Abstract
AIDS-related stigmas are pervasive in some segments of South African society and stigmas can impede efforts to promote voluntary counselling and testing and other HIV-AIDS prevention efforts. The current study examined associations among the belief that AIDS is caused by spirits and supernatural forces, AIDS-related knowledge and AIDS-related stigmas. A street intercept survey with 487 men and women living in a Black township in Cape Town, South Africa showed that 11% (n=54) believed that AIDS is caused by spirits and supernatural forces, 21% (n=105) were unsure if AIDS is caused by spirits and the supernatural, and 68% (n=355) did not believe that AIDS is caused by spirits and supernatural forces. Multiple logistic regression analyses controlling for participant age, gender, years of education and survey venue showed that people who believed HIV-AIDS is caused by spirits and the supernatural demonstrated significantly more misinformation about AIDS and were significantly more likely to endorse repulsion and social sanction stigmatizing beliefs against people living with HIV-AIDS. However, nearly all associations between beliefs that AIDS is caused by spirits and AIDS stigmas were non-significant when logistic regressions were repeated with AIDS-related knowledge included as a control variable. This finding suggests that relationships between traditional beliefs about the cause of HIV-AIDS and AIDS stigmas are mediated by AIDS-related knowledge. AIDS education efforts are urgently needed to reach people who hold traditional beliefs about AIDS to remedy AIDS stigmas.
Acknowledgments
This research was supported by National Institute of Mental Health (NIMH) grant R01-MH61672 and the World AIDS Foundation Grant 278.
Notes
Analyses were conducted to examine participants who provided ‘don't know’ responses to the traditional beliefs item. This group fell between the group that endorsed the belief and the group that did not endorse the belief on most knowledge and stigma measures. When combined with individuals who endorsed the traditional belief, none of the findings were altered, although the magnitude of differences between groups was reduced. To increase the interpretative clarity of the results, we therefore used an extreme group approach by omitting persons who either did not accept or reject the traditional belief.