Conspiracy beliefs and knowledge about HIV origins among adolescents in Soweto, South Africa

Purpose We examined adolescents’ knowledge regarding the origin of HIV/AIDS and correlates of beliefs surrounding conspiracy theories in Soweto, South Africa. Now, a decade post-AIDS denialism, South Africa has the largest antiretroviral therapy roll-out worldwide. However, conspiracy theories stemming from past AIDS denialism may impact HIV prevention and treatment efforts. Methods Study participants were recruited through the Kganya Motsha Adolescent Health Centre and the Perinatal HIV Research Unit’s Botsha Bophelo Adolescent Health Study (BBAHS). Adolescents were eligible to participate if aged 14–19 years and living in Soweto. We calculated the proportion of adolescents who correctly believed that HIV originated from non-human primates, and used contingency table analysis and logistic regression modeling to describe correlates associated with accurate knowledge and beliefs in conspiracy theories. Results Of 830 adolescents, 168 (20.2%) participants correctly identified HIV as originating from chimpanzees and one third (n = 71, 8.6%) believed in a conspiracy theory about the origins of HIV, including that it originated from the US government (2.3%), the pharmaceutical industry (2.2%), a vaccine (2.1%), space (1.5%), and a scientist (0.6%). Participants who were more likely to correctly identify the origin of HIV were older, men, and unemployed. Participants who were men, unemployed or students, and who had a parent or close relative who had died of HIV, were more likely to believe in a conspiracy theory regarding the origins of HIV. Conclusions Adolescents living in Soweto did not have high levels of accurate knowledge regarding the origins of HIV/AIDS and conspiracy beliefs were present among a small minority of participants. Accurate knowledge of the origins of HIV and debunking myths are important for improving uptake of HIV prevention tools in this population.


For each of the following questions, consider what has happened in the past 30 days.
Please answer whether this happened never, rarely (once or twice), sometimes (3 -10 times), or often (more than 20 times) in the past 30 days.

Never
Rarely Step-father n m l k j n m l k j n m l k j n m l k j n m l k j Step-mother n m l k j n m l k j n m l k j n m l k j n m l k j Mother's boyfriend n m l k j n m l k j n m l k j n m l k j n m l k j   n m l k j Other What family planning or pregnancy prevention methods do you use? Check all that apply to you.

Have you EVER been pregnant?
Male condoms g f e d c What family planning or pregnancy prevention methods do you use? Please check all that apply to you.

Have you EVER made/got somebody pregnant?
Male condoms g f e d c g f e d c

What would make it easier for you and people your age to test for HIV?
Have you EVER been tested for HIV? We are going to ask you some questions about boyfriends and/or girlfriends and sexual relationships that you may or may not be involved in. We want to stress that any information you share is absolutely confidential. Please also be assured that we will not judge you or any information you share with us. The number of sexual partners people have varies from person to person; there is no right or wrong number. For some young people, it is normal to have sexual partners or girlfriends/boyfriends who are the same sex. Also, while some young people may not be having sexual intercourse, some may be having oral sex. We know these are difficult issues to discuss but would appreciate it if you could tell us now about any types of sexual behaviour you may be engaged in. If you feel you can't answer honestly please skip to the next question by checking the "Prefer not to answer" option.

How do you identify your sexual orientation?
Have you had a boyfriend/girlfriend in the past 6 months? How old do you think most of your friends were the first time they had consensual oral sex? By consensual we mean they wanted and agreed to have oral sex.

Do you think a person is at risk for HIV when having oral sex?
Have you ever had consensual oral sex before? By consensual we mean you wanted and agreed to have oral sex. Prefer not to answer n m l k j

Other
We understand that questions about sex are hard to answer but please answer honestly and if you feel you cannot, there is a "Prefer not to answer" option. We appreciate you providing this information and assure you it will be kept confidential.

Have you had any kind of sexual intercourse with a WOMAN in the past 6 months?
This section is for people who have had sex with WOMEN in the past 6 months... Prefer not to answer n m l k j When you had vaginal sex with women in the past six months, how often did you use condoms? By using a condom we mean you used it from start to finish of one sexual act.
What were the ages of the women you had sex with in the past 6 months? 1.
8. Prefer not to answer n m l k j

How many women have you had consensual anal sex with in the past 6 months?
How often did you use a condom when having anal sex with women in the past 6 months? By using a condom we mean you used it from start to finish of one sexual act. In your current/most recent sexual relationship, would you say that your girlfriend has more control over whether or not you used condoms than you did?
In your current/most recent sexual relationship, does your girlfriend have more control over whether or not you have sex than you do?
Have you ever had sex with someone in order to get material goods such as money, food, presents, clothes, better grades, or other items? Prefer not to answer n m l k j We understand that questions about sex are hard to answer but please answer honestly and if you feel you cannot, there is a "Prefer not to answer" option. We appreciate you providing this information and assure you it will be kept confidential.

Have you had any kind of sexual intercourse with a MAN in the past 6 months?
This section is for people who have had sex with MEN in the past 6 months. Prefer not to answer n m l k j When you had vaginal sex with men in the past six months, how often did you use condoms? By using a condom we mean you used it from start to finish of one sexual act.
What were the ages of the men you had sex with in the past 6 months? 1.
8. In your current/most recent sexual relationship, would you say that your boyfriend has more control over whether or not you used condoms than you did?
In your current/most recent sexual relationship, does your boyfriend have more control over whether or not you have sex than you do?
Have you ever had sex with someone in order to get material goods such as money, food, presents, clothes, better grades, or other items? Prefer not to answer n m l k j We are now going to ask you about some possible sexual experiences that may have happened to you. We recognize that they might be hard to talk about, and if you do not wish to answer them please check the "Prefer not to answer" option. We know that sex is really hard to talk about, particularly sexual violence, but please understand that your honesty is really important so that we can better respond to the risks for HIV in you community. Please also know that sex and sexual violence are unfortunately very common in your age group and in your community. Therefore, you will not be alone in anything you tell us. If you feel you can't or don't want to answer a question honestly, then just check the "Prefer not to answer" option. Also, if anything you tell us leaves you feeling sad or scared, there is a social worker that is available to sit with you after the interview. The information you share with us today is important and will be used to advocate for services to support the health of adolescents.

Has someone ever forced you to have sexual intercourse with them?
Yes n m l k j No n m l k j Unsure n m l k j We would like to ask you some questions about drug and alcohol use. Some of the questions that we ask might be uncomfortable. Please remember that anything you share with us about alcohol or drugs will not be shared with anyone else. If you do not want to answer a question, please check the "Prefer not to answer" option.
Have you had alcohol to drink in the past 6 months?   n m l k j n m l k j n m l k j n m l k j n m l k j n m l k j n m l k j n m l k j n m l k j n m l k j n m l k j n m l k j n m l k j n m l k j n m l k j For each of the following statements, we would like you to tell us whether you agree or disagree.

Agree Disagree
It is more difficult to refuse sex with a partner who is older than you compared to a partner who is the same age as you.
n m l k j n m l k j Condom use is a shared responsibility for both partners.
n m l k j n m l k j It is cool to have a sexual partner who is older than you (5+ years).
n m l k j n m l k j It is okay to have sex with a sugar mommy, sugar daddy, or a person with whom you have sex so that they will buy you things. n m l k j n m l k j One of Kganya Motsha's objectives is to reduce the fear surrounding HIV testing by making HIV testing a normal part of being a young person. We encourage and support all young people to come and test for HIV, even if they are not yet having sex. We will give you a coupon to come back to Kganya Motsha to have an HIV test as part of this study, and encourage you to do so, even if you are not yet having sexual intercourse.
Are you planning on returning to Kganya Motsha for an HIV test as part of this study?

Conclusion
Yes n m l k j No n m l k j Unsure