ANN ARBOR—School-based programs that encourage safe behavior among teens are especially important in Latin America where total HIV/AIDS cases increased to nearly 2 million people last year, a new study says.

A researcher at the University of Michigan, who conducted an initial study as part of his dissertation at the University of South Florida, shows how HIV/AIDS prevention programs that are in English and created in the United States can be translated into Spanish to advance research and program evaluation efforts to target Hispanic populations.

“The most important finding is that this questionnaire can be used to assess HIV/AIDS knowledge and attitudes in youths from Latin America and with Latinos in the United States,” said Carlos Zometa, the study’s lead author and an assistant research scientist in the U-M School of Social Work.

The findings appear in the June issue of AIDS Education and Prevention.

HIV/AIDS continues to be a serious international and domestic problem. In 2006 UNAIDS reported 1.7 million people live with HIV/AIDS in Latin America and 1.4 million in the United States. Since young persons are vulnerable to HIV infection, there is a great need to increase the number of school- and community-based programs to prevent transmission, Zometa said.

Zometa documented the process to translate to Spanish from English a questionnaire initially developed by the Centers for Disease Control and Prevention that assessed knowledge about HIV transmission and attitudes towards peer pressure, abstinence, drug use and the threat of HIV infection. The importance of HIV/AIDS knowledge and attitudes were that they act as mediators in prevention programs. Specifically, programs have highlighted the importance of attitudes toward condom use and abstinence in reducing transmission, he said.

The process involved translating and cross culturally adapting the questionnaires from English to Spanish by using a procedure requiring less time and resources than traditional methods. Salvadorian experts reviewed the translations for accuracy and cultural acceptability, while 483 Spanish-speaking Salvadorian students from public high schools offered input regarding the questionnaire. This study is important because investigators can rapidly create a questionnaire to assess prevention programs, Zometa said.

Among the questions answered correctly by more than 90 percent of the students. (All answers are true):

• HIV can be found in semen, vaginal fluids and blood.
• A person can get HIV by sharing drug needles.
• Once you are infected with HIV, you are infected for life.

About 50 percent or less of the students answered these questions correctly (Only the second item is false):

• A person can “pass” an HIV antibody test (test negative), but still be infected with HIV.
• People infected with HIV are usually very thin and sickly.
• Using latex condoms can prevent HIV/AIDS.

The cross-cultural adaptation of the HIV/AIDS questionnaire is viable for researchers in Latin America to interpret and validate findings from prevention programs.

“Conversely, researchers in the United States can also adapt the questionnaire to assess HIV/AIDS knowledge and attitudes among the growing U.S. Hispanic population,” Zometa said.

The study’s other authors include Robert Dedrick, Michael Knox, Wayne Westhoff and Ann Debaldo, all from the University of South Florida, and Rodrigo Siman Siri of Ministry of Public Health and Social Assistance in El Salvador.

Zometa

School of Social Work

AIDS Education and Prevention

UNAIDS