Knowledge, Attitudes And Sexual Behaviors With Regard To HIV Among Senior Primary School Pulpils In Gabon

Objective: The aim of this study was to explore Knowledge, Attitudes and Behaviors (KABs) regarding HIV/AIDS among pupils of the last two classes in primary schools, before joining high school (CM1and CM2), in four cities in Gabon.Method: We used a cross-sectional survey design on male and female pupils between9and16years old, from July to August2014, to evaluate their (KABs). We selected840pupils from the last two grades in primary school (CM1and CM2) through a random sample chosen from twelve primary schools in four cities in Gabon.Results:Participants of this study had a mean of12.94years (SD=1.741), with400(47.6%) males and440(52.4%) females. The majority of them (61.3%) were in6th grade (CM2) in primary school and38.7%were in5th grade (CM1). The majority of pupils (74%) belonged to Christian religion and lived with their both parents (53.2%).54.4%of pupils had only one parent working.7.1%had both parents not working. Only38.7%had both parents working. The majority of both male (97.8%) and female (98.2%) pupils had heard of HIV/AIDS. They knew that this disease can be transmitted by sexual intercourse (87.6%), blood (87.6%), sharing needles or syringes (78.6%) and from mother to child (66.9%). Misconceptions about risks of transmission were noted. Example, less than sixty percent (53.5%) had correctly answered that "HIV can be transmitted by saliva","a person can spread HIV by coughing"(55.2%). About half of the pupils (50.5%) believed that it is possible for a healthy-looking person to have the virus that causes AIDS. A positive attitude towards PLWHIV was observed among pupils,83.3%of males and81.8%females were willing to take care of an infected relatives,74.5%of females and73.3%of males agreed that an HIV positive pupil can continue his studies, while65.5%of females and67.8%of males agreed that an HIV positive teacher should be allowed to continue teaching in school. Some pupils already had sexual experience. Significantly more males than females have had sex (p=0000) and with more than one partner. Age at first sex was11years, for pupils who have had sex,4.8%of males and18%of females did not use condom during their first sexual act. Significantly more males than females had used condom. Younger pupils were more likely to have low HIV/AIDS knowledge (AOR=1.12,95%CI=1.01-1.24, p<0.029). Pupils with high level knowledge on transmission and prevention were more likely to have a positive attitude towards PLWHIV (AOR=4.77,95%CI=3.23-7.14, p＜0.000). Similarly, risky sexual practice were observed among older pupils with medium (AOR=3.72,95%CI=2.47-5.60, p0.000) and in pupils belonging to Muslim religion (AOR=3.05,95%CI=1.01-9.19). The male pupils were more likely to have sexual relation than female pupils (AOR=3.72,95%CI=2.47-5.60, p0.000).Conclusion:Despite a good awareness of HIV/AIDS among pupils, misconceptions about transmission and prevention were noted. Age, tends to play important role on the lack of knowledge as regards transmission, prevention and on positive attitude toward PLWHIV. While gender and religion influenced on the adoption of sexual risk behavior.Ministry of Education of Gabon should include the curriculum of sex education program including prevention of HIV in primary school (CM1&CM2); Governments should create programs for Information, Education and Communication in churches, mosques and civic organizations. Policy makers should elaborate the policies to regulate Cyber-cafe pornographies, shop selling alcohol around schools and improving parental responsibility.Scientific contributions and limitations:This study had certain limitations:1. We focused on adolescents who are in school. Many primary schools pupils drop out of school before they finish their primary school. Thus, school attending adolescents could not represent all the adolescents in the country.2. The health behaviors, knowledge and attitude may be different between these two groups of adolescents.3. The questionnaire was self-completed in presence of a teacher and an investigator, we think that it’s possible that some pupils may not have reported right answers, some of them were shy to talk about sex, so they did not answer the whole questions, and these questionnaires were excluded of this study.Despite these limitations, the current study may contribute to:Setting a baseline among primary school pupils for the prevalence an estimate which maybe compared against future studies;Better understanding of the factors associated with adolescents’pupils KABs, this understanding could be incorporated in the programmes which promote adolescent sexual reproduction health including the prevention of HIV.Recognize that the problem of adolescent sexual health implicate a multi-sectoral approach with due consideration of alcohol use and increased the elementary school and parental responsibility to improve adolescents health well-being.