Introduction
The HIV/AIDS epidemic in Jamaica has become well established and is now classified as generalized. It represents growing concern in the country, and additional efforts and resources need to be mobilized to control and prevent it. This will involve the cooperation of the health sector and other public sectors in Jamaica, such as education and finance, as well as the private sector, voluntary
groups, and nongovernmental organizations. An effective, strengthened response is urgently needed in order to adequately address this epidemic. The
epidemic could spread both more quickly and more widely if this kind of response is lacking. Although awareness of AIDS and HIV is high and condom use has increased considerably, there are no grounds for complacency. Efforts to combat HIV/ AIDS should focus on such priority areas as behavior change communication to encourage safe sex practices and delay in the initiation of sexual activity. Using existing technologies and interventions, other countries have been able to reduce the spread of HIV. These successes demonstrate
the importance of sound prevention and treatment programs as well as political commitment, and they can serve as examples for Jamaica.
The focus is geared towards assessment of HIV/AIDS in Jamaica particular programs to be posted and executed at the Ministry of Health, Kingston Jamaica. Truly, such HIV/AIDS pandemic, many people who worked in HIV/AIDS have thought of health ministers and organizations as antagonistic to what they were trying to accomplish. Preliminary literature review is core for this research along with several methods and its projected results as well as discussions. Research will address the following questions:
- What are imperative levels of assessment study towards HIV/AIDS programs at Kingston, Jamaica linked at the Ministry of Health? Discuss and have secondary support base
- How HIV/AIDS programs be of effective assessment given the fact that some factors of the situation have negative impacts in Jamaica? Critique some views from various perspectives
- To what extent do psychological, interpersonal and sociocultural factors relate to the assessment of HIV/AIDS program as noted by Kingston's health ministers?
- Are there significant differences in the HIV/AIDS knowledge, attitudes, and risk behaviors between the African-American and Caribbean college women?
Literature Review
AIDS in Jamaica was diagnosed in November 1982 (Hawkins, 2003; Nicholls, McLean, Theodore, Henry and Camara, 2000; Pan American Health Organization, 1998). Since 1987 the annual HIV/AIDS case rate has doubled every two years, with 69 percent of infected individuals having died with AIDS (Figueroa, Brathwaite, Ward, DuCasse, Tscharf, Nembhard et al., 1995). The reported incidence of HIV/ AIDS in Jamaica has steadily increased, with it being 0.05 per 100 000 in 1982, 0.1 per 100 000 in 1985, 20.2 per 100 000 in 1995, and 36.26 per 100 000 in 2001 (Jamaica, Ministry of Health, 2002; King, Wynter, Bain, Brown, Johnston and Delk, 2000). Jamaica has had the largest increase in the rate of HIV/AIDS infection of any country in the Caribbean since 1997, according to the country's Ministry of Health (Jamaica, Ministry of Health, 2002) as Jamaicans make up one out of every thirty new cases of HIV per year in the Caribbean. There was an estimated 0.7 percent of the adult population in Jamaica living with HIV/AIDS at the end of 1999 (World Health Organization, 2002). HIV/AIDS and other sexually transmitted infections have become the number one cause of morbidity and mortality for both men and women in the age group of 30-34 years (World Health Organization, 2002).
In 2001 there were 66 children under the age of 10 years newly reported with AIDS, 20 percent decrease from the previous year. This might be result of decline in the fertility of women with HIV/AIDS. HIV/AIDS was the second leading cause of death in Jamaican children aged 1-4 years old in 1999. In the three years prior to 2002, on average three children per month died of AIDS (Jamaica, Ministry of Health, 2002). HIV/AIDS epidemic has had the greatest impact in the urban areas of Jamaica (Gayle and Hill, 2001). Despite the increase in the number of HIV/AIDS cases in Jamaica, there are some factors that have acted in concert to slow the spread of the epidemic. These factors include an efficient national health system, establishment of national HIV/AIDS control program, improved management of STIs, increased condom use and condom sales, reduced high-risk sexual behavior, and improved funding for HIV/AIDS control and prevention. Jamaica has an efficient national health system. The health indicators in Jamaica are favorable than those of other countries in Latin America and the Caribbean at similar income levels. Jamaica has had comprehensive national HIV/STI control program since 1987 (Henry, 1997), that program has instituted HIV/STI control measures that appear to have slowed the HIV/AIDS epidemic (Figueroa, Brathwaite, Wedderburn, Ward, Lewis-Bell, Amon et al., 1998). In addition, the National AIDS Committee was established in 1988 to advise the Ministry of Health on policy issues and to mobilize different sectors of the society in the fight against HIV/AIDS (World Bank, 2002). Some programs designed to slow the spread of HIV need to focus on reducing transmission through sexual contact and on treating STIs (Policy Project, 2001).
Research Methodology
Several variables are to be selected based upon review of the literature in ample area focusing on HIV/AIDS programs design for people in Kingston who are affected by the painful truth and real situation as the limited data on HIV/AIDS have provided salient insight regarding important issues to consider for the research study
Research participants
The research participants will comprise of 50 members of the Ministry of Health in Kingston, Jamaica. The participants have worked at the ministry for not less than a year and are regular employees as health ministers of the place.
Instruments
The instruments will include the behavior subscale of the AIDS Knowledge, Feelings, and Behavior Questionnaire, the knowledge subscale, the attitudes towards AIDS Scale. The Cronbach alpha internal consistency reliability coefficients for each of the measures by the ministry will be provided as well as to fill up certain demographic questionnaire. Sexual risk-taking behaviors were assessed by the behavior subscale of the AIDS Knowledge, Feelings, and Behavior Questionnaire (Dancy, 1991). Subscale consists of 18 items which asked respondents about frequency of condom use and other kinds of risky behaviors they have engaged in over the last six months. Scores on the Behavior Subscale are totaled, yielding possible score ranging from 0-54, with higher scores indicating greater generalized sexual risk-taking. AIDS knowledge subscalecontains 24 items which assess respondents' knowledge of high risk sexual transmission, knowledge of prevention, knowledgeof casual contact, knowledge of HIV testing, knowledge of moderate risk sexual transmission, knowledge of basic facts, and knowledge of transmission related to blood. Items are summed to yield a total possible knowledge score ranging from 0-80, with higher scores indicating more accurate HIV/AIDS knowledge.
The attitudes towards AIDS scale (Goh, 1993) assesses affective responses to AIDS as disease, HIV infected persons, and AIDS-related issues. The scale consists of 25 items, answered on 5-point response scale. Items are summed, yielding possible score ranging from 25-125 with higher scores indicating more positive or accepting attitudes toward people with HIV/AIDS. The demographic questionnaire obtains information on the participant's age, place of birth, school classification and marital status. Once the research participants are being assembled, they will be provided such consent form prior to testing as program assessments can be anonymous, self administered and be completed at the Ministry of Health group settings, the questionnaire will be conducted for about sixty minutes for the participants to complete.
Results
For such projection of outcome, such mean age can be about 23 years such as in terms of the psychological variables examined, comparison of sexual knowledge, attitudes, and risk-related behaviors. Different superscripts denote significant cultural groups differences at the p < 0.05 level of significance, while same superscripts denote nonsignificant cultural group differences No significant differences can be found on the self-esteem measures.Pearson correlations were generated to determine any significant relationshipsbetween selected variables. Closer inspection of the data reveal significant negative correlation between generalized sexual risk-taking and condom self-efficacy while no significant relationship emerged between the variables, self-esteem and HIV/AIDS attitudes were positively related. No significant relationship was found between HIV/AIDS programs in lieu to knowledge and sexual risk taking nor between HIV/AIDS knowledge and others.
Discussion of results
The study provides descriptive data on HIV/AIDS knowledge, attitudes, and sexual riskbehaviors. There highlights some similarities and differences between these two groups. Psychological, interpersonal, and sociocultural factors related to these young college women's sexual knowledge, attitudes, and sexual risk-behaviors are elucidated. Similar to findings from other studies, results show that the vast majority of these young women are sexually active (Baldwin and Baldwin, 1988; Strader and Beaman, 1989). Findings will demonstrate that knowledge concerning HIV/AIDS programs are high with majority of health ministers understanding how assessment be of effective stature. Indeed, there can be no significant relationship between HIV/AIDS program, knowledge and risk-taking behaviors as there implies that knowledge does not translate into behavioral change for the study.
References
Baldwin, J. & Baldwin, J. (1988). Factors affecting AIDS related sexual risk taking behavior among college students. Journal of Sex Research 25: 181-196.
Dancy, B.L., Marcantonio, R. & Norr, K. (2000). The long term effectiveness of an HIV prevention for low income African American women. AIDS Education and Prevention 12(2): 113-125.
Figueroa JP, Brathwaite A, Ward E, DuCasse M, Tscharf I, Nembhard O, et al. The HIV/AIDS epidemic in Jamaica. AIDS. 1995;9(7):761-8.
Figueroa JP, Brathwaite AR, Wedderburn M, Ward E, Lewis-Bell K, Amon JJ, et al. Is HIV/STD control in Jamaica making a difference? AIDS. 1998;12 Suppl 2:S89-98.
Gayle HD, Hill GL. Global impact of human immunodeficiency virus and AIDS. Clin Microbiol Rev. 2001:14(2): 327-35
Goh, D.S. (1993). The development and reliability of the attitudes towards AIDS scale. College Student Journal 27(2): 208-214.
Hawkins BD. HIV/AIDS a predator in paradise. Black Issues Higher Educ. 2003;19(25):19-22
Henry K. Jamaicans begin to embrace safer sex. Aidscaptions. 1997;4(1):18-22.
Jamaica, Ministry of Health. Jamaica AIDS report 2001. Kingston: MOH; 2002.
King SD, Wynter SH, Bain BC, Brown WA, Johnston JN, Delk AS. Comparison of testing saliva and serum for detection of antibody to human immunodeficiency virus in Jamaica, West Indies. J Clin Virol. 2000;19(3):157-61.
Nicholls S, McLean R, Theodore K, Henry R, Camara B. Modelling the macroeconomic impact of HIV/AIDS in the English speaking Caribbean: the case of Trinidad and Tobago and Jamaica. S Afr J Econ. 2000;68(5):916-32
Pan American Health Organization. Jamaica - country profile. In: Pan American Health Organization. Health in the Americas. 1998 edition. Washington, D.C., PAHO; 1998. Pp. 343-55
Policy Project. HIV/AIDS in Southern Africa - background, projections, impacts and interventions. Washington, D.C.: Futures Group International; 2001.
Strader, M.K. & Bearman, M. (1989). College students knowledge about AIDS and attitudes toward condom use. Public Health Nursing 6: 62-66.
World Health Organization. Epidemiological fact sheets on HIV/AIDS and sexually transmitted infections - Jamaica. 2002 update. Geneva: WHO; 2002.
World Bank. Jamaica - HIV/AIDS Prevention and Control Project (second phase of the multi-country HIV/AIDS prevention & control APL for the Caribbean). Washington, D.C.: World Bank; 2002
Comments