Community Influences on Young People's HIV/AIDS Knowledge, Attitudes & Practices

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DESCRIPTION (provided by applicant): Background: Targeting young people is essential in defeating the global HIV/AIDS epidemic and although much attention has been given to the individual and familial factors that influence the knowledge, attitudes and sexual behavior of young people, the role of structural elements of the community remains poorly understood. Objectives: We will estimate the influence of several dimensions of the community environment on a young person's knowledge of HIV/AIDS, attitudes towards others with HIV/AIDS and recent sexual behaviors in three countries: Burkina Faso, Ghana and Zambia. Data and Method: The analysis samples are males and females (15-24) from the latest Demographic and Health Surveys from Burkina Faso (2003), Ghana (2003) and Zambia (2001-02). Community level variables representing economic prosperity, gender norms and inequalities, the health care infrastructure and knowledge, attitudes and behaviors in the community will be examined. A multilevel modeling strategy will be applied to identify the role of community level characteristics in young people's knowledge of HIV/AIDS, their attitudes to others with HIV/AIDS, and their recent sexual behaviors. Significance: Previous studies of young people's knowledge, attitudes and behaviors have examined only the role of single elements of the community; this research is innovative in its conceptualization of a holistic view of the community, examining the role of economic, social and normative community characteristics in determining young people's knowledge, attitudes and behaviors. This research will provide new information on the associations between characteristics of a community's physical, behavioral, social and normative environment and young people's knowledge, attitudes and behaviors. In addition to strengthening the scientific field of community influences on health, the research will generate interest in examining community influences on other health outcomes, and will lead to a greater motivation to improve the collection of community level data. The innovative methodology and conceptualization of the community can be employed to examine other health outcomes in both domestic and international settings. The research will also identify community characteristics that can be harnessed in the development of public health interventions, strengthening public health practice for the improvement of program and policy aimed at reducing HIV transmission among young people.