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 (CM1 and CM2), in four cities in Gabon.
Method: We used a cross-sectional survey design on male and female pupils between 9 and 16 years old, from July to August 2014, to evaluate their (KABs). We selected 840 pupils from the last two grades in primary school (CM1 and CM2) through a random sample chosen from twelve primary schools in four cities in Gabon.
Results: Participants of this study had a mean of 12.94 years (SD=1.741), with 400(47.6%) males and 440 (52.4%) females. The majority of them (61.3%) were in 6th grade (CM2) in primary school and 38.7 % were in 5th 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. Only 38.7% 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 and 81.8% females were willing to take care of an infected relatives, 74.5% of females and 73.3% of males agreed that an HIV positive pupil can continue his studies, while 65.5% of females and 67.8% 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 was 11 years, for pupils who have had sex, 4.8% of males and 18 % 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, p<0.000) 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, p<0.000).
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-café pornographies, shop selling alcohol around schools and improving parental responsibility.
Keywords: knowledge, attitudes, behaviors, Primary school pupils, HIV/AIDS, Gabon