Unprotected sex, multiple partners, wild parties and boozing are characteristics of student life that could lead to a high prevalence of HIV — but not for students at Rand Afrikaans University (RAU).
A study by sociology academics found that of a large sample of urban RAU students tested, only 1,1% were HIV-positive.
The students showed a high tendency to practise safe sex and 74,2% of sexually active students said they had used condoms in their most recent sexual encounters.
The findings throw doubt on estimates of high HIV-infection rates among university students.
The research was initiated to ascertain the HIV/Aids situation at RAU. It was spurred by studies at the University of Durban-Westville that revealed infection rates of 26% in women and 12% in men. The Mail & Guardian reported last year that 22% of undergraduate students could be infected, rising to 33% by 2005.
The researchers hoped to break through the ”thick cloak of ignorance” surrounding the epidemic on campus in order to investigate the role and responsibility of RAU in dealing with HIV/Aids.
Last October 1188 volunteer students participated in the ”Spit for Science” campaign during RAU’s Aids week. They completed anonymous questionnaires and an oral test to determine HIV prevalence on campus.
Two nurses and a phlebotomist took the fluid samples and the University of the Witwatersrand Medical School analysed the samples.
The most important aspect of the process was to assure the students that there was no chance that the anonymity of questionnaires and especially the samples would be breached. The researchers accomplished this by using bar codes for the oral fluid tests.
The researchers also anticipated that the study might spark concern among students about their HIV status, so extra provision was made for students to be tested free at the neighbouring Helen Joseph hospital. Only 27,4% of sexually active students reported ever knowing their HIV status.
”We were very surprised at the results,” says Tina Uys, a sociology professor. ”While it is impossible to argue, conclusively, that the prevalence of HIV infection among RAU students is only 1%, in our judgement it is certainly likely to be closer to that figure than to 5%.”
The study does warn that because the survey was based on self-selection, it is necessary to be more cautious about generalising from the findings than would have been the case had random sampling been possible.
”However, given the anonymous nature of the survey it was unlikely that students concerned about their HIV status would have been discouraged from participating.”
The sample size represented 8,1% of the student body.
Peter Alexander, director of the Centre for Sociological Research, says the high prevalence of condom usage was a positive finding but the reasons for students not using condoms are important. The most significant finding was that students did not use condoms when using another form of contraceptive. Unavailability of condoms and preference were also cited as reasons for unprotected sex. The overall finding was that most students are aware of the importance of using a condom.
”Ideally, I would love to have sex without a condom, but the danger is too much,” said a white male student.
The research recommends that condoms be widely distributed. Students also said they preferred brand-name condoms to government-issue. Attitudes to female condoms were positive, as they would empower women, giving them more control over HIV prevention.
The study found that the use of condoms did not vary significantly on the basis of race, age, gender or whether students did or did not stay in a university residence. This is a high rate of condom usage compared to other South African studies. Alcohol consumption did not affect condom usage.
The level of sexual activity was average, with 57,3% of respondents reported having had sexual intercourse.
”Sexual activity is not risky in itself but the most disturbing fact was that very few students know their HIV status,” says Uys.
She says the questionnaire did not ask the reason for students abstaining from sexual intercourse but that ”religious affiliation is significantly associated with sexual activity, with the most sexually active groups being those with no religious affiliation (82,9%), as well as Christian (59,6%) and Jewish (57,7%) groups. The least sexually active groups are the Muslim (26%) and Hindu (25%) groups.”
Although the survey highlighted gaps in what students knew about HIV/Aids, the overall level of knowledge appeared to be high. Students who had had friends or relatives die of Aids — notably female and black students — were especially knowledgeable.
The media was regarded as the most important source of information, the university as the least. The government’s ABC (abstinence, be faithful and condomise) programme was also shown to be effective in changing behaviour.
But the study found a disturbing level of confusion among students, with 8,6% of respondents believing that HIV does not cause Aids and 6,4% not knowing whether HIV causes Aids.
Other findings that reinforce the need for educational initiatives at university level are that 5,4% of respondents believe that a person can get HIV from mosquito bites, while 8,4% are unsure. A quarter believes that a person cannot get HIV by engaging in oral sex while 16% of respondents do not know, and 12,9% do not know that sexually transmitted infections increase the risk of HIV.
The study is not the end of the road for RAU. There are plans to do more studies, revising the questionnaires to include more questions on behaviour and making the methodology available to other universities.