5.4 3.0 13.9 21.7 17.5 11.4 12.0 7.2 1.2 3.0 3.6 166 21 1.1 1.1 2.2 6.7 7.9 9.0 14.6 14.6 19.1 9.0 4.5 7.9 2.2 89 Don’t Know

0.7 0.7 0.7 2.1 4.3 4.3 2.8 2.1 0.7 26.2 55.3 141

ALL 26 24 55 79 133 159 128 97 54 27 6 114 618 1520 1.7 1.6 3.6 5.2 8.8 10.5 8.4 6.4 3.6 1.8 0.4 7.5 40.7

Male = 1499 Female =1520


59

Table 4.2.3 Age Status of First Sexual Partner

10+

Years Older

5-10 Years Older

0-4 Years Older

Younger

Don’t Know

No

Response

Other AREA Bo 3.2 8.9 27.1 14.7 3.2 42.9 -

Kenema 7.5 7.1 24.9 15.1 3.5 40.1 0.8 Port Loko 1.3 8.4 18.6 12.8 5.7 53.0 0.3 Western Area 4.9 9.0 26.7 12.1 3.8 43.2 0.3

TYPE Urban 4.6 8.3 26.5 10.4 4.0 45.6 0.6 Rural 3.8 8.1 23.2 15.2 4.3 45.2 0.2 IDP Camp 4.5 7.7 21.2 9.0 1.9 55.1 0.6 Floating 5.8 12.6 25.7 28.3 5.8 22.0 -

SEX Male 2.6 3.9 19.8 22.9 3.3 46.8 2.3 Female 6.1 12.8 29.1 4.1 4.7 43.0 1.8

ALL 4.3 8.4 24.5 13.4 4.0 44.9 2.1


60

Table 4.3.1 Knowledge of STDs and STIs

Knowledge of

STIs

Knows at least one type of STI

Syphilis

Gonorrhoea HIV AIDS

AREA Bo 56.4 7.0 38.0 3.9 Kenema 50.6 14.3 31.0 2.0 Port Loko 36.8 6.4 20.3 2.8 Western Area 74.3 14.4 44.4 5.9

TYPE Urban 68.4 13.8 42.0 5.2 Rural 44.4 6.9 27.2 2.7 IDP Camp 50.0 9.0 28.8 5.1 Floating 75.9 25.7 45.0 1.0

SEX Male 58.3 11.2 36.4 3.9 Female 55.3 11.1 32.7 3.8

ALL 56.8 11.1 34.5 3.9

Table 4.3.2 Contraction of STIs

Contraction of

STI Status Action if Contracts STI

Yes No Response

Go to hosp or h/centre

Self T/ment

Herbalist D/ Know

No response

Other

AREA Bo 13.0 42.4 46.4 6.8 2.3 1.8 42.2 0.5 Kenema 5.8 47.8 43.1 4.4 2.4 2.0 47.9 0.1 Port Loko 7.5 61.9 23.0 6.1 3.6 4.5 61.7 1.0 Western Area 8.8 25.4 67.8 2.4 0.7 2.9 25.2 1.0

TYPE Urban 8.7 31.0 60.7 3.7 0.6 2.9 31.0 1.1 Rural 6.3 54.5 34.3 4.5 3.5 3.0 54.4 0.4 IDP Camp 3.8 48.4 42.0 4.5 2.6 2.9 47.8 0.3 Floating 31.4 22.5 63.9 10.5 1.0 1.0 22.5 1.0

SEX Male 11.3 40.4 47.8 5.6 2.6 2.6 40.5 0.9 Female 6.0 43.9 47.8 3.5 1.5 3.0 43.7 0.5

ALL 8.6 42.2 47.8 4.5 2.1 2.8 42.1 0.7


61

Table 4.4.1 Knowledge about HIV AIDS

Ever

Heard of HIV AIDS

Source of Information about HIV/AIDS

Mass Media

Teacher Parents Peers Sexual Partner

Other


TYPE Urban 84.8 54.5 12.5 2.6 8.4 0.3 5.7 Rural 58.8 36.9 2.1 2.8 9.0 0.6 6.2 IDP Camp 72.4 39.4 5.8 1.9 9.0 1.6 10.6 Floating 82.7 46.6 3.7 0.5 21.5 1.6 7.3

SEX Male 73.6 48.2 6.7 2.1 9.1 0.3 6.3 Female 71.1 41.8 7.0 2.9 9.9 1.0 6.6

ALL 72.3 45.0 6.9 2.5 9.5 0.7 6.5

Table 4.4.2 Major information on HIV/AIDS

Knows difference between HIV and

AIDS

Believes there is no difference between HIV and

AIDS

Knows someone

with HIV/AIDS

Knows condom can protect from HIV during sex

Knows HIV can affect anyone

Knows a healthy looking

person can carry the HIV virus

AREA Bo 4.2 8.6 5.8 38.4 54.1 53.1 Kenema 5.8 7.8 5.1 22.9 34.5 27.2 Port Loko 1.6 3.0 5.7 22.8 34.1 30.6 Western Area 14.7 11.3 9.6 58.4 64.7 61.3

TYPE Urban 14.1 11.0 9.0 54.0 62.0 58.8 Rural 1.9 4.8 4.3 21.6 35.3 31.5 IDP Camp 5.1 5.1 5.4 32.7 43.6 40.1 Floating 8.9 16.2 13.6 55.0 59.7 52.4

SEX Male 8.3 8.5 7.0 40.5 52.2 46.4 Female 7.1 7.8 6.8 35.9 45.1 43.4

ALL 7.7 8.1 6.9 38.2 48.6 44.9


62

Table 4.4.3 Knowledge of Protection Methods

Protection

by sticking to one

uninfected partner

Protection through Sexual

Abstinence

Using a condom

every time

Knows all three ways

Knows at least one

way

Doesn't know any

way AREA Bo 46.9 46.8 9.3 6.3 54.5 45.5

Kenema 31.0 30.6 4.0 3.1 33.9 66.1 Port Loko 35.5 35.7 5.5 3.9 41.0 59.0 Western Area 61.3 59.3 18.9 12.6 71.6 28.4


SEX Male 47.2 46.7 10.5 7.1 54.5 45.5 Female 43.9 42.9 10.7 7.4 51.4 48.6

ALL 45.6 44.8 10.5 7.2 52.6 47.4

Table 4.5 Attitude and practice to HIV/AIDS Testing

Believe people

should Know their HIV

AIDS Status

Willing to be

Tested for HIV/AIDS

Know where to get an HIV

Test

Ever had an HIV Test

AREA Bo 77.9 72.3 23.1 1.6 Kenema 62.4 61.2 10.9 1.0 Port Loko 61.0 49.7 12.0 0.7 Western Area 82.3 63.6 28.7 2.7


SEX Male 72.7 64.6 21.7 1.5 Female 71.2 58.5 17.6 1.8

ALL 71.9 61.5 19.7 1.6


63

Table 4.6.1 Personal Feelings about People with HIV AIDS

Personal Feelings about People with HIV AIDS

Sympathise They Deserve

it

Nothing They are Immoral

Help less

Other Don’t Know

No Response

AREA Bo 74.3 3.9 4.2 1.1 1.8 3.7 8.6 2.6 Kenema 55.7 2.5 6.6 0.6 1.3 1.0 29.1 3.1 Port Loko 56.1 1.3 14.8 0.9 0.3 6.7 16.5 3.5 Western Area

83.2 2.8 3.7 0.4 0.8 2.0 5.4 1.8

TYPE Urban 80.2 2.8 3.2 0.5 0.9 1.8 8.6 2.0 Rural 59.3 2.5 9.1 1.0 1.0 4.0 20.2 2.9 IDP Camp 64.4 1.9 8.7 0.6 4.5 15.1 4.8 Floating 67.0 2.6 14.7 0.5 1.6 4.2 7.9 1.6

SEX Male 70.6 2.0 6.9 0.8 1.2 2.9 12.9 2.7 Female 67.2 3.2 7.2 0.5 0.7 3.4 15.3 2.6

ALL 68.9 2.6 7.0 0.7 1.0 3.1 14.1 2.6

Table 4.6.2 Discrimination against People with HIV AIDS I

Believe

people with AIDS should be discrimina

ted Against

Believe an infected Teacher/ Worker

should not be allowed

to work

Believe one should

not buy food from

Trader with HIV

AIDS?

Believe on should not share Meal

with an HIV/AIDS Infected Person

Believe a student

with HIV but no AIDS

should not be allowed

Class

Can keep Secret the HIV/AIDS Status of Family

Member

AREA Bo 74.1 72.7 83.9 82.3 73.4 23.8 Kenema 46.8 54.6 67.2 67.6 56.2 16.4 Port Loko 63.9 79.0 89.9 88.0 78.1 22.8 Western Area

59.2 66.2 83.0 76.1 65.7 37.7


SEX Male 62.2 68.8 83.1 79.0 69.1 25.3 Female 58.2 66.5 79.0 77.0 66.4 28.0

ALL 60.2 67.6 81.0 78.0 67.7 26.7


64

Table 4.6.3 Care for Relatives with HIV AIDS

Willing to care for a

Male Relative with HIV in Household

Willing to care for a Female Relative with

HIV in Household

Believe that there is HIV AIDS in Sierra

Leone AREA Bo 27.0 27.0 72.5

Kenema 22.9 24.6 51.1 Port Loko 23.5 22.9 63.0 Western Area 37.4 36.3 78.7

TYPE Urban 35.0 34.4 76.2 Rural 26.6 26.7 59.8 IDP Camp 17.3 17.3 66.7 Floating 23.0 24.1 63.4

SEX Male 30.6 28.6 68.8 Female 27.2 28.9 66.1

ALL 28.9 28.7 67.5

Table 4.6.4 HIV/AIDS and Condom Use

At Risk of

Getting HIV AIDS

Ever Heard of Condom

Know Where to get a

Condom

Use Condoms

for Sex AREA Bo 52.0 64.4 35.7 14.7

Kenema 78.4 48.5 18.7 8.1 Port Loko 42.2 45.7 14.5 8.0 Western Area 65.0 82.5 42.5 20.3


SEX Male 61.2 65.6 32.9 14.1 Female 59.7 59.9 25.7 13.0

ALL 60.5 62.7 29.2 13.5

Table 4..6.5 Practices and HIV AIDS

Discuss HIV

AIDS with Parents

Teachers

Talk to Sexual Partners about

HIV AIDS

Willing to change Sexual

Practice to avoid HIV

Caution in using Blades, Needles and

Knives AREA Bo 34.0 33.6 44.5 97.4

Kenema 27.9 29.8 45.5 91.2 Port Loko 22.2 24.5 47.7 92.5 Western Area 40.3 40.9 50.4 95.4


SEX Male 29.6 31.6 48.8 94.9 Female 34.5 34.8 46.3 93.4

ALL 32.1 33.2 47.5 94.1


65

Table 4..6.6 Methods of preventing Unwanted Pregnancy

By Using Condoms

Family Planning

Pills

Abstaining from Sex

Other

Don’t Know

No

Response AREA Bo 23.1 28.5 14.4 2.8 29.2 1.9



SEX Male 33.2 14.3 12.8 2.2 34.2 3.3 Female 20.9 28.2 15.1 1.9 30.9 3.1

ALL 27.0 21.3 14.0 2.1 32.5 3.2

Table 4.7.1a Access to Media

Access to Radio

Access to Television

Visit to Video Cinema House

Read Local News papers

Read Magazines

Access to Flyers Posters

AREA Bo 78.3 1.4 56.2 15.4 10.0 20.3 Kenema 70.2 7.6 44.0 11.2 7.9 6.9 Port Loko 76.5 5.1 15.7 12.0 8.0 9.1 Western Area

85.8 65.6 48.0 46.4 39.7 41.8

TYPE Urban 86.7 51.6 50.0 45.8 38.4 38.8 Rural 71.9 7.4 28.1 8.2 4.6 8.4 IDP Camp

75.3 4.8 42.9 8.7 5.1 11.5

Floating 76.4 19.9 69.9 20.9 18.3 22.5 SEX Male 82.2 26.8 47.2 27.1 21.1 24.2

Female 75.1 25.3 35.4 21.8 17.6 20.0 ALL 78.6 26.0 41.2 24.4 19.4 22.1


66

Table 4.7.1b Access to Media

Belong to

youth groups

Attend Performances by Drama Groups

Listen to Sermons

in Churches

or Mosques

Accept

Messages from

Sermons

Ever Listened

to an HIV AIDS

Related Sermon

Ever Watched

a Play with an

HIV AIDS

Theme AREA Bo 23.6 45.2 96.0 95.4 23.3 12.8



SEX Male 25.9 41.6 96.4 95.7 22.9 16.1 Female 15.5 33.5 96.3 95.6 23.9 15.9

ALL 20.6 37.5 96.3 95.6 23.4 16.0

Table 4.7.2 Source Preference for Information on HIV AIDS

Source Preference for Information on HIV AIDS

Radio

Television

News papers

Posters

Theatre

Other

No Response

AREA

Bo 61.8 1.8 1.2 0.5 2.8 27.0 4.9 Kenema 65.9 3.4 0.3 1.0 14.9 14.6 Port Loko 68.4 1.3 0.7 0.7 0.3 16.5 12.0 Western Area

58.9 17.8 2.6 0.6 2.1 10.6 7.5

TYPE

Urban 60.4 14.9 14.9 0.2 1.7 12.9 7.4 Rural 65.6 2.1 2.1 0.6 0.9 19.1 11.3 IDP Camp 64.1 1.9 1.9 1.3 1.9 17.9 11.9 Floating 64.9 6.8 6.8 4.2 12.6 10.5

SEX

Male 66.6 6.7 1.8 0.7 1.9 14.4 7.9 Female 60.0 8.6 0.9 0.2 1.3 17.6 11.4

ALL 63.3 7.6 1.4 0.5 1.6 16.0 9.7


67

Table 4.8.1 Source of Messages you believe best

Source of Messages you Believe Best

Drama Group

Street Theatre

Peer Group

Radio

Television

News paper

ChurchMosque

Don’t Know

No Response

AREA Bo 2.5 1.2 4.6 60.8 0.9 1.4 25.4 0.9 2.5 Kenema 0.4 0.3 8.3 60.5 3.3 0.1 21.5 2.4 2.8 Port Loko

0.3 0.1 1.6 70.6 0.6 0.7 12.2 6.8 5.8

Western Area

1.8 0.9 1.5 50.5 22.8 1.7 15.3 2.4 2.8

TYPE Urban 1.3 1.1 2.8 54.4 19.0 1.9 15.0 1.8 2.3 Rural 0.9 0.1 3.7 63.3 1.4 0.3 22.3 3.4 4.1 IDP Camp

1.0 0.3 4.2 61.2 1.6 0.6 19.6 6.7 4.8

Floating 4.2 2.1 8.9 62.3 7.3 1.0 5.8 3.7 4.2 SEX Male 1.5 0.8 3.8 63.3 8.1 1.3 15.3 3.0 2.5

Female 1.0 0.5 3.6 55.5 9.9 0.8 20.6 3.2 4.3 ALL 1.3 0.6 3.7 59.4 9.0 1.1 18.0 3.1 3.4

survey report - hivhealthclearinghouse.unesco.org · survey report (conducted by central statistics...

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