Population-based survey with necessary questions to ascertain respondents’ knowledge about HIV transmission. The indicator should be disaggregated as separate percentages for males and females, by age groups, and by most at-risk populations. PEPFAR and UNGASS specifically target the indicator for 15 to 24 year olds and recommend further disaggregation for the age groups 15-19 and 20–24 years.

Data Source(s):

Population-based survey tools, such as the AIDS Indicator Survey (AIS), Demographic and Health Survey (DHS), or Multiple Indicator Cluster Survey (MICS).

Purpose:

HIV epidemics are perpetuated through primarily sexual transmission of infection to successive generations of young people. Sound knowledge about HIV is an essential pre-requisite, although often an insufficient condition, for adoption of behaviors that reduce the risk of HIV transmission. The belief that a healthy-looking person cannot be infected with HIV is a common misconception that can result in unprotected sexual intercourse with infected partners. Rejecting major misconceptions about modes of HIV transmission is as important as correct knowledge of true modes of transmission. For example, belief that HIV is transmitted through mosquito bites can weaken motivation to adopt safer sexual behavior, while belief that HIV can be transmitted through sharing food reinforces the stigma faced by people living with HIV. This indicator is particularly useful in countries where knowledge about HIV and AIDS is poor because it permits easy measurement of incremental improvements over time. However, it is also important in other countries as it can be used to ensure that pre-existing high levels of knowledge are maintained.

Issue(s):

This indicator does not measure actual behaviors regarding HIV transmission and people’s correct knowledge does not necessarily translate into altering their high-risk behaviors. The recommended questions for this indicator are somewhat limited in scope, for example, there are no questions about preventing mother-to child (PMTCT) transmission during pregnancy, labor and delivery, or breast milk or exposure to blood, particularly for health care workers. Note: Indicator #9 in this section of the database refers specifically to knowledge of ways for PMTCT of HIV.

Gender Implications:

Women may be less informed about prevention of HIV transmission in settings where gender social norms limit women’s access to health care services and information.  Women may be reluctant to seek out information that could make them look sexually active if unmarried or promiscuous, and health care workers may not discuss HIV prevention (e.g., use of male or female condoms) with women clients. Where rates of female literacy are low, women may not benefit from media and communication strategies that rely on printed materials.  The UNAIDS (2010) agenda for women, girls, and gender equality calls for national AIDS authorities and ministries of health to incorporate gender quality into HIV prevention and policies, which includes a gender quality education component and comprehensive sexuality education.

References:

PEPFAR, 2009, The President’s Emergency Plan for AIDS Relief: Next Generation Indicators Reference Guide, Washington, DC: USAID/PEPFAR.  https://www.k4health.org/toolkits/igwg-gender/president%E2%80%99s-emergency-plan-aids-relief-next-generation-indicators-reference