Indicator 4.2: "No incorrect beliefs about AIDS - Composite of 3 components"
The percent of respondents who, in response to a prompted question, correctly reject the two most common local misconceptions about AIDS transmission or prevention, and who know that a healthy-looking person can have the AIDS virus, based on 4.2.1, 4.2.2 and either 4.2.3 or 4.2.6.
UNAIDS general population survey; DHS AIDS module; FHI BSS; MICS (UNICEF).
What It Measures
Many of the people who know that condoms protect against AIDS also believe that AIDS can be contracted from a mosquito bite or other uncontrollable event. Why bother to reduce the pleasure of sex, they reason, if they might in any case be infected by something as random as a mosquito bite? At high levels of HIV-related awareness, a reduction in misconceptions that act as a disincentive to behaviour change may actually be a better reflection of the success of an IEC campaign than an incremental shift in already high levels of "correct" knowledge. This indicator measures progress made in reducing misconceptions.
How to Measure It
In a series of prompted questions, respondents are given correct and incorrect statements about AIDS transmission and prevention. Responses to the correct statements about prevention are used to calculate Knowledge Indicator 1. Responses to a question about infection status in healthy-looking people and to two incorrect statements about transmission or prevention are used to calculate this indicator.
The incorrect statements will vary to reflect the misconceptions most common in the local context. Very often these will include the belief that AIDS can be spread through an insect bite or through witchcraft. Sometimes they will include beliefs about prevention or cure, such as AIDS being preventable by eating certain types of food or herbs, or being curable by having sex with a certain type of person such as a virgin (or simply being curable at all). One question will always centre on knowledge of the "healthy carrier" concept, that is, knowledge that a person may contract HIV by having unprotected sex with an apparently healthy person. The exact wording may vary locally. For example, in some areas "fat" may be synonymous with "healthy" in this context and may better reflect people's misunderstanding of who constitutes a "safe" partner.
The local misconceptions should be identified shortly before a survey takes place. They may vary over time within the same country.
To enter the numerator for this indicator, a respondent must correctly reject both misconceptions, and must know that a healthy-looking person can have the AIDS virus. The denominator is all respondents, including those who have not heard of AIDS. For programme purposes, the indicator should be disaggregated by misconception, and the percentage believing that a healthy-looking person cannot transmit HIV should also be reported separately.
Strengths and Limitations
This indicator gives a good picture of the level of false beliefs that may impede people's determination to act on correct knowledge. When the data are disaggregated, they provide invaluable information for programme managers planning future IEC campaigns, telling them which misconceptions must be attacked, and in which sub-populations.
A word of caution is in order, however. There is always a danger that the inclusion of misconceptions in a questionnaire actually increases their credibility. Preparatory research should be sure to establish commonly held misconceptions (rather than run the risk of promoting new ones), and the questionnaire should make very clear that some of the statements in the sequence are true while others are false.
One limitation is the indicator's ability to distinguish between misconceptions which are likely to influence behaviour and those which are merely incidental. Measurement of this indicator also requires preparatory work to determine which misconceptions are currently most likely to be common.