National trends in AIDS knowledge and sexual behavior in Zambia 1996-98

Author(s): Banda C, Bloom S S, Songolo G, Mulendema S, Cunningham A E, Boerma J T

Year: 1999

Abstract:
Objective: To describe the trends in AIDS knowledge and sexual behaviour in Zambia between 1996 and 1998. Design: Analysis of data collected in two nationally representative surveys. Methods: Analyses were stratified by sex. In order to assess whether there had been changes in the levels of knowledge and high risk sexual behaviour over the two-year period, differences between estimated population proportions between both surveys were tested across several indicators, based on robust estimates of variance. Results: Levels of knowledge about AIDS transmission were already high in 1996, and very little change was observed over the two-year period. The proportion of men with multiple sexual partners decreased, and there was a lower level of premarital sexual activity among men. In 1996, 20.8% of men reported having two or more partners during the last year, compared to 15.2% in 1998 (p=0.002). Among men with four or more partners, the figures were 6.7% and 4.9%, respectively (p=0.05). Likewise, there was an increase of never married men who reported no sexual activity between the two years, with 35.8% in 1996 and 52.6% in 1998 (p Conclusions: After a decade of HIV-prevention activities in Zambia, one of the most severely affected countries in the world, some favorable changes in indicators of male sexual behaviour have been observed during 1996-1998. Other areas showed little change, indicating the need for renewed efforts in HIV/STD prevention programmes.