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East Afr Med J. 1993 Jul;70(7):414-7.

HIV infection among secondary school students in Djibouti, horn of Africa: knowledge, exposure and prevalence.

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  • 1Epidemiology Branch, US Naval Medical Research Unit 3 (NAMRU-3), FPO AE 09835-0007.


A study of HIV infection among secondary school students was conducted in Djibouti in February 1990 during a national hepatitis survey. Serology was negative for HIV and syphilis among 294 students (ages 14 to 20 years) in spite of a dramatic increase of HIV seropositivity (as high as 41%), and a high level of syphilis positive serology (up to 46%) among adult high-risk groups such as street prostitutes. Results of a face-to-face interview of these pupils indicated that 64% had a basic knowledge of AIDS. As expected, a much better knowledge of AIDS was found among those who recently received AIDS education. However, 80% of secondary school teenagers did not consider themselves at risk for acquiring HIV. Transmission of HIV among school-children would be possible through sexual activity (22% stated to be sexually active) or parenteral therapy (75% had received at least one intramuscular injection), and not likely through blood transfusion or intravenous drug abuse. Results, close to those of a similar study in Zimbabwe, suggest that AIDS education programme should be given to all secondary school pupils and include public health lectures on syphilis, tuberculosis, and HIV infection.


In February 1990 in Djibouti, a study of 147 male and 147 female students (data obtained from a national hepatitis survey) aimed to determine knowledge about AIDS, sexually transmitted diseases, and sexual experience; exposure to HIV infection; the potential weight of sexual and parenteral routes of HIV infection; and the significance of their exposure to HIV infection. Students represented all the secondary schools in the capital city. None of the students tested seropositive for HIV or syphilis, even though as many as 41% and 46% of high risk adults (e.g., prostitutes) tested positive for HIV and syphilis, respectively. 21.2%, 5.6%, 2.7% and 0.68%, and 0.5% tested positive for anti-hepatitis B (HB) s antibody, HBs antigen, anti-HBe antibody, HBe antigen, and delta hepatitis respectively. Anti-HBs seropositivity rose linearly with age (p .01). About 64% had basic knowledge about AIDS. Almost 100% had at least heard of it. Special lectures on AIDS during a recent national campaign likely contributed to the higher knowledge level among the 18-year-old students. 88.1% of all students wanted more information about AIDS. Boys were more likely to want to learn more about AIDS than girls (91.8% vs. 84.3%; p = .047). About 40% of the students knew about tuberculosis (TB). 78.6% wanted more information about TB. Boys were more likely to be sexually active than were girls (40.8% vs. 2.7%; p .01). Sexual activity increased with age among boys (p .01). 51.6% of sexually active students never used condoms. Just 24.2% always used them. 80% of students did not consider themselves to be at risk for HIV infection. Almost all students had previously been exposed to the risk of parenteral infection, especially vaccines (99%) and intramuscular injections (75.2%). No one had used intravenous drugs. These findings suggested the need for AIDS education for secondary school students which covers HIV prevalence in Djibouti, TB, syphilis, and HIV transmission via sexual and parenteral routes.

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