AIDS health beliefs and intention for sexual abstinence among male adolescent students in Kathmandu, Nepal: a test of perceived severity and susceptibility.

OBJECTIVES In Nepal, male adolescent students are at high risk for infection with human immunodeficiency virus (HIV) because of their risky sexual behaviours. This study examined whether two subscales of the Health Belief Model (HBM), perceived severity and perceived susceptibility, are associated with abstinence intention among Nepalese male adolescent students for HIV/acquired immunodeficiency syndrome (AIDS) prevention. STUDY DESIGN AND METHODS A school-based study was conducted at a single school located in central Kathmandu from July to August 2002. Participants included 183 male students in Grades 9-12 aged 14-19 years. Anonymous self-reported questionnaires were used, and Zagumny's AIDS Health Belief Scale was adopted as a measure of perceived severity and perceived susceptibility. RESULTS Over half of the students (53%) strongly agreed with abstinence intention. Students with higher levels of perceived severity strongly agreed with abstinence intention [crude odds ratio 1.86, 95% confidence interval (CI) 1.02-3.38; adjusted odds ratio 1.94, 95% CI 1.05-3.58], but those with higher levels of perceived susceptibility did not. Moreover, age-stratified analysis showed that a high level of perceived susceptibility tended to decrease strong abstinence intention among students aged 16-19 years. CONCLUSIONS Perceived severity enhanced abstinence intention. The interpretations of perceived susceptibility need further examination through a longitudinal study among students aged 16-19 years. Furthermore, future research is needed to assess the effect of HIV/AIDS education on HIV/AIDS prevention strategies using perceived severity as a motivational tool to help persuade Nepalese male students to abstain from sexual intercourse.

[1]  R. Petosa,et al.  Using the Health Belief Model to Predict Safer Sex Intentions of Incarcerated Youth , 1994, Health education quarterly.

[2]  R. Petosa,et al.  The AIDS education needs of adolescents: a theory-based approach. , 1990, AIDS education and prevention : official publication of the International Society for AIDS Education.

[3]  J. A. Epstein,et al.  Determinants of Intentions of Junior High School Students to Become Sexually Active and Use Condoms: Implications for Reduction and Prevention of AIDS Risk , 1994, Psychological Reports.

[4]  M. Puri,et al.  Sexual behaviour and risk perceptions among young men in border towns of Nepal , 2001 .

[5]  G. Yep,et al.  HIV prevention among Asian-American college students: does the health belief model work? , 1993, Journal of American college health : J of ACH.

[6]  C. Skinner,et al.  The health belief model. , 2008 .

[7]  Kentucky Workforce Investment Board Annual Report 2001-2002 , 2002 .

[8]  R. DiClemente,et al.  Predictors of condom use in sexually active adolescents. , 1992, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[9]  M. Damond,et al.  The Evaluation of Setting and a Culturally Specific HIV/AIDS Curriculum: HIV/AIDS Knowledge and Behavioral Intent of African American Adolescents , 1993 .

[10]  P. Donovan School-based sexuality education: the issues and challenges. , 1998, Family planning perspectives.

[11]  P. Auinger,et al.  Keeping middle school students abstinent: outcomes of a primary prevention intervention. , 2002, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[12]  A. Gielen,et al.  Women's protective sexual behaviors: a test of the health belief model. , 1994, AIDS education and prevention : official publication of the International Society for AIDS Education.

[13]  R. DiClemente,et al.  Comparison of human immunodeficiency virus related knowledge, attitudes, intentions, and behaviors among sexually active and abstinent young adolescents. , 1992, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[14]  Unaids Aids,et al.  Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections , 2004 .

[15]  R. Allard Beliefs about AIDS as determinants of preventive practices and of support for coercive measures. , 1989, American journal of public health.

[16]  D. Siegel,et al.  Long-term effects of a middle school- and high school-based human immunodeficiency virus sexual risk prevention intervention. , 2001, Archives of pediatrics & adolescent medicine.

[17]  K. Glanz,et al.  Health behavior and health education : theory, research, and practice , 1991 .

[18]  J. Newell,et al.  A systematic review of current knowledge of HIV epidemiology and of sexual behaviour in Nepal , 2002, Tropical medicine & international health : TM & IH.

[19]  T. Heeren,et al.  Beliefs about AIDS, use of alcohol and drugs, and unprotected sex among Massachusetts adolescents. , 1990, American journal of public health.

[20]  Zagumny Mj,et al.  Development of the AIDS Health Belief Scale (AHBS). , 1998 .

[21]  M. Puri SEXUAL RISK BEHAVIOUR AND RISK PERCEPTION OF UNWANTED PREGNANCY AND SEXUALLY TRANSMITTED INFECTION AMONG YOUNG FACTORY WORKERS IN NEPAL , 2001 .

[22]  K. Peltzer Factors affecting condom use among South African university students. , 2000, East African medical journal.

[23]  S. J. Hiltabiddle,et al.  Adolescent condom use, the health belief model, and the prevention of sexually transmitted disease. , 1996, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[24]  R. Kessler,et al.  The Health Belief Model in understanding compliance with preventive recommendations for AIDS: how useful? , 1989, AIDS education and prevention : official publication of the International Society for AIDS Education.

[25]  C. Alexander,et al.  Determinants of condom use to prevent HIV infection among youth in Ghana. , 1999, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[26]  Andrew Copas,et al.  Condoms and seat belts: the parallels and the lessons , 2000, The Lancet.

[27]  D. Taylor,et al.  Randomized crossover trial comparing the eZ.on plastic condom and a latex condom. , 2001, Contraception.

[28]  J. Kinsman,et al.  Evaluation of a comprehensive school-based AIDS education programme in rural Masaka, Uganda. , 2001, Health education research.

[29]  K. Jackson,et al.  Using the Health Belief Model to Predict Safer Sex Intentions among Adolescents , 1991, Health education quarterly.

[30]  D. Shuey,et al.  Increased sexual abstinence among in-school adolescents as a result of school health education in Soroti district, Uganda. , 1999, Health education research.