Lack of HIV/AIDS knowledge among school-age children and caregivers in an area of high HIV/AIDS prevalence: A descriptive analysis of a peri-urban population outside Lusaka, Zambia

Background: In 2005, prevalence of HIV/AIDS infection in Zambia was 13.9% while rates in the capital, Lusaka, were over 20%. Peri-urban compounds surrounding Lusaka have a similar HIV/AIDS prevalence to the capital. Inadequate access to health education through schools or clinics may contribute to lack of knowledge about HIV/AIDS. Methods: We conducted child health surveys with 331 children and caretakers. We administered the survey to a convenience sample (54% female, ages 5 to 17) and gathered information related to illness burden, health seeking behavior, and knowledge and attitudes regarding HIV/AIDS. Results: 9% of caretakers listed HIV/AIDS as one of the most important health problems facing school-children in their community. 69% had not spoken to their child about HIV/AIDS. The most commonly cited reasons for not speaking to children were: the child was too young (56%) and the caretaker assumed the child learned about HIV/AIDS somewhere else (14%). Although 68% of children stated that they had heard of HIV/AIDS, only 39% had discussed HIV/AIDS with their peers. 17% of children named unprotected sex or mother-to-child as modes of transmission. When asked to name a method of HIV transmission, unexpectedly, 21% of children cited razor blades. Conclusion: Despite high prevalence of HIV/AIDS, few caretakers discuss HIV/AIDS with children. Moreover, few children clearly understand the prevalent modes of HIV transmission and prevention. Considering the extant educational deficiencies and the high risk status of school-age children in peri-urban Lusaka, increased focus on health education is a potentially high-impact mode of promoting HIV preventative behaviors.