Knowledge and attitudes to HIV and AIDS and sexual practices among university students in Lusaka, Zambia and London, England: are they so different?

Surveys conducted among university students in Lusaka, Zambia, and London, England, in 1993-94 revealed comparable AIDS-related knowledge, attitudes, and sexual practices, despite vast differences between the two countries in AIDS prevalence. Questionnaires were completed by 946 seniors and 294 new students from the University of Zambia in 1993 and 1994 and by 100 seniors and 117 new students from London University in 1994. Both groups of students were quite knowledgeable about transmission of HIV through semen, blood, and vaginal fluid; however, 50% in both settings believed saliva transmits HIV. Although more than two-thirds of Lusaka students, compared with one-fourth of London students, knew or had known someone with HIV, British students had more compassionate, less judgmental attitudes toward AIDS patients. 90% of Lusakan but under 50% of London students worried about catching HIV. By their senior year, 61% of female and 85% of male students in Zambia had had one or more sexual partner compared with 73% and 76%, respectively, in London. 66% of Lusakan and 75% of London students used condoms most of the time with casual partners; with regular partners, these rates were only 23% and 35%, respectively. Lusakan students were less likely than their London counterparts to discuss HIV with their partners. 75% of students in both countries had received some type of AIDS education, but the majority expressed an interest in additional counseling. Recommended, in both settings, are university-based AIDS education programs, with particular emphasis on the importance of condom use with all sexual partners.