Recent Trends in HIV-Related Knowledge and ... - Measure DHS

1. INTRODUCTIONRwanda is situated in central Africa, immediately south of the equator between latitude 1°4' and2°51' South and longitude 28°63' and 30°54' East. It has a surface area of 26,338 square kilometers and isbordered by Uganda to the north, Tanzania to the east, the Democratic Republic of the Congo to the west,and Burundi to the south. Landlocked, Rwanda lies 1,200 kilometers from the Indian Ocean and 2,000kilometers from the Atlantic Ocean. Nearly all Rwandans speak Kinyarwanda, the country’s official firstlanguage, followed by English and French. Kiswahili, the third most common foreign language, isgenerally spoken in urban areas and in the provinces bordering other countries where this language iswidely spoken, such as the Democratic Republic of the Congo and Tanzania.HIV infection is a major public health concern in Rwanda, where it is one of the main causes ofmortality, and carries negative social and economic consequences that affect everyone in the country.Results from the 2010 Rwanda Demographic and Health Survey show that 3 percent of Rwandan adultsage 15-49 are infected with HIV. The prevalence iss much higher in urban areas, among women, andamong adults who have had multiple lifetime sexual partners and used a condom at last sexualintercourse. The level of and differences in HIV prevalence in Rwanda in 2010 are very similar to thoseobserved in 2005 (National Institute of Statistics of Rwanda [NISR] and ORC Macro 2006; NationalInstitute of Statistics of Rwanda [NISR] et al. 2012).At the very early stage of the epidemic, the government of Rwanda demonstrated a strongcommitment to lead in HIV prevention and treatment. It promptly recognized the negative impact of theAIDS epidemic on the country’s social and economic development. The government adopted a multisectoralapproach, and developed a national HIV/AIDS strategic plan. Rwanda received assistance andsupport from the international community for its pledge to develop a comprehensive program to fightHIV/AIDS. The program includes a full range of preventive, medical, and support services for thoseliving with HIV/AIDS. Most activities have had a nationwide focus, and the important beneficiariesinclude but are not limited to civil society organizations, faith-based groups, and grassroots associations.Since the initiation of the 2005-2009 National Multi-sector Strategic Plan (NMSP), Rwanda hasmade significant progress in the provision of universal access to HIV and AIDS services (National AIDSCommission [Rwanda] 2005). To continue this progress, Rwanda has developed and implemented a2009-2012 National Strategic Plan (NSP) against HIV and AIDS (National AIDS Commission [Rwanda]2009). The NSP set out its ambitious goals for the country’s response to HIV and AIDS and affirmedRwanda's commitment to a multi-sector response. It is based on the most available understanding of theepidemic and the strengths and weaknesses of the response systems and mechanisms.The objective of this study is to describe trends in key HIV/AIDS-related knowledge andattitudes, and sexual behavior indicators using data from the two recent Rwanda Demographic and HealthSurveys (RDHS), conducted in 2005 and 2010 (NISR and ORC Macro 2006; NISRet al. 2012). Toaddress the concern of young adults’ vulnerability to HIV/AIDS infection, this study also examinesseveral indicators among participants age 15-24.1