Community Knowledge and Perceptions about the Causes, Prevention, and Treatment of HIV/AIDS and Other Sexually Transmitted Diseases (STDs) in Bahir Dar

Objective: To study knowledge and perceptions among residents of Bahir Dar about the causation, prevention, and treatment of sexually transmitted illnesses.

Methods: Sixty randomly selected informants, including 20 key informants, were interviewed about the occurrence of the most common sexually transmitted and other diseases, as well as illness perception, causation, prevention, and treatment in Bahir Dar using semi-structured interview guides. Ten health practitioners also were interviewed about their knowledge and attitudes about sexually transmitted diseases (STDs) and patients infected with them.

Results: The five most frequently named STDs were AIDS, gonorrhea, syphilis, chancroid, and lymphogranuloma venereum (LGV), in that order. HIV/AIDS and gonorrhea were relatively well known compared to the other STDs, reflecting their high prevalence. Community members used many local vernacular names to refer to sexually transmitted illnesses. This use of euphemisms reflects the cultural belief that such diseases should not be talked about openly. While the considerable stigma attached to all STDs inhibits open discussion, it is easier to talk about AIDS because of the wider publicity the epidemic has received. A number of misconceptions about causes and ways to prevent STDs were identified. Government health services were found to be used relatively infrequently by persons with STDs. Stigma, inconvenience, problems in patient-provider interactions, and issues of confidentiality and privacy were major factors in both the underutilization of public health services and the widespread use of self-medication, traditional healers, private doctors, and injectionists (local practitioners who administer medical injections for a fee).

Conclusion and Recommendations: A combination of persisting misconceptions about the causation, transmission, and treatment of most STDs exists. The ethnomedical environment surrounding these diseases is characterized by strong stigmas, secrecy, delayed treatment, widespread self-medication, and problematic patient-health services relationships, all of which impede the prevention and control of STDs in Bahir Dar. Development and implementation of collaborative programs involving official health services and community-based organizations may increase STD clinic utilization rates.