Factors contributing to high HIV and AIDS prevalence : development of a multifaceted theoretical model

Abstract

South Africa is estimated to have about 7.06 million of the global HIV/AIDS infections of 36.7 million people in 2017 (UNAIDS, 2017a; Statistics South Africa, 2017). It is estimated that 19.2 percent of South Africans of ages 15 to 59 were infected with HIV/AIDS in 2015 (UNAIDS, 2015a). In South Africa, Gauteng province had the fifth highest HIV and AIDS prevalence in 2012 (Human Sciences Research Council, 2014). There is a need to reduce HIV infections amongst adolescents in Gauteng province of South Africa. The study focused on developing a model of factors contributing to high HIV and AIDS prevalence amongst adolescents in Gauteng province of South Africa. To establish the specific model, the researcher elicited learners‟ perceptions of contributing factors to adolescents‟ high HIV and AIDS. Various individual models used to design interventions in South Africa had been criticised. In this study, three of these models were explored; the Theory of Planned Behaviour, the Information Motivation Behaviour Skills Model and the Social Ecology Theory. These three models were integrated into a new model to determine the applicability of interventions based on each model, as well as to find out other factors that contribute to HIV infection besides behaviour. This was done to fill the gap of the narrow perspectives and non-lasting effects of each model based intervention. In this study a qualitative research method was used. The study was influenced by, but not exclusively based on Grounded Theory. Purposive and convenient sampling methods were used to identify Grade 11 learners (n=24) in three high schools in Gauteng province. However, 15 Grade 11 learners were the actual sample size that provided information that addressed the purpose of the study. Data was collected using semi structured interviews. The results were analysed using initial and focused coding and comparative analysis. Results were situated in the context of these three existing models. Findings show that intentions, subjective norms, perceived behavioural control, knowledge and social ecology settings were contributing factors to adolescents‟ high HIV and AIDS prevalence in Gauteng province. In addition, novel findings extended the existing definitions of intentions, subjective norms, perceived behavioural control, knowledge and social ecology settings. Consequently, the researcher developed a new multifaceted theoretical model to describe those factors that participants regarded as contributing factors to the high HIV and AIDS prevalence amongst adolescents. This model may describe HIV and AIDS behavioural studies and prevention more effectively than existing models, although the study did not include the development of interventions to test the model. Policy makers, researchers, educators and adolescents may use findings of this study. It is hoped that the model would be useful for the scholarship pertaining to HIV and AIDS studies and prevention.