A total of 1581 HIV cases were registered up to January 1st, 2010 in Lithuania. HIV incidence was 6.5 per 100,000 young people (age group 15 – 24) in 2009 (1). Since young people are one of the most vulnerable groups for HIV infection, the Centre for Communicable Diseases and AIDS pursued prevention campaigns for secondary school students in 2009 to assess Lithuanian school students’ knowledge and attitudes towards HIV/AIDS and risk behaviour. All students were asked to complete a questionnaire on HIV/AIDS, sexual behaviour, quality of life and attitude towards people living with HIV (PLWHIV).
Results showed that 30.7% of all respondents had engaged in sexual relationships and that 14.7% of first sexual intercourse occurred before the age of 15 years. Only 3% (n=14) of students knew a lot about HIV/AIDS and 56.9% reported an average knowledge. Most students receive information about HIV/AIDS at school (63.1%) and via the Internet (35%). New HIV infections could be prevented in the future if adequate information regarding behaviours that put young people at risk is provided.
Knowledge about HIV/AIDS is the first step in preventing infection. Moreover, educating young people about HIV is one of the best long-term strategies to fight the epidemic by helping to reduce risk behaviours. This is especially important for young people (aged 15 to 24), who, in 2009, accounted for 11.5 % of new HIV infections in the WHO European Region and EU/EEA (4).
The first case of HIV in Lithuania was diagnosed in 1988. The cumulative number of HIV cases as of January 1st, 2010 was 1581 and the male/female distribution of HIV cases was 1314/267. HIV incidence per 100,000 people aged either 15-19 or 20-24 was 1.6 and 11.0 in 2009, respectively (1). A total of 19.7% laboratory-confirmed HIV cases were among young people (aged 15 to 24) during the registration period in Lithuania (1988-2009).
The Centre for Communicable Diseases and AIDS organized prevention campaigns for young people in secondary schools and colleges in 2009 to reduce vulnerability among students and to give more information about HIV/AIDS in an effort to develop knowledge and change attitudes to HIV/AIDS. Results from this survey will help to develop future strategies, prevention efforts, educational programmes and ways in which young people in or out of school can be most effectively reached.
Materials and methods
In 2009 specialists from the Centre for Communicable Diseases and AIDS (state institution under the Ministry of Health in Vilnius) met with young people at secondary schools to discuss HIV/AIDS issues using interactive methods. The secondary schools and colleges of higher education were selected at random in different cities of Lithuania, and young people aged 15-24 years were asked to fill in questionnaire on voluntary basis.
Students who agreed, completed an anonymous questionnaire (25 questions) before the prevention campaign. This consisted of 5 sections including: demographics, sexual life and general health, behaviour features, attitudes and knowledge about HIV/AIDS according to 13th indicator, which is a percentage of young women and men aged 15-24 years who both correctly identify ways of preventing sexual transmissions of HIV and who reject major misconceptions about HIV transmission, of the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS. 13th indicator included the following issues: 1) can the risk of HIV transmission be reduced by having sex with only one steady uninfected partner who has no other partners, 2) can a person reduce the risk of getting HIV by using a condom every time they have sex, 3) can a healthy-looking person have HIV, 4) can a person get HIV from mosquito bites, 5) can a person get HIV by sharing food with someone who is infected (3). Students were asked to answer question „how much do you know about HIV/AIDS“ and rate their personal knowledge by marking one of the following answers based on their own judgment: 1) know a lot, 2) know average, 3) know a little, 4) haven’t heard of disease, don’t know anything. Statistical analysis was conducted using the Statistical Package for the Social Sciences (SPSS 13.0).
A total 469 students completed the questionnaires. The average age of the respondents was 16.6 years (15.4 – 17.8), 45.4% (n=213) were males and 54.6% (n=256) were females. In response to the question “how much do you know about HIV/AIDS”, only 3% (n=14) of the students reported, that they knew a lot about HIV/AIDS while 56.9% (n=267) reported average knowledge. More females than males considered their knowledge to be average (64.5% and 47.9%, respectively, p=0.001). Only 11.5% (n=54) of the respondents correctly answered the five questions from the 13th UNGASS indicator. HIV prevention knowledge in general was better among females than males (70.4% and 29.6%, respectively, p=0.01): one steady uninfected partner who has no other partners can reduce HIV infection –50.4% females and 32.4% males, a person can reduce the risk of getting HIV by using a condom every time they have sex – 88.3% females and 87.3% males, a healthy-looking person can have HIV – 77.7% females and 73.7% males. The results for the three different questions regarding attitudes towards PLWHIV for females and males are shown in Figure 1 (number of respondents differs by question).
Fig. 1. Attitude towards PLWHIV (%) among respondent students in Lithuania (by gender)
The analysis of the responses shows that there were no statistically significant differences between females and males about attitude towards studying with PLWHIV (27.7% and 24.9% respectively, p=0.12) and attitudes towards nursing PLWHIV (22.1% and 25.4% respectively, p=0.65) or living in the same neighbourhood (35.2% and 46.1% respectively, p=0.58) as PLWHIV.
Approximately one third of the respondents, 30.7% have had sexual relationships and 14.7% had their first sexual intercourse before the age of 15 years. More young males than young females (25.8% and 5.5%, respectively, p=0.0001) had sexual intercourse before the age of 15. The distribution of first sexual intercourse by age is shown in Figure 2. Only 6.9% (n=10) of the respondents were tested for HIV during last 12 months.
Fig.2. First sexual intercourse distribution by age among students in Lithuania, n=144
Results of the study indicated that 19.8% (n=93) of the respondents used illegal substances during the preceding 12 months (28.6% males and 12.5% females, p=0.0001). The questions about substances were open and most answers indicated that alcohol and/or cannabis were used. Regarding physical health, 32.3% (n=151, 40.4% males and 25.4% females, p=0.02) reported their health as good and 3.2% (n=15) of all respondents felt unhealthy.
Loneliness and low personal life assessment could be a signal or indicator of important needs. Evaluations of students’ personal life and feeling of loneliness are shown in Figure 3 and Figure 4. More females than males reported that they were not very happy (11.7% and 7.0%, respectively, p=0.03) and more females (68.0%) than males (46.9%) quite often felt lonely in their life (p=0.003).
Fig.3. Evaluation of personal life by gender among students in Lithuania (%), n=469
Fig.4. Feeling of loneliness by gender among students in Lithuania (%), n=469
Most students receive information about HIV/AIDS at school (63.1%), from the Internet (35%) or mass media (29.9%).
Analysis of the survey indicates that students in general had an average knowledge concerning HIV/AIDS prevention and that they received information at school or via the Internet. More young females than young males are tolerant toward PLWHIV. Young people started their sexual life at an early stage and therefore prevention campaigns should focus on young people. Only a few of the respondents had been tested for HIV during the last 12 months. More males than females used alcohol or drugs during the past 12 months, and such substance use may result in less responsibility concerning health. A lot of females felt lonely very often and more than a half of them felt unhappy. This could also lead to risk behaviour.
It is very important to provide accurate and relevant information about HIV transmission and an enabling and protective environment in young people communities where they can talk openly about risk behaviours. It is also important to provide necessary preventive interventions, which include voluntary counselling and testing for HIV and other sexually transmitted infections. Prevention campaigns are one of the modalities that can be used to help adolescents to adopt beliefs, attitudes and behaviours that reduce their risk of infection.
- Centre for Communicable Diseases and AIDS. Annual report of sexually transmitted infections in Lithuania, 2009:9. [In Lithuanian]. Available from: http://ulac.lt/
- ECDC/WHO HIV/AIDS surveillance in Europe, 2009. Available from:
- Monitoring the Declaration of Commitment on HIV/AIDS : guidelines on construction of core indicators. UNAIDS/09.10E / JC1676E. Available from:
- European Centre for Disease Prevention and Control/WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2009; doi 10.2900/36146:9.