In 2014, the Joint United Nations Program on HIV/AIDS estimated 36.9 million people were living with HIV – more than 26 million in Africa. A vast majority of those are in Sub-Saharan Africa, with teens and young adults making up a plurality of new infections.

Now, research from Nebraska researchers and partners in Zambia highlights the misconceptions and risk factors among those youth that may help drive the epidemic, and suggests that continued education about the immunodeficiency virus that can lead to AIDS is needed.

University of Nebraska-Lincoln sociology professor Kimberly Tyler led a study of 250 Zambian street youth – children who spend their days working on the streets – to learn what they knew about HIV/AIDS and what risk factors were most likely to lead to infection. Zambia, in southwest Africa, has an estimated 1.2 million people living with HIV, and about 12,000 children are infected each year.

“In many ways, these street youths are very similar to U.S. homeless youth in their rates of high-risk behaviors such as substance abuse and sexual risk-taking, but Zambian street youth are at a much higher risk for HIV infection because the adult HIV rate is so much higher so the risk pool is larger,” Tyler, who has studied homeless youth throughout her career, said.

“To go to school there, you must have a uniform. Many families cannot afford uniforms and the required supplies. Thus, only about one-third of street youth in our sample were currently attending school full time.”

The study revealed that many false beliefs exist about the virus’ transmission. For example, 38 percent did not know that HIV could be transmitted from a mother to her unborn baby; 17 percent were not aware that the virus is carried in the blood and bodily fluids and that symptoms show up later; and 70 percent believe that bathing daily decreases risk of contracting the virus.

“There are a lot of youths, still, that don’t understand how HIV can be transmitted,” Tyler said. “This shows that more education is warranted.”

The study also found three risk factors that significantly raised the HIV infection rate: Those that were homeless were three times more likely to be HIV positive, and children who reported parental drug use problems were more than four and a half times more likely to be HIV positive. Youth who binge drank in the past 30 days were twice as likely to be HIV positive compared to those who did not binge drink. The overall infection rate of the research sample was just over 6 percent, although Tyler said that rate is low compared to other estimates.

“Women generally are more vulnerable to HIV and tend to have higher rates compared to men. Because our sample had a very small number of females, this may have contributed to the lower infection rate that we found compared to other studies,” Tyler said.

Tyler said she and her co-authors are eager to continue this line of research among African youth.

“Though we would expect a lot of research to be going on in this region because they have such high rates and Zambia has one of the highest, there really wasn’t that much, especially with actual testing to establish HIV rate.”

The article, “Risk Factors for HIV Among Zambian Street Youth,” was published in the Journal of HIV/AIDS & Social Services.

Health Sociology