Recent Trends in HIV-Related Knowledge and ... - Measure DHS
Recent Trends in HIV-Related Knowledge and ... - Measure DHS
Recent Trends in HIV-Related Knowledge and ... - Measure DHS
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1. INTRODUCTIONRw<strong>and</strong>a is situated <strong>in</strong> central Africa, immediately south of the equator between latitude 1°4' <strong>and</strong>2°51' South <strong>and</strong> longitude 28°63' <strong>and</strong> 30°54' East. It has a surface area of 26,338 square kilometers <strong>and</strong> isbordered by Ug<strong>and</strong>a to the north, Tanzania to the east, the Democratic Republic of the Congo to the west,<strong>and</strong> Burundi to the south. L<strong>and</strong>locked, Rw<strong>and</strong>a lies 1,200 kilometers from the Indian Ocean <strong>and</strong> 2,000kilometers from the Atlantic Ocean. Nearly all Rw<strong>and</strong>ans speak K<strong>in</strong>yarw<strong>and</strong>a, the country’s official firstlanguage, followed by English <strong>and</strong> French. Kiswahili, the third most common foreign language, isgenerally spoken <strong>in</strong> urban areas <strong>and</strong> <strong>in</strong> the prov<strong>in</strong>ces border<strong>in</strong>g other countries where this language iswidely spoken, such as the Democratic Republic of the Congo <strong>and</strong> Tanzania.<strong>HIV</strong> <strong>in</strong>fection is a major public health concern <strong>in</strong> Rw<strong>and</strong>a, where it is one of the ma<strong>in</strong> causes ofmortality, <strong>and</strong> carries negative social <strong>and</strong> economic consequences that affect everyone <strong>in</strong> the country.Results from the 2010 Rw<strong>and</strong>a Demographic <strong>and</strong> Health Survey show that 3 percent of Rw<strong>and</strong>an adultsage 15-49 are <strong>in</strong>fected with <strong>HIV</strong>. The prevalence iss much higher <strong>in</strong> urban areas, among women, <strong>and</strong>among adults who have had multiple lifetime sexual partners <strong>and</strong> used a condom at last sexual<strong>in</strong>tercourse. The level of <strong>and</strong> differences <strong>in</strong> <strong>HIV</strong> prevalence <strong>in</strong> Rw<strong>and</strong>a <strong>in</strong> 2010 are very similar to thoseobserved <strong>in</strong> 2005 (National Institute of Statistics of Rw<strong>and</strong>a [NISR] <strong>and</strong> ORC Macro 2006; NationalInstitute of Statistics of Rw<strong>and</strong>a [NISR] et al. 2012).At the very early stage of the epidemic, the government of Rw<strong>and</strong>a demonstrated a strongcommitment to lead <strong>in</strong> <strong>HIV</strong> prevention <strong>and</strong> treatment. It promptly recognized the negative impact of theAIDS epidemic on the country’s social <strong>and</strong> economic development. The government adopted a multisectoralapproach, <strong>and</strong> developed a national <strong>HIV</strong>/AIDS strategic plan. Rw<strong>and</strong>a received assistance <strong>and</strong>support from the <strong>in</strong>ternational community for its pledge to develop a comprehensive program to fight<strong>HIV</strong>/AIDS. The program <strong>in</strong>cludes a full range of preventive, medical, <strong>and</strong> support services for thoseliv<strong>in</strong>g with <strong>HIV</strong>/AIDS. Most activities have had a nationwide focus, <strong>and</strong> the important beneficiaries<strong>in</strong>clude but are not limited to civil society organizations, faith-based groups, <strong>and</strong> grassroots associations.S<strong>in</strong>ce the <strong>in</strong>itiation of the 2005-2009 National Multi-sector Strategic Plan (NMSP), Rw<strong>and</strong>a hasmade significant progress <strong>in</strong> the provision of universal access to <strong>HIV</strong> <strong>and</strong> AIDS services (National AIDSCommission [Rw<strong>and</strong>a] 2005). To cont<strong>in</strong>ue this progress, Rw<strong>and</strong>a has developed <strong>and</strong> implemented a2009-2012 National Strategic Plan (NSP) aga<strong>in</strong>st <strong>HIV</strong> <strong>and</strong> AIDS (National AIDS Commission [Rw<strong>and</strong>a]2009). The NSP set out its ambitious goals for the country’s response to <strong>HIV</strong> <strong>and</strong> AIDS <strong>and</strong> affirmedRw<strong>and</strong>a's commitment to a multi-sector response. It is based on the most available underst<strong>and</strong><strong>in</strong>g of theepidemic <strong>and</strong> the strengths <strong>and</strong> weaknesses of the response systems <strong>and</strong> mechanisms.The objective of this study is to describe trends <strong>in</strong> key <strong>HIV</strong>/AIDS-related knowledge <strong>and</strong>attitudes, <strong>and</strong> sexual behavior <strong>in</strong>dicators us<strong>in</strong>g data from the two recent Rw<strong>and</strong>a Demographic <strong>and</strong> HealthSurveys (R<strong>DHS</strong>), conducted <strong>in</strong> 2005 <strong>and</strong> 2010 (NISR <strong>and</strong> ORC Macro 2006; NISRet al. 2012). Toaddress the concern of young adults’ vulnerability to <strong>HIV</strong>/AIDS <strong>in</strong>fection, this study also exam<strong>in</strong>esseveral <strong>in</strong>dicators among participants age 15-24.1