Assessment on Knowledge, Attitude and Practice (KAP) on Adolescents (10 -15 YEARS) in Zanzibar

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This assessment of the knowledge, attitude and practice related to HIV/SRH among adolescents aged 10 to 15 in Zanzibar has been carried out in May, 2016 with the aim of determining baseline information that will enable monitoring and evaluation of progress regarding behavior change among these adolescents. Specifically, the survey sought to assess awareness, understanding, and misconceptions about HIV/AIDS and SRH; along with the understanding of prevention of new HIV infections and risk behaviors. The assessment was conducted both in Unguja and Pemba in five districts which covered 31 Shehias and 26 schools. The exercise involved 477 respondents of which 235 (49.3%) females and 242 (50.7%) males, and accounts for about 95.4% coverage out of the target sample size of 500 respondents. The adolescents assessed included in and out of school. Regarding the adolescents’ attendance to school and those who are out of schools, the assessment findings showed that 93% of all 477 assessed youngsters are attending school and only 7.1% were found to be out of school. Youth who attend both schools and Madrassas were found that 81% of them are attending madrassa with females being more likely to attend compared to their male counterparts. Females attending Madrassas are leading by 86.4% against males who account for 77%. A special focus was given to whether the assessed youngsters are living with their born parents or guardians. With regard to this interest, the assessment revealed that 58.7% are living with their biological parents (fathers and mothers) and over one third (36.1%) are living with single parent (mother). Youth living with people other than their biological parents accounts for only 5%. Marital status for this age group was initially seemed to be not applicable but later it was not overlooked. Findings from the assessment showed the presence of about 12% of the assessed adolescents in marital bond, portraying evidence of early marriage practices. Distressingly, five youths (4 females and 1 male) which accounts for 1% reported to live together with sexual partners outside marital bond. Findings from this assessment indicate that there is high awareness related to HIV/AIDS with low awareness of Sexual Reproductive Health (SRH) in the assessed areas. The reason for this big difference in awareness between HIV/AIDS and SRH was not explored in this assessment was because it was beyond the understanding of the target group and was not known before. The main source of information for those who have heard HIV/AIDS was TV and radio which together accounts for 76.7%, while all other sources (schools/Madrassas, magazine, books and journals) accounting for only 32.3%. Another focus of this assessment was to measure what adolescents 10-15 know about HIV/AIDS and SRH while most of attitudes and practices appeared to be crosscutting between the two areas. Other findings which are rather astonishing, is the presence of early sexual practices among this group of adolescents from the lowest age of 10 years accounting for 12% of respondents of this age. Apart from those of age 10, all other ages from 11-15 years are practicing sex, which negates the inherent culture of Zanzibar, where youth start engaging in sex 11 only during marriages. These sexual practices reported to be done with limited of use condoms indicating that they are done unprotected, exposing this naïve group to the risk of HIV and other sexually transmitted infections and early pregnancies. Findings further disclosed the prevalence of early marriages among the adolescents who are in and out of schools and the underlying reasons for this include, among others, limited role on the part of imparting knowledge on HIV/ AIDS and SRH to this age group. This responsibility which was supposed to be done by parents/guardians was found to be not adequately done, despite the fact that majority of adolescents are living with their biological parents. Civil Society Organizations (CSOs) found to have inadequately played their part in educating adolescents on HIV/ AIDS and SRH. This calls for HIV/ AIDS and SRH actors/players to strengthen the existing initiatives and synergy to address this target group. A need to devise alternative approaches that will focus this age group and streamline the support for prevention against the spread and subsequent response to HIV/AIDS among adolescents deem necessary. About knowledge on how HIV is transmitted, the results of this assessment further indicate that 56.6% of the adolescents interviewed are aware of the ways in which HIV virus is transmitted. For instance, 56.6% of the respondents agreed that HIV is infected through sexual intercourse; blood contacts were 55.4%; mother to child transmission 59.7% and risk behaviors 60%. The level of knowledge, attitudes and practices explored within this age group, are among the valuable inputs to guide the government in undertaking necessary interventions focusing this target group. Either, findings from this assessment will be appropriate to support government efforts to respond to HIV/AIDS and SRH for this adolescent group in the society. In addition, the findings indicate positive and negative responses with regards to issues of HIV/AIDS and SRH. Despite the fact that a good number of respondents found to be aware and have right information regarding the two assessed areas, there are considerable responses which express either ignorance or uncertainty. The situation explained in this report warrants for creating special awareness programs that target the adolescents of this age group. Based on these assessment results, the assessment team therefore recommend to HIV/AIDS and SHR players to develop appropriate awareness and training programs; incorporate HIV/ AIDS and SRH in school curriculum; improve role of parents and NGOs in educating and disseminating HIV/AIDS and SRH information to adolescents and develop a monitoring and evaluation mechanism for its sustainability