Belief in conspiracy theories means less HIV testing in South Africa

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South Africans who believe in a conspiracy theory that HIV was introduced by white people as a way of controlling the black population are significantly less likely to have had an HIV test, according to a study published in the September 1st edition of the Journal of Acquired Immune Deficiency Syndromes. For the South African government to restore the public’s faith in their response to HIV, they need to “present a consistent and strong prevention platform about the importance of testing”, argue the investigators.

Although over 20% of South Africans aged 15 – 49 are infected with HIV, fewer than a fifth have been tested for HIV. Media reports suggest that there is widespread misinformation amongst the South African population about HIV, including popular belief in conspiracy theories, for example that the apartheid-era South African government manufactured HIV as a way of controlling the black population.

The behaviour of both pre- and post-majority rule administrations has provided some foundation for such beliefs, with the New York Times reporting in 2001 that the apartheid government had tried to develop biological weapons using a range of bacteria and viruses, including HIV. Furthermore, the Mbeki administration was sympathetic to theories that HIV was not the cause of AIDS.

Glossary

sample

Studies aim to give information that will be applicable to a large group of people (e.g. adults with diagnosed HIV in the UK). Because it is impractical to conduct a study with such a large group, only a sub-group (a sample) takes part in a study. This isn’t a problem as long as the characteristics of the sample are similar to those of the wider group (e.g. in terms of age, gender, CD4 count and years since diagnosis).

stigma

Social attitudes that suggest that having a particular illness or being in a particular situation is something to be ashamed of. Stigma can be questioned and challenged.

confounding

Confounding exists if the true association between one factor (Factor A) and an outcome is obscured because there is a second factor (Factor B) which is associated with both Factor A and the outcome. Confounding is often a problem in observational studies when the characteristics of people in one group differ from the characteristics of people in another group. When confounding factors are known they can be measured and controlled for (see ‘multivariable analysis’), but some confounding factors are likely to be unknown or unmeasured. This can lead to biased results. Confounding is not usually a problem in randomised controlled trials. 

bacteria

Single-celled micro-organisms.

Belief in conspiracy theories about HIV have been shown to be associated with lower levels of condom use amongst African-American men. But there has been no research examining an association between such beliefs and HIV risk behaviours in South Africa.

Investigators therefore designed a study involving 503 men and 438 women who were recruited from sexual health clinics in three townships. They completed a questionnaire about their HIV testing history and attitudes and beliefs towards and about HIV. One of the questions asked individuals to agree or disagree with a statement that AIDS was introduced by white people as a way to control black Africans.

Almost all (94%) the study sample were black Africans. The investigators found that a high proportion of the study sample had been tested for HIV (68%), with 24% of the tested individuals being HIV-positive.

The investigator’s first set of statistical analysis showed that individuals who had not tested for HIV had lower levels of knowledge about HIV and also had more stigmatising views about the virus (p < 0.05). The only belief about HIV that was associated with lower levels of testing was the belief in a conspiracy theory that HIV was created by white people to control the black population.

In subsequent analysis that controlled for possible confounding factors such as demographics, HIV knowledge and stigma, only age (p < 0.05) and a belief in conspiracy theories (p < 0.01) remained associated with lower levels of HIV testing.

“Our results suggest that genocidal HIV beliefs undermine public support for government-sponsored HIV-related programs and individuals’ participation in such programmes”, write the investigators.

References

Bogart LM et al. Endorsement of genocidal HIV conspiracy as a barrier to HIV testing in South Africa. J Acquir Immune Defic Syndr 49: 115 – 116, 2008.