By Steve Buist
A new study shows that University of Zambia (Unza) students get a failing grade when it comes to HIV prevention measures.
More than 80 per cent of the students who took part in a scientific survey said they aren’t willing to use a freely-available pre-exposure drug regime that can prevent HIV infection in healthy individuals.
The survey also showed that Unza students are engaging in risky sexual behaviours despite the high rate of HIV prevalence in Zambia.
More than 60 per cent of the survey respondents said they or their sexual partner hadn’t used a condom during the previous six months, and about one-third of the students who said they engage in sex indicated they currently have more than one sexual partner.
The study, led by a team of researchers in university’s Department of Pharmacy, has just been published in the September 2024 edition of the Health Science Reports Journal.
The study surveyed 346 Unza students at all year levels, asking them about their willingness to use the pre-exposure drug regime as well as some questions about sexual behaviours.
PrEP, an acronym for “pre-exposure prophylaxis,” is a novel daily drug regime intended to prevent HIV infection in high-risk individuals. An oral antiretroviral, typically a combination of tenofovir and emtricitabine, is taken daily and the drug regime has been available for free in all of Zambia’s public hospitals since 2016.
Clinical trials have shown that HIV infection can be halted when adherence to the PrEP regime is greater than 70 per cent. Zambia is one of just a handful of sub-Saharan countries to have implemented a full-scale national PrEP programme.
Zambia continues to have one of the world’s highest rates of HIV infection. According to the World Health Organisation, about 1.4 million Zambians are infected with HIV, and the infection rate is about 11 per cent for those between the ages of 15 to 49.
Martin Kampamba, the study’s lead author, said the results of the survey were both “surprising and concerning.”
“It highlights a disconnect between acknowledging risk and taking proactive measures to reduce that risk,” stated Kampamba, a clinical pharmacist and lecturer in the university’s Department of Pharmacy. “Even with access to PrEP, there may be deeper psychological, cultural, or educational barriers that prevent students from adopting it.”
Overall, male students were less likely than female students to consider using the PrEP treatment. About 15 per cent of male students said they would be willing to use PrEP compared to nearly 19 percent of female students.
The study showed that willingness to consider the PrEP treatment increased by university year level.
Only 13 per cent and 10 per cent of first-year and second-year students said they’d be willing to use the PrEP treatment compared to 27 per cent of fifth-year students who said they would consider the treatment.
Interestingly, about 62 per cent of sexually-active respondents said they or their partner hadn’t used a condom in the previous six months, yet nearly 80 per cent of them said they still wouldn’t be willing to use the PrEP treatment despite their risky sexual behaviour.
Those who did use a condom were even less likely to consider the PrEP treatment, with 85 per cent indicating they wouldn’t use it.
Despite more than 60 per cent of the survey participants admitting they hadn’t used a condom in the previous six months, 80 per cent of all participants in the study said they don’t think they’ll ever be infected with HIV.
The findings were particularly surprising given that the study’s participants are among the most highly educated members of the Zambian population.
“Education alone doesn’t always translate into safe practices, especially when it comes to sensitive issues like sexual behaviour,” Kampamba said. “The findings suggest that factors beyond formal education—such as social norms, peer influence, or misconceptions about PrEP—might be influencing students’ behaviour.”
The study also showed the students are shockingly uninformed about their partners’ HIV status.
Nearly 75 per cent of the sexually-active respondents said they were unaware of their partners’ HIV status while more than 80 per cent of participants said they had never discussed HIV with their sexual partner.
“It underscores the need for more comprehensive sexual health education that not only promotes awareness of HIV but also emphasises communication between partners about HIV status and risk,” Kampamba added.
Steve is a retired investigative journalist based in Canada. He previously worked as a feature writer and editor at The Hamilton Spectator and The Toronto Star, Canada’s largest circulation daily newspaper.
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