Adolescent and Young Adult Understanding of the Differences between Chlamydia, HIV & AIDS
Document Type Poster
Medical student James Anderson participated in this study as part of the Senior Scholars research program at the University of Massachusetts Medical School.
Background: While representing 25% of the sexually active population, 15- to 24-years olds acquire nearly one-half of all new sexually transmitted infections (STIs). Chlamydia trachomatis (CT) is the most common bacterial STI, is frequently asymptomatic, and young people often know little about the disease. A quarter of new HIV infections occur among adolescents and young adults (ages 13 to 29). Misperceptions about the differences between CT, HIV and HIV may serve as barriers to early testing and treatment.
Objectives: Explore young people’s understanding of the differences between CT, HIV and AIDS.
Methods: Design: Self-administered survey. Setting: Adolescent clinic of a university medical center. Participants: A consecutive sample of 135 patients aged 14 to 22 years who visited the clinic for any reason between 6/1/10 and 7/8/10 were invited to participate. Exclusion criteria: Language barrier or inability to complete survey independently. Informed assent or consent was obtained from all interested participants. Outcome measures: Accuracy of participants’ written responses regarding similarities and differences between HIV and CT and between HIV and AIDS. Participants were first asked to check ‘yes’, ‘no’, or ‘don’t know’ regarding whether there are any similarities and differences between HIV and CT and between HIV and AIDS. Those who checked ‘yes’ were asked to explain why they chose this answer. An additional question asked if HIV and AIDS are two words for the same health problem. Demographic data and questions about prior sex and STD testing were included. Analyses: Two investigators coded written responses for accuracy using a scale of 0 for incorrect, 0.5 for partially correct, and 1 for fully correct answers. Investigator consensus was reached for all discordant scores. Descriptive statistics were performed for all variables and Pearson’s correlations were used to test for associations between continuous and dichotomous variables.
Results: 119 patients (88% response rate) participated with a mean age of 17.4 yrs (SD=2.0) and median educational level of 12th grade completion. Seventy-nine (66%) reported previous sex, and 48 (41%) reported previous testing for CT, HIV, or AIDS. Ninety-six (81%) participants were female, and 30% self-identified as Hispanic. Racial composition was 53% White, 8% Black, 7% Asian, 10% Multiracial, and 17% Other. Insurance coverage included 42% private, 39% public, 1% none, and 18% unsure. Of the participants, 42 (35%) checked ‘don’t know’ for similarities between HIV and CT, 9 (8%) checked ‘no’, and 68 (57%) checked ‘yes’, with 77% of codable answers correct. Fifty-four (45%) participants checked ‘don’t know’ for differences between HIV and CT, 2 (2%) checked ‘no’, and 63 (53%) checked ‘yes’, with 96% of codable answers correct. For similarities between HIV and AIDS, 22 (19%) checked ‘don’t know’, 6 (5%) checked ‘no’, and 90 (76%) checked ‘yes’, with 67% of codable answers correct. For differences between HIV and AIDS, 39 (33%) checked ‘don’t know’, 14 (12%) checked ‘no’, and 65 (55%) checked ‘yes’, with 68% of codable answers correct. Forty-five (39%) respondents checked ‘yes’ that HIV and AIDS were two words for the same health problem, 66 (56%) checked ‘no’, and 6 (5%) checked ‘don’t know’. Selecting ‘yes’ for differences between CT and HIV positively correlated with previous testing for CT, HIV, or AIDS (r=0.295, p=.002), female gender (r=0.217, p=.025), age (r=0.336, p=.001), and educational level (r=0.309, p=.001). Selecting ‘yes’ for differences between HIV and AIDS positively correlated with age (r=0.225, p=.014) and educational level (r=0.291, p=.001).
Conclusion: Almost half of our sample selected ‘no’ or ‘don’t know’ to questions regarding the differences between CT and HIV and between HIV and AIDS. More than one in three thought HIV and AIDS were two words for the same health problem. Lack of understanding about the differences between CT, HIV, and AIDS may serve as a deterrent to test seeking if youth fear that a CT diagnosis has the same implications as an HIV diagnosis.