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thesis entitled

AGE, EDUCATION, RELIGIOSITY, AND MAPROFITA
AS INDICATING FACTORS OF AIDS KNOWLEDGE
IN ZIMBABWEAN PREGNANT WOMEN

presented by

Maresa Janee' Murray

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MasteuiAms— degree in _Eami_l;L_&_Child Ecology

Harrieggg McAdoo

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AGE, EDUCATION, RELIGIOSITY, AND MAPROFIT A
AS INDICATING FACTORS OF AIDS KNOWLEDGE
IN ZIMBABWEAN PREGNANT WOMEN

by
Maresa Janeé Murray
College of Human Ecology
Michigan State University

Major Professor
Harriette McAdoo, Ph.D.
College of Human Ecology
Michigan State University

 

ABSTRACT

AGE, EDUCATION. RELIGIOSITY, AND MAPROFITA AS INDICATING
FACTORS OF AIDS KNOWLEDGE IN ZIMBABWEAN PREGNANT WOMEN

By

Maresa J aneé Murray

There is an absence of research on the HIV/AIDS epidemic in Zimbabwe.
Moreover, most of the current research on HIV/AIDS in Third World countries does not
address the inﬂuence of the country’s cultural context. Therefore, this research is
important for three reasons: (1) HIV/AIDS is an epidemic; (2) women of color are the
most at risk group; and (3) there is little research addressing the impact of traditional
culture on HIV/AIDS in Black Zimbabwean women. This study addresses the inﬂuential
factors on AIDS knowledge in Zimbabwean pregnant women. The purpose of this
research is to determine the relationship between age, education, religiosity, maproﬁta and

AIDS knowledge in Zimbabwean pregnant women.

TABLE OF CONTENTS

LIST OF TABLES ............................................... iv
INTRODUCTION ............................................... . 1
REVIEW OF LITERATURE ....................................... . 3
METHODS ..................................................... 13
RESULTS ...................................................... 16
DISCUSSION/IMPLICATION S ..................................... 23
APPENDIX ..................................................... 27

Table

Table

Table

Table

Table

Table

Table

Table

Table

 

 

LIST OF TABLES

1- Correlational Analysis of Age by AIDS Knowledge

Questions .....................................

2 - Correlational Analysis of Education by AIDS Knowledge

Questions .....................................

3 - Correlational Analysis of Religion by AIDS Knowledge

Questions .....................................

4 - Correlational Analysis of Maproﬁta by AIDS Knowledge

Questions and Total Scores .......................

5 - One«Way Analysis of Variance of Signiﬁcant Age and AIDS

Knowledge Questions ............................

6 - One-Way Analysis of Variance of Signiﬁcant Education and

AIDS Knowledge Questions .......................

7 - One-Way Analysis of Variance of Signiﬁcant Religion and

AIDS Knowledge Questions .......................

8 — One-Way Analysis of Variance of Signiﬁcant Religion and

AIDS Knowledge Questions .......................

9 - One-Way Analysis of Variance of Signiﬁcant Religion and

AIDS Knowledge Questions .......................

Table 10 - One-Way Analysis of Variance of Signiﬁcant Religion and

AIDS Knowledge Questions .......................

Table 11 - One-Way Analysis of Variance of Signiﬁcant Religion and

AIDS Knowledge Questions .....................

Table 12 - One-Way Analysis of Variance of Signiﬁcant Religion and

AIDS Knowledge Questions . . . .

27

28

29

3O

31

32

33

34

35

36

. 37-38

. 39-40

INTRODUCTION

W
This study addresses the inﬂuential factors on AIDS knowledge in Zimbabwean

pregnant women. The purpose of this research is to determine the relationship between

age, education, religiosity, and AIDS knowledge in Zimbabwean pregnant women.

5' ‘E E l E l 1

There is an absence of research on the HIV/AIDS epidemic in Zimbabwe.
Moreover, most of the current research on HIV/AIDS in Third World countries does not
address the inﬂuence of the country’s cultural context. Therefore, this research is
important for three reasons: (1) HIV/AIDS is an epidemic; (2) women of color are the
most at risk group; and (3) there is little research addressing the impact of HIV/AIDS on
women of color in Zimbabwe.

First. the contraction of HIV/AIDS is a national epidemic affecting millions. At
least 30 new infectious diseases have emerged in the last 20 years, including HIV/AIDS
from which 26.6 million adults may be infected by 2000.

Second, women of color are the fastest growing group at risk of contracting
HIV/AIDS. One of the reasons is the socioeconomic challenges faced by minority
women. Women of color receive inadequate health care primarily because of economic
deprivation and delayed diagnosis. Additionally, with disenfranchised populations such as

minority women, there is an increased likelihood of at-risk factors such as sharing infected

drug needles and having multiple sex partners. These conditions for women of color are
especially compounded by their physiological and anatomical structure which makes them
more susceptible to the contraction of the HIV/AIDS virus than their White counterparts.
The vaginal and cervical oriﬁces are more vulnerable to the retention of seminal and
vaginal ﬂuids which transmit the disease (Spencer, 1990).

Third, in spite of the alarming spread of HIV/AIDS, there is a paucity of research
involving those high-risk populations such as minorities and women. The social, cultural,
and educational factors which may inﬂuence the incidence of HIV/AIDS among minority
women have been understudied. Given the rapid progression of the HIV/AIDS virus in
Zimbabwe, it would be advantageous for countries to understand the contributing factors
associated with this phenomena, as they are also in danger of repeating such epidemic
proportions. This study will examine the social, cultural, and educational practices of
pregnant Zimbabwean women.

It has been shown that culture and tradition are large contributing factors to the
incidence of HIV/AIDS (Spencer, 1990). Although women are the largest HIV/AIDS
infected population, to date, no studies have been published which examine their cultural
beliefs and behaviors. This study will help to increase the cultural knowledge base for

teachers and practitioners in the education of younger females.

REVIEW OF RESEARCH

There are many factors associated with the high rate of HIV/AIDS infection in
Zimbabwe. The cultural HIV/AIDS context in which the woman lives involves a unique
interface of providing children to increase the Zimbabwean economy, understanding
HIV/AIDS through religious beliefs, and examining her role in the marital relationship. It
is important to understand these cultural inﬂuences that help shape the perceptions of

HIV/AIDS in Zimbabwean pregnant women.

1!! ’B l‘El'Z'll E '12]

In most developing countries, lower levels of production and incomes mean that
individuals, their families, communities, health-care delivery organizations, and
government agencies all have fewer resources for the AIDS pandemic (Norr, Tlou, &
Norr, 1993). They divide developing countries into two groups. The ﬁrst group
consisting of the poorest countries that comprise most of sub-Saharan Africa and Asia all
have a per capita gross national product (GNP) lower than $600 per year compared to the
average GNP per capita of $12,000 for the industrialized countries. The second group
consists of the middle-income developing countries that predominate Latin America, the
Middle East, North Africa and the Paciﬁc, which have average GNPs of less than $2,000
(UND Programme, 1991).

Compared to industrial countries, the non-farming resources of developing

countries are more concentrated geographically, leading to greater urban-rural and

regional inequalities and potential conﬂicts over scarce resources. Most developing
countries rely on only a few raw materials for international trade, making their economies
more volatile and more dependant on the larger industrial economies of Japan, Germany,
Great Britain, France, and the United States. When industrialized nations suffer recession,
developing countries are affected by decreased exports and decreased aid from foreign
donors. These economic factors have serious implications for women in the HIV/AIDS
pandemic in developing countries, such as Zimbabwe. Cultural factors such as
reproductive traditions confound the economic struggles to effectively meet the challenges
of HIV/AIDS.

Women’s reproductive roles increase their likelihood of infection with HIV. It is
important to consider the strong desire for men and women to have children, even in the
face of HIV/AIDS infection. Kurth ( 1993) asserts that many women have traditional roles
that can have an adverse inﬂuence on HIV/AIDS diagnosis. Women often see themselves
as care providers, as the ones who must take care of everyone else’s needs, thus affecting
their experiences with HIV/AIDS disease from testing to clinical care. The experience of
one HIV counseling center, for example, has been that women “to an incomparably larger
extent than men [feel] responsible for the life, the well-being and the distress of their
partners, friends and relatives” (Hutterer, Blaas, Oberauer, Ogris, & Zupan, 1991). Thus,
many of these women took excellent care of their children but neglected to take care of
themselves.

Children provide labor, economic contributions, emotional beneﬁts, and other

values to the family. When examining women speciﬁcally, however, the signiﬁcance of

childbearing goes beyond conditions in the household. According to Durrant (1994),
childbearing renders the most important means to an acceptable social position for
women. She further asserts that a major obstacle for women who wish to protect
themselves against HIV infection is the desire for children. In many cultures, childless
women face a massive stigma; sometimes the penalty is desertion or divorce. If women
are dependant on children for status and economic security, AIDS poses a serious threat.

(If

When a woman is confronted with the decision of whether or not to have a child or avoid

possible HIV infection, the child is preferred.

Bl"'

The three streams of religious beliefs currently held by most Zimbabweans are
traditional ways, Christianity, and newer indigenous African Christian movements.

The mixture of traditional respect for ancestors, traditional customs, and
traditional beliefs all form traditional ways. Due to the massive number of conversions
from the evangelization of Sub-Saharan Africa, Christianity increasingly became an
attractive spiritual alternative (Bourdillon, 1987). Yet, even with the emergence of more
Christian churches and beliefs, the Zimbabwean people kept the traditional ways and
rituals. There was a need for the older traditional ways of the ancestors and the newer
ways of Christianity to combine so that the Zimbabweans could beneﬁt from both the past
and the present. The maproﬁta holds this new belief system (Bourdillon, 1987). Typically
a woman, the maproﬁta is a spiritual authority ﬁgure who guides peoples’ lives by using

both traditional ways and Christianity. Within the cultural context, the maproﬁta has a

high authority level and is highly regarded as a socializer and educator. These traditional
ways are continued by some persons who are Christian (McAdoo & Runkuni, 1993).

The majority of Christian churches are of EurOpean and American origin. The
churches established day and boarding schools that were the only source of highly valued
education for a long time (Bourdillon, 1987). The churches allowed social mobility of a
few, but provided a form of control that was used during the period of colonial
dominance. The new African movements, the Zionistic and Apostolic churches, are /
growing religious movements that originated in Africa, which, in turn, combines elements

from the two Christian and Traditional religions (McAdoo, 1993).

El" . S IE . lHIICIEIES

Religiosity has been conceptualized as a personal control against deviance and, t/ '
therefore, positively associated with conventionality and conformity (Rohrbaugh & lessor,
1975). Mahoney (1980) stated that there were conﬂicting ﬁndings for the relationship
between sexual intercourse and religiosity. He found that for a sample of 441 college
students, religiosity was negatively related to sexual experience across a wide range of
sexual behaviors and dimensions of sexuality. His findings also indicated that the personal
control in religiosity may be more complex and less complete than Rohrbaugh and Jessor’s
(1975) conclusions suggest.

Given these mixed ﬁndings, religiosity and its association with conformity in

relation to AIDS and sexuality knowledge, attitudes, beliefs, and practices were assessed

using a sample of Black South African ﬁrst-year college students (Nicholas & Durrheim,

1995). The results indicate that stated religious commitment is associated with a lower
prOpensity to engage in sexual intercourse and later age of onset sexual activity.
Nevertheless, on the average, the high-scoring religious subjects had been sexually active

but were less likely than the low-scoring subjects to make use of safe sex practices.

III . l I l . C

Emphasis on the importance of gender is particularly signiﬁcant in the African
context, where gender distinctions are strongly marked in both traditional rural settings
and in the new urban areas. A major context in which gender differences emerge is in
marriage and its imposition of different expectations on women and men. Udvardy and
Cattell (1992) assert that marriages create different pathways for women and men through
which to seek the same ultimate goals of monetary and food security, physical and social
support, inﬂuence in the affairs of younger kin and community members, and positions of
power.

Until recently many Zimbabweans were polygamous. A survey that was done in
1984 showed that one woman in eight was a second or third wife (Young, 1989). It has
been suggested that the polygamous marital practices foster competition among wives for
their husbands affections which may lead to unsafe sexual practices that increase the
likelihood of HIV/AIDS contraction. Many women felt that they were at risk because of
their male partner’s multiple sexual relationships.

The risk occurs partly with their subordinate position in the marriage relationship

obligating their participation in sexual activities (Spencer, 1990). Most women are

contracting HIV through heterosexual intercourse and, according to UNAIDS, more than
75% of all HIV infections come from this source (Penins, 1995). The sexual behavior of
HIV -positive and HIV-negative women in Africa has been found to be very similar (Bell,
1996). African marriages are systems of unequal, gendered hierarchies (Cattell, 1989).

Most cases of infection in women in the developing world result from straight-
forward sexual relations within regular partnerships, usually between an infected husband
and wife. This risk is increased by the expectation and requisite that women bear children.
Durrant (1994) states that women can, and do, use birth control in various forms against
the desires and without the knowledge of their husbands; yet this is extremely rare because
of the wife’s subordinate position. Moreover, condoms (the only form of birth control
other than abstinence that is also effective in reducing HIV/AIDS infection) require
agreement from the husband.

The fading of polygamy may tempt men to choose women from outside rather than
remaining faithful to their wives (McAdoo, 1996). Poor men leave their wives in the
country and resort to prostitutes or informal marriages in the towns. Rich men in town
may attract more women. Those men who are mobile are most at risk of spreading

infection. The virus spreads along lorry drivers’ routes throughout the African countries.

W
The majority of the infected women are in developing countries, particularly in
sub-Saharan Africa. The growing incidents of HIV/AIDS in women is more problematic

and devastating for families than the incidence with men. The maternal fatalities are

critical because the major responsibility of child care and rearing falls mostly on women.
The social functioning and roles that women play are more signiﬁcant for the most part
than men (Ross and Clark-Alexander, 1996).

Every year in Zimbabwe, there are an estimated 120,000 of HIV positive women
(European Collaborative Study, 1994). In Harare, Zimbabwe in 1990 a study of 1,168
pregnant women from four antenatal clinics were surveyed to determine the HIV
prevalence rate. An overall prevalence rate of 30.4% was obtained, with a range for each
clinic from 23.6% to 33.2%. The single pregnant women and the unemployed were more
likely to test positive for HIV (Mbizvo, 1996).

In a study of 1,532 Zimbabwean secondary school pupils from 12 schools, most
knew that AIDS is fatal and incurable. 40% felt that most African HIV/AIDS infected
people were homosexual, that 40% thought that you can catch AIDS from a toilet seat,
that mosquitos carry AIDS, and that you can have AIDS and still look healthy (Wilson,
Greenspan & Wilson, 1989). Pupils from homes in the urban area were better informed
than those from the rural area.

In a study of 194 University of Zimbabwe education students and employed adult
education students, McAdoo et al. found that the students were knowledgeable about
HIV/AIDS infection, transmission procedures, contraceptive methods, and were realistic
about means of prevention of infection (McAdoo, Simmons, Webster, Magoo &
Cummings, 1995).

Although a religious orientation is a belief in a supreme being, it may not always

mean church attendance or membership (McAdoo, 1995). The importance of religion and

the church in coping in the lives of African Americans has well been documented
(Billingsley, 1968, 1992; Frazier, 1963; Hill. 1971; Pipes, 1992). Brown and Gary ( 1985)
found that religious participation is a source of support with anxiety-related problems.
Studies have shown that the church provides emotional well—being (Neighbors and
Jackson, 1984) and that women are more religiously involved than men (Taylor, Thornton

and Chatters, 1987).

Summary

There are many potential factors that inﬂuence the reproductive lives of
Zimbabwean women. Their pregnancies not only effect the immediate family, but also the
nation’s economy as farm labor is a major form of economic advancement. With the
threat of the HIV/AIDS epidemic, this presents a major threat to the Zimbabwean
economy as many children will be born with HIV/AIDS and therefore not be a viable part
of the labor force. Moreover, HIV/AIDS is an impending invisible threat as women are
- contracting it through heterosexual intercourse with their husbands. Furthermore,

traditional and spiritual inﬂuences provide a framework for understanding HIV/AIDS.

Watkins

From this review of research, a set of guiding research questions emerged.

0 What is the relationship between religiosity and AIDS knowledge in Zimbabwean
pregnant women?

0 What is the relationship between maproﬁta as a cultural variable and AIDS

10

knowledge in Zimbabwean pregnant women?

What is the relationship between age and AIDS knowledge in Zimbabwean
pregnant women?

What is the relationship between education and AIDS knowledge in Zimbabwean

pregnant women?

11

Hmothescs

H‘) Zimbabwean pregnant women who are older will have signiﬁcantly high scores on
the AIDS Knowledge scale.

H2) Zimbabwean pregnant women who have high levels of education will have high
scores on the AIDS Knowledge scale.

H3) Zimbabwean pregnant women who have high scores on the Religiosity Scale will
have high scores on the AIDS Knowledge scale.

H") Zimbabwean pregnant women who visit Maproﬁtas will have high scores on the

AIDS Knowledge scale.

Variables: Independent and Dependent

Independent:

1. Respondent’s age

2. Respondent’s level of education

3. Respondent’s level of religiosity

4. Respondent’s use of a Maproﬁta
Dependent:

1. Respondent’s AIDS Knowledge

12

METHODS

Researchﬂesign

The purpose of this research is to determine the relationship between age,
education, religiosity, and AIDS knowledge in Zimbabwean pregnant women (n=206).
The AIDS Knowledge Scale and Religiosity Index, characteristics of Zimbabwean
women’s traditions and sexual awareness, will be assessed. HIV/AIDS related questions
were based upon a review of recent literature of the characteristics that research
conducted by the Centers of Disease Control have found were related to HIV/AIDS

infection.

Instrumentation

Age was self reported by the respondent.

Education was self reported by the respondent.

W was based on the following questions: (1) the religious level of
the respondent (not, fairly, very religious); (2) frequency of respondent’s and partner’s
church attendance (rarely, monthly, weekly). Each of the items is scored on a three-point
scale. Higher scores reﬂect higher levels of religiosity, and lower scales reﬂect lower
levels of religiosity.

Conceptualﬂeﬁnition: Religiosity extends beyond church attendance or
membership and relates instead to the importance of religion and spirituality in everyday

life.

13

 

QperatianaLDeﬁnitiQn: Religiosity will be measured in this study with the
Religiosity Scale (Bailey, 1993; McAdoo, 1983). It consists of ﬁve items that measure:
the frequency of attendance at religious services; frequency of prayer; degree to which
every-day decision making is inﬂuenced by God; degree of religiosity; and the irnportance
of religion in individuals’ personal lives.

Mapmﬁta is a spiritual authority ﬁgure who guides peoples’ lives by using both
traditional ways and Christianity. Respondents were asked the extent to which they use

the maproﬁta: (1) never; (2) sometimes; (3) often.

W

The sample was composed of 206 pregnant women who were patients at two
antenatal clinics in Harare, Zimbabwe. The M ’bare Edith Opperman Clinic was located in
the “high density” low socioeconomic area within the original restricted area for black
Zimbabwe residents. The M’bare area had a total population in 1995 of 126,443 persons
(Posted statistics, 1996). The Burdoriro Clinic is in a newer suburban development of
black Zimbabwean residents that is of somewhat higher SES background. This area in
1995 had an estimated population of 78,536; 15,707 (20%) were of child bearing age with
627 expected pregnancies that year or 4% of those of child bearing age (Posted statistics,

1996).

Winn

Before any questions were asked or procedures begun, each woman was

14

introduced to the project and told of the objectives and procedures. They were told that
the research was approved by the Zimbabwe Research Council and the director of Health
Services of Harare. They were then asked to sign that the project had been explained to

them and that they were aware of all of the procedures.

DataAnalxsis

Variables were dichotomized and Lambda correlational analyses were used to
examine associations between age, education, religiosity, maproﬁta, and AIDS knowledge.
Analysis of variance statistics were used to examine signiﬁcant associations between age.

education, religiosity, maproﬁta, and AIDS knowledge.

15

RESULTS

A preliminary correlational analysis was conducted to determine the relationships
between the independent variables and dependent variable: age, education, religiosity,
maproﬁta and AIDS knowledge (Tables 1-4). There was a signiﬁcant relationship
between the Zimbabwean mothers’ education and knowledge of AIDS transmission
through the toilet seat (r=.l9, p<.001); knowledge on the transmission of AIDS from
giving blood (r=. 17, p<.01); and knowledge on AIDS transmission through sharing
needles (r=. 16, p<.05). Zimbabwean mothers’ age and knowledge on AIDS transmission
through sharing needles with a drug user (r=.16, p<.05); knowledge on AIDS transmission
from sharing water with a person who has AIDS (r=.17, p<.05); knowledge on AIDS
transmission associated with condom usage (r=.20, p<.01); and knowledge on AIDS
transmission due to sex with multiple partners (r==.29, p<.001). There was a signiﬁcant
relationship between Zimbabwean mothers and knowledge on AIDS transmission through
kissing (r=. l7, p<.01); knowledge on AIDS transmission from a toilet seat (r=.18, p<.01);
knowledge on AIDS transmission from sharing water (r=.17, p=.01); knowledge on AIDS
transmission from a man having sex with an AIDS infected woman (r=.19, p<.01);
knowledge of AIDS transmission to an unborn child (r=. 18, p<.01); and knowledge on
what an AIDS infected person looks like (rt-.13, p<.05); knowledge on AIDS transmission
through prostitution (r=.18, p=.01); knowledge on AIDS transmission from sex with

multiple partners (r=. 18, p<.01); and knowledge of AIDS mortality (p.21, p<.01).

16

Hl Zimbabwean pregnant women who are older will have signiﬁcantly high scores on

the AIDS Knowledge scale.

Lambda correlational analysis and one-way analysis of variance was conducted to
examine the relationship between age and AIDS knowledge (Table 5). The older
Zimbabwean mothers tended to have the higher AIDS Knowledge scores. The analyses
indicate that more older mothers believe that AIDS can be transmitted even with the use
of a condom (M=4. 14, p<.01); that a mother with AIDS can give it to her unborn baby
(M2233, p<.05); and that sex with multiple partners can help the spread of AIDS
(M=2.62, p<.01). They believed that AIDS can be spread by sharing a drug needle with a
drug user who has AIDS (r=.17, p<.05), that condom use could lower the spread of AIDS
(r-.20, p<.01), and that sex with multiple partners will increase chances of AIDS spread

(12.29, p<.001).

H2 Zimbabwean pregnant women who have high bvels of education will have high

scores on the AIDS Knowledge scale.

Lambda correlational analysis and one-way analysis of variance was conducted to
examine the relationship between education and AIDS knowledge (Table 6). Zimbabwean
women with less education believed that AIDS can be spread by sharing a needle with a
drug user who has AIDS (r=-.25, p<.001); that prostitutes have a higher chance of AIDS

transmission (r=-.22, p<.01); AIDS can be spread if a man has sex with a woman who has

17

 

AIDS (r=-.l9, p<.01); and if a man has sex with a man who has AIDS (1:45, p<.05).
Mothers with high education levels also believe that pregnant mothers with AIDS can give
AIDS to her unborn baby (r=-. 14, p<.05) and that having sex with multiple partners can
raise one’s chance of getting AIDS (r=-.18, p<.01).

Zimbabwean mothers with less than a primary school education believe AIDS can
be transmitted if a man has sex with an infected woman (M=2.00, p<.01); if a person
shares a needle with a drug user (M=3.25, p<.01) and if a person has sex with multiple
partners (M=3,00, p<.05). Mothers with a primary level education believe that AIDS can

be transmitted if one has sex with a prostitute (M=2.74, p<.01).

H3 Zimbabwean pregnant women who have high scores on the Religiosity Scale will

have high scores on the AIDS Knowledge scale.

Lambda correlational analysis and one-way analysis of variance was conducted to
examine the relationship between “how religious” Zimbabwean mothers are and their
AIDS knowledge (Table 7). The Zimbabwean women who were very religious believe
that one can get AIDS from a blood transfusion (r=.18, p<.01) and that one can have
AIDS virus without being sick from it (Fr. 17, p<.01).

Zimbabwean mothers who were not religious believe that one can get AIDS from a
blood transfusion (M=3.57, p<.05); that one can get AIDS from shaking hands (M=5. 19,
p<.01); and that one can spread AIDS by having sex with an infected man (M=l.76,

p<.001 ).

18

MntherslﬁhurchAttendance

Mothers who do not go to church believe that one can get AIDS from a blood
transfusion (M=4.00, p<.01); believe that one can get AIDS from shaking hands (M=5.25,
p<.01); believe that AIDS can be spread from sex with an infected woman (M=1.75,
p<.001); believe that AIDS can be spread from sex with an infected man (M=1.75,
p<.001); and believe that a mother can spread AIDS to her unborn baby (M=2.25, p<.001)
(Table 8). Zimbabwean mothers who attended church more frequently believed sex with
someone who uses drugs increases the chance of transmission (1:.21, p<.01); they
believed that AIDS can be spread when a man has sex with a woman who has it (12.15,
p<.05); and when a woman has sex with a man who has it $.15, p<.05). Mothers who
attend church on a weekly basis believe that AIDS can be spread by having sex with a

drug user (r=2.63, p<.01).

BannerslﬁhumhAttendance

Partners who attend church on a weekly basis believe that AIDS can be spread
through sex with an infected man (M=1.35, p<.01) and shaking hands (M=4.74, p<.05)
(Table 9).

Zimbabwean mothers with partners who attended church more frequently believed
that one can get AIDS from kissing on the mouth (1:. l3, p<.05); AIDS can be spread
when a man has sex with a woman who has it (r=.14, p<.05); but partners who went to
church often strongly believed that women can get AIDS by having sex with a man who

has AIDS (r=.21, p<.01).

19

I l' . l H l

Zimbabwean mothers who often visit traditional healers believe that one cannot get
AIDS from kissing on the mouth (r=.18, p<.01) or from sitting on the toilet seat $.20,
p<.01), but believe that it can be spread by sharing a needle with a drug user who has it
(r=.16, p<.05), by giving blood (r=.18, p<.01), from a blood transfusion (r=.13, p<.05),
and by sharing a glass of water with someone who has AIDS (r=.14, p<.05) (Table 10).
AIDS transmission when a man has sex with an infected woman (r=.29, p<.001) and when
a woman has sex with an infected man (r=.28, p<.001) are strongly associated with
mothers who visit the traditional healers often. Zimbabwean mothers who often visit
traditional healers also believe that AIDS can be spread when a man has sex with an
infected man (r=.l9, p<.01) and that condoms help to slow the spread $.19, p<.01).

There is a signiﬁcant relationship between mothers who visited traditional healers
and those who believe a pregnant woman will give AIDS to her unborn child (r=.30,
p<.001); those who believe that prostitutes are likely to get it (rt-.27, p<.001); those who
believe that masturbation can cause AIDS (r=.15, p<.05); those who believe that eating
healthy foods can prevent AIDS (r=. l6, p<.05); those who believe that you can tell if
someone has AIDS just by looking at them (r=.19, p<.01); those who believe that sex with
more than one partner will help you get AIDS (r=.24, p<.001) and that people with AIDS
will die from it (1:.30, p<.001).

Mean comparison scores were conducted to determine the relationship between
AIDS Knowledge and mothers who visited the traditional healers. Mothers who reported

that they “sometimes” visit a traditional healer believe that one can become infected with

20

AIDS from giving blood (M=2.50, p<.05); that once can get AIDS through a blood
transfusion (M=2.50, p<.05); that one can get AIDS from sex with an infected woman
(M=1.28, p<.001); that one can get AIDS from sex with an infected man (M=3.36,
p<.05); and that AIDS can be transmitted through the sharing of a drug needle (M=2.63,

p<.01).

I l' . l 1!!

Zimbabwean mothers who try to hold onto traditional ways believe that one can
get AIDS by shaking hands with someone who has it (r=.14, p<.05) and they believe that
there is a cure for AIDS $.16, p<.01) (Table 11). Zimbabwean mothers who are holding
onto traditional ways believe that one can get AIDS by sharing a needle (M=2.25,
p<.001); that AIDS can be transmitted by having sex with an infected man (M=l.40,
p<.001); that a mother can give AIDS to her unborn baby (M=1.52, p<.05); that it can be
transmitted through a blood transfusion (M=2.69, p<.001); that it can be spread by having
sex with an AIDS infected woman (M2136, p<.001); that one can have AIDS without
being sick (M=2.63, p<.01); that the use of a condom will stop the spread of AIDS
(M=2.60, p<.01); that AIDS can be spread from sex with multiple partners (M=1.67,
p<.001); and that someone with AIDS will die from it (M=1.58, p<.001).

Zimbabwean mothers who do not hold onto the “traditional ways” of life believe
that one can spread AIDS without being sick from it (M=2.44, p<.01); that healthy foods
can help prevent the spread of AIDS (M=3.54, p<.05); and that there is a cure for AIDS

(M=4.39, p<.01).

21

H" Zimbabwean pregnant women who visit Maproﬁtas will have high scores on the

AIDS Knowledge scale.

Lambda correlational analysis and one-way analysis of variance was conducted to
examine the relationship between education and AIDS knowledge (Table 12). Mothers
who reported that they “sometimes” visit a maproﬁta believe that AIDS can be spread by
having sex with a drug user (M=3.09, p<.01); by infection from a toilet seat (M=4.37,
p<.05); by having sex with an AIDS infected man (M=1.38, p<.001); by having sex with
an AIDS infected woman (M=1.39, p<.001); and by giving blood (M=3.85, p<.01).
Mothers who reported that they “sometimes” visit a maproﬁta also believe that a mother
can give AIDS to her unborn baby (M=1.76, p<.001); that people with AIDS will die from
it (M=1.33, p<.001); and that one can spread AIDS without being sick from it (M=2.57,
p<.05). Zimbabwean mothers who “often” visit a maproﬁta believe that one can get AIDS
from a prostitute (M=2.33, p<.05) and that AIDS can be spread from having sex with

multiple partners (M=2.42, p<.001).

22

DISCUSSION/IMPLICATIONS

Correlational analyses were conducted to determine associations between the
predictor variables of Age, Education, Religion and the dependant variables in the AIDS
Knowledge Scale and Total Scores (Table 7).

Education and values and beliefs are primarily reﬂected in de-institutionalized
forms of communication such as word of mouth, storytelling, and kinship bonds (Hill,
1994).

There was little relationship between the three levels of education and the AIDS
Knowledge Scale, for nineteen of the twenty-four items were not signiﬁcantly correlated.
The predictor Education Variable was negatively correlated with three items and the total
score on the AIDS Knowledge Scale: sharing a needle with a drug user, sharing a glass of
water with someone who has AIDS, and giving blood. Less educated mothers had higher
levels of AIDS Knowledge for the ﬁve items.

The ﬁrst hypothesis was supported. In Shona culture, there are more gender
speciﬁc roles than age speciﬁc roles (Kurth, 1993). Women are socialized by the women,
and men are socialized by the men. This would account for the overall lack of variance.

The second hypothesis was not supported. This reﬂects different ways of
education between Western and Southern African cultures (Cattel, 1993). Western
education is more abstract, but it is functional in Southern Africa. For instance,
Zimbabwean education focuses on sex role development and prosperity in the land and the

pe0ple. Children are taught these cultural values from birth onward.

23

In comparison, the Western world teaches subjects that are more abstract such as
math and science, but there is a lack of cohesion between the abstract and the daily
practical things in life. Western thinking lacks the applied component that the
Zimbabwean has with their education. This shows that religion is more of an interactive
educator, as with the traditional healer and maproﬁta, than institutionalized education.

The third and fourth hypotheses were supported. The religion variables that were
found to be signiﬁcant with AIDS Knowledge were traditional healer and maproﬁta.
Twenty-two of the twenty-four variables were not signiﬁcant. The predictor religion
variable measuring “How Religious” was negatively correlated with two signiﬁcant items
on the AIDS Knowledge Scale. Religious Importance variable has little relationship with
the AIDS Knowledge Scale. Twenty~three of the twenty-four items on the scale were not
signiﬁcant.

Research has shown that traditional healers in Zimbabwe are well respected among
both the men and the women (Mbizvo, 1996). This study lends itself to support the
powerful role of the traditional healer to step outside of the “religious” role and into the
place of an educator. For instance, Zimbabwean mothers who were very religious
believed that AIDS can be transmitted through a blood transfusion and that one can have
AIDS but not look sick. In Shona culture, blood is a very sacred part of the culture and
not likely to be changed easily by social environmental factors. The beliefs about the
sanctity of blood have been culturally intertwined into the fabric of the mother, starting at
the time of early childhood.

This study supports past research ﬁndings that the role of traditional healers

24

continues to play a vital role in the lives of Shona women, despite the impact of Western
cultural practices that have moved away from such indigenous ways. It is possible that the
traditional healer has decided the culturally relevant beliefs about blood and imparted
those ideas to the women well before they contend with knowledge about HIV/AIDS. In
other words, their beliefs about blood being sacred and not to be wasted are already in
place.

This research supports that these values are not a function of academia, but of the
cultural griot/teacher found in the traditional healer. The mothers in this study who visited
traditional healers believed that one can have AIDS but not look sick from it. This could
come from the belief that the body, if submitted to a traditionally believed spiritual
authority, has the ability to heal itself. It is believed that many times people are ill for a
reason, but once that reason is revealed to the traditional healer and/or the maproﬁta then
they will help the healing be obtained and symptoms and/or the sickness will disappear.
Therefore, there may be other reasons for the signiﬁcant association between those who
visit traditional healers and the belief that one can have AIDS without being sick. It is
possible that although it is true that one can have AIDS and not be sick, the Zimbabwean
mothers might have come to this conclusion due to the guidance received from traditional
healers rather than institutionalized educators. For this reason, the traditional healer
variable is strongly associated with AIDS knowledge rather than the education variable,

because traditional healers are the cultural disseminators of information.

25

Cnnclusiun

This research emphasizes the power of de-institutionalized forms of AIDS
education. There are so many aspects of Shona tradition and culture that are well
guarded. Investigation into private and sacred religiosity variables, such as traditional
ways and maproﬁta, shows that these are the stronger inﬂuences on AIDS knowledge.
While the religiosity and maproﬁta variables reﬂect the most revealing aspects of tradition
and culture, they only skim the surface of understanding exactly how AIDS knowledge is
disseminated among Zimbabwean pregnant women. The key to effective AIDS
intervention in Zimbabwe is to respect the culture by ascribing the major planning and
organizational role to traditional leaders within the cultural framework, instead of

imposing traditional Western framework.

26

 

Table 1. Correlation of Age by AIDS Knowledge Questions (N=206)

 

 

 

A86
AidsKnumledgeScale
Spread by sharing a needle .167*
with a drug user who has it?
Condoms help you not get it? .204“
Sex with more than one partner 239*"
will help you get it?
*p<.05 **p<.01 ***p<.001

27

Table 2. Correlation Analysis of Education by AIDS Knowledge Questions (N=206)

 

 

 

Education
Aids.Knmuledge.Scale
Spread by sharing a needle -.245***
with a drug user who has it?
Spread if a man has sex with -.194**
a woman who has it?
Spread if a man has sex with -.150*
another man who has it?
Pregnant woman with it can -.142*
give it to her unborn child?
Prostitutes are likely to get it? -.215**
Sex with more than one partner -.l87**
will help you get it?
*p<.05 **p<.01 ***p<.001

28

Table 3. Correlational Analysis of Religion by AIDS Knowledge Questions (N=206)

 

How

Resp.

WWW

Partner
Church Ways Healer

Trad.

Trad.

 

 

Get it by kissing on the mouth? .114 -.041 .134* .102 .175**
Get it from a toilet seat? .095 .055 .046 .106 .204**
Spread by sharing a needle with

a drug user who has it? .037 .057 .008 .010 . 160*
Having sex with one who has it

raises risk? .099 .213** -.040 -.057 .109
You can get it by giving blood? -.038 .077 .013 .045 .181**
Get it from a blood transfusion? -. 184** -.043 .047 -.059 . 134*
Spread by sharing water? -.023 .062 .009 .094 . 141*
Get it by shaking hands? -.040 .094 .069 . 143* .060
Spread if a man has sex with a

woman who has it? .081 .150* .135* .006 .293***
A woman can get it by having sex

with a man who has it? .083 .147* .205** .015 .275***
Spread if a man has sex with

another man who has it? .015 .021 .026 .071 .183**
Pregnant woman with it can give it

to her unborn child? -.099 .049 .037 .043 .295***
Condoms help you not get it? .009 .036 .044 .044 .l90**
Healthy foods prevent it? .005 .084 .045 .068 . 155*
Masturbation can cause it? -.346 .001 .004 .095 . 159*
You can always tell if someone

has it by looking at them? -.102 .041 .051 .001 .194**
Prostitutes are likely to get it? -.338 .060 -.016 -.024 .273***
Sex with more than one partner

will help you get it? -.047 .042 .080 .051 .238***
People with AIDS will die? -.039 .083 .015 -.027 .296***
There is a cure for AIDS? -. 101 .046 .025 .157** .094
You can have the AIDS virus

without being sick from it? -. 169** .026 .092 .045 .097
Can have the AIDS virus and

spread it without being sick? -.106 .040 .031 .108 .030
*p<.05 **p<.01 ***p<.001

29

Table 4. Correlational Analysis of Maproﬁta by AIDS Knowledge Questions
and Total Scores (N=206)

 

 

 

Manmfrta
Aids—WWW
Get it by kissing on the month? .188**
Get it from a toilet seat? .195**
Spread by sharing water? .143*
Spread if a man has sex with .186**
a woman who has it?
Condoms can help you not get it? .137*
Prostitutes are likely to get it? .210**
Sex with more than one partner .174*
will help you get it?
People with AIDS will die? .197**
*p<.05 **p<.01 ***p<.001

30

Table 5. One-Way Analysis of Variance of Signiﬁcant Age and AIDS Knowledge

 

 

 

 

Questions
Variable Mean df ERatiQ E21012
UsenLCnndum
Age (2,201) 6.03 .003
Teenage mothers 2.28
Young mothers 2.42
Older mothers 4.14
GixeAIDSinJlnbntabx
Age (2,201) 3.39 .036
Teenage mothers 1.33
Young mothers 1.42
Older mothers 2.33
SexMMultipleEartners
Age (2,201) 5.14 .006
Teenage mothers 1.28
Young mothers 1.52
Older mothers 2.62
*p<.05 **p<.01 ***p<.001

31

Table 6. One-Way Analysis of Variance of Signiﬁcant Education and AIDS Knowledge

 

 

 

 

Questions
Variable & df ERaIiQ EELQb
Mmhasﬁramﬂnfeetedﬂnman
Education (3,201) 3.29 .022
Less than primary 2.00
Primary 1.60
Some Secondary 1.12
Secondary and beyond 1.10
W
Education (3,201) 4.40 .005
Less than primary 3.25
Primary 2.79
Some Secondary 2.00
Secondary and beyond 1.57
AIDSJIQmELQstitutes
Education (3,201) 3.59 .014
less than primary 2.50
Primary 2.74
Some Secondary 2.09
Secondary and beyond 1.59
Wuhinleﬂartners
Education (3,201) 3.30 .021
Less than primary 3.00
Primary 1.98
Some Secondary 1.45
Secondary and beyond 1.40
*p<.05 **p<.01 ***p<.001

32

Table 7. Signiﬁcant Religion and AIDS Knowledge Questions One-Way Analysis

 

 

 

 

of Variance
Variable Mean _t1_f EBmiQ EEmb
Blondlransﬁrsiun
How Religious (2,201) 3.10 .027
Not 3.57
Fairly 2.39
Very 2.10
Shakingliands
How Religious (2,201) 4.47 .004
Not 5.19
Fairly 4.20
Very 4.76
W
How Religious (2,201) 6.57 .000
Not 1.76
Fairly 1.24
Very 1.24
*p<.05 **p<.01 ***p<.001

33

Table 8. Signiﬁcant Religion and AIDS Knowledge Questions One-Way Analysis of

 

 

 

 

Variance
Variable Mean de ERatiu EEmb
SexMDrungser
Respondent’s Church Attendance (2,201) 3.98 .008
Never 2.12
Occasionally 2.13
Weekly 2.63
BlQQdIransfusien
Respondent’s Church Attendance (2,201) 4.83 .002
Never 4.00
Occasionally 2.13
Weekly 2.18
ShakinaHands
Respondent’s Church Attendance (2,201) 5.09 .002
Never 5.25
Occasionally 3.86
Weekly 4.58
SexMAIDSInfeetedﬂuman
Respondent’s Church Attendance (2,201) 8.93 .000
Never 1.75
Occasionally 1.17
Weekly 1.17
WW3!)
Respondent’s Church Attendance (2,201) 6.27 .000
Never 1.75
Occasionally 1.17
Weekly 1.27
AIDSmllnhemBab!
Respondent’s Church Attendance (2.201) 5-43 001
Never 2.25
Occasionally 1.69
Weekly 1.35
*p<.05 **p<.01 ***p<.001

34

Table 9. Signiﬁcant Religion and AIDS Knowledge Questions One-Way Analysis of

 

 

 

 

Variance
Variable Mean if ERatie Eﬂeb
SexsulAIDSJnfeetedMan
Partner’s Church Attendance (2,200) 4.71 .003
Never 1.27
Occasionally 1.00
Weekly 1.35
Shakingﬂands
Partner’s Church Attendance (2,200) 2.67 .048
Never 4.57
Occasionally 3.74
Weekly 4.74
*p<.05 **p<.01 ***p<.001

35

Table 10. Signiﬁcant Religion and AIDS Knowledge Questions One-Way Analysis of

 

 

 

 

Variance
Variable Mean df ERatie £21111!
[3' . E] l
Traditional Healer (2,201) 2.47 .046
Never 3.26
Sometimes 3.36
Often 3.29
BloedIransﬁrsien
Traditional Healer (2,200) 2.75 .029
Never 2.29
Sometimes 2.50
Often 2.43
SexMAIDSInfeetedﬂeman
Traditional Healer (2,200) 13.71 .000
Never 1.22
Sometimes 1.28
Often 1.00
W
Traditional Healer (2,200) 2.47 .046
Never 3.26
Sometimes 3.36
Often 3.29
NeedESharing
Traditional Healer (2,200) 3.67 .006
Never 1.95
Sometimes 2.63
Often 1.57
*p<.05 **p<.01 ***p<.001

36

Table 11. Signiﬁcant Religion and AIDS Knowledge Questions One-Way Analysis of

 

 

 

 

Variance
Variable Mean df ERatiu EBreb
NeedleShating
Traditional Ways (1,198) 4.69 .001
Yes 2.25
No 1.91
Wan
Traditional Ways (1, 198) 4.85 .001
Yes 1.40
No 1.21
W
Traditional Ways (1,198) 2.64 .034
Yes 1.52
No 1.45
Bloedlransfusiun
Traditional Ways (1,198) 5. 18 .000
Yes 2.69
No 2.08
SexMAIDSJnfeetedﬂQman
Traditional Ways (1,198) 5.99 .000
Yes 1.36
No 1.00
H 5 IE 5 I E . S' l
Iraditicnalﬂays (1,198) 3.38 .010
Yes 2.63
No 2.51
Traditional Ways (1,198) 3.97 .004
Yes 2.26
No 2.44
*p<.05 **p<.01 ***p<.001

37

Table 11 cont. Signiﬁcant Religion and AIDS Knowledge Questions One-Way Analysis

 

 

 

 

of Variance
Variable Mean if ERatin EEIeh
Ilseanfaﬁnndnm
Traditional Ways (1,198) 3.63 .007
Yes 2.60
No 2.47
Whit-E0935
Traditional Ways (1,198) 2.45 .047
Yes 3.49
No 3.54
SexndMultinleEartners
Traditional Ways (1,198) 9.99 .000
Yes 1.67
No 1.48
DiendAIDS
Traditional Ways (1,198) 5.92 .000
Yes 1.58
No 1.29
CurefQLAIDS
Traditional Ways (1,198) 3.54 .008
Yes 3.95
No 4.39
*p<.05 **p<.01 ***p<.001

38

Table 12. Signiﬁcant Religion and AIDS Knowledge Questions One-Way Analysis of

 

 

 

 

Variance
Variable Mg df ERatiQ EEIeb
Seuulengser
Maproﬁta (2,200) 3.45 .009
Never 2.46
Somewhat 3.09
Often 1.97
W
Maproﬁta (2,201) 2.92 .022
Never 3.86
Somewhat 4.37
Often 4.05
aneetedMan
Maproﬁta (2,200) 4.74 .001
Never 1.36
Somewhat 1.38
Often 1.00
SexMAIDSJnfeetedﬂeman
Maproﬁta (2,200) 5.75 .000
Never 3.68
Somewhat 4.37
Often 4.05
When
Maproﬁta (2,201) 3.22 .014
Never 3.32
Somewhat 3.85
Often 2.44
W
Maproﬁta (2,200) 5. 10 .000
Never 1.40
Somewhat 1.76
Often 1.1 1
*p<.05 **p<.01 ***p<.001

39

Table 12 cont. Signiﬁcant Religion and AIDS Knowledge Questions One-Way Analysis

 

 

 

 

of Variance
Variable Mean if ERaIiQ EELQb
AIDSfmumstitutrs
Maproﬁta (2,200) 2.56 .040
Never 1.77
Somewhat 2.32
Often 2.33
SeerZMultipleBartners
Maproﬁta (2,200) 5.93 .000
Never 1.54
Somewhat 1.64
Often 2.42
W
Maproﬁta (2,200) 4.69 .001
Never 1.27
Somewhat 1.77
Often 1.33
S 1 51125 I E . S' l
Maproﬁta (2,200) 2.91 .022
Never 2.46
Somewhat 2.57
Often 1.94
*p<.05 **p<.01 ***p<.001

4O

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