AIDSQuest: The HIV/AIDS Survey Library
Topic E: Knowledge and Misconceptions

Overview
While not directly related to behavior change, increasing widespread knowledge about STIs such as AIDS is considered an important first step in leading to possible behavior change. It is important to explore issues other than knowledge in behavioral surveys, as studies have clearly shown that increases in accurate knowledge about HIV/AIDS do not always correlate with increases in safer sex behavior. At the same time, misconceptions can prevent individuals from making informed choices and taking appropriate action. HIV/AIDS continues to be subject to much misconception and misinformed opinion, and it is important to understand how accurate and inaccurate knowledge may contribute to individual or population behavioral patterns.  

Knowledge and misconception questions often ask a respondent whether, or how much, they agree or disagree with specific facts or common misconceptions about prevention, transmission, treatment, and symptoms of HIV/AIDS. Other investigations into this topic probe awareness—or ask if people have “heard of” or “know” certain facts. Sometimes knowledge and misconception questions can be easily converted to attitude questions by adding a statement such as “Do you think that…” or “Is it acceptable…” to the fact or misconception.    

• Questions about prevention typically ask the respondent what is safer sex and what is not. More in depth queries will ask what prevention methods are available, and how to use them correctly.
• Knowledge and misconception questions regarding transmission are often used also. These questions will typically ask how HIV can and can not transmit, such as, “Can you get AIDS from kissing someone with AIDS?” An innovative approach could first ask the respondent to (1) list all known modes of transmission (thereby avoiding prompting), and then (2) investigate particular issues that may have emerged using “yes/no” statements.
• Treatment questions inquire about the respondent’s holistic views about treatment and resources—“Is there a cure for AIDS?” Another aim of the researcher would be to determine what the respondent knows about available treatment options, care and support, or vaccine availability.
• Questions about symptoms often aim to measure the respondent’s knowledge about particular physical signs of AIDS or STIs. A common question seen in many surveys is “Is it possible for a healthy-looking person to have HIV?”  

There are different ways questions about knowledge and misconceptions may be asked. One kind of question may have more than one possible answer (“What are some of the symptoms of AIDS?”). Answers to such questions with potential multiple responses may be recorded in an open-ended format, but will require more coding and cleaning—making the data potentially more difficult to analyze. A better method is to do preliminary research and pretest the questionnaire, and then print answer options on the instrument—the interviewer can then probe the respondent and “tick” off the answers given. This is more preferable in some cases than simply “reading out” the answer options, as this may “feed” answers that the respondent would not have given on his/her own.  

Other common questions simply ask for a “yes/no” answer—“Does HIV cause AIDS?” In many cases, adding “Don’t know” as an answer option is also necessary. It is also helpful to mix/reverse how questions are asked so that “yes/no” or “true/false” questions do not always follow the same pattern—for instance, you will sometimes want to ask a question testing agreement with a true assertion followed with a question making a false statement. This also applies to “agree/disagree” questions. If there is a pattern in the questioning, the respondent may soon figure this out and pattern their responses accordingly. If this is done, however, analysis of the data should take this into consideration, and recode if necessary—especially for more scientific procedures such as factor analysis.  

Another important point is to make sure similar questions within or among questionnaires in the same study are similarly structured. Questions should ask for information in the same consistent manner, otherwise comparison may be inaccurate or invalid. This point should also be remembered if the data is to be compared to results from other surveys or outside sources.

Examples of questions relating to knowledge and misconceptions have been selected from the questionnaires below:

1. HIV risk, prevention, and treatment

• Horizons—Transitions to Adulthood in the Context of HIV/AIDS

• Horizons—Targeted vs. General Population Interventions for STD Control  

• Horizons—Testing Clinic- and Community-based Strategies for Reducing Mother-to-Child Transmission of HIV

• UCSF CAPS—Healthy Oakland Teens Survey

• PSI—Condom Social Marketing Consumer Profile

• MEASURE DHS+—AIDS Module

• FHI—Behavioral Surveillance Surveys

• UNAIDS/MEASURE—Evaluation HIV/AIDS Prevention Indicator Survey

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This page updated 21 August 2006

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