Archive for Sexology
Michail A. Okoliyski
December 1, 1997AIDS Prevention in Bulgaria: Preliminary
findings of a dissertation project
- General Situation
- Target Groups
- Goals of the Investigation
- Some Preliminary Findings
- Sexual Knowledge and HIV/AIDS Education
- AIDS Prevention and Public Perception
- Conclusion
Since early 1996, the Bulgarian student Michail A. Okoliyski
has been doing research on his doctoral dissertation, mostly at
the RKI - Archiv für Sexualwissenschaft - and on location
in Bulgaria. The subject is "AIDS Prevention in Bulgaria"
(dissertation committee: Prof. Dr. Ernst von Kardorff (HU) and
Prof. E. J. Haeberle (RKI)). As the dissertation is nearing completion,
some preliminary findings can be reported here:
General Situation
The dramatic political changes of recent years have created a
difficult situation with regard to AIDS prevention in Bulgaria.
On the one hand, rapid modernization and the opening to the West
have created an overabundance of new sexual options (pornography,
prostitution, the self-identification of sexual minorities etc.),
but on the other hand, there is no public education on the dangers
of the new sexual freedom, no sex counseling, no educational literature,
no outreach to persons at risk, no concerted prevention effort.
Under these circumstances, the dissertation project has tried
to find promising starting points for future Bulgarian STD and
AIDS prevention campaigns.
Target Groups
It was extremely difficult to find cooperative persons at risk
for HIV infection in Bulgaria. Nevertheless, after many futile
attempts it proved possible to motivate a total of 61 persons
from the following target groups to fill out questionnaires:
-Intravenous drug users: 12 (of these, 1 had worked as prostitute),
-persons with bisexual behavior: 15 (of these, 1 had worked as
a prostitute),
-persons with homosexual behavior: 20 (of these, 10 had worked
as prostitutes),
-persons with exclusively heterosexual behavior: 14.
Goals of the Investigation
It was hoped that an analysis of the data provided by these 61
persons, in combination with findings from other sources, would
help answer to following questions:
- What kind of person can be considered a member of what target
group in Bulgaria?
- What do Bulgarians know about HIV/AIDS?
- What are the sexual attitudes in Bulgaria, and how do people
feel about using condoms?
- Which factors influence the acceptance of prevention programs?
- Are HIV-infected persons being stigmatized in Bulgaria, and
if so, how does this manifest itself?
- How do Bulgarians feel about those AIDS prevention efforts they
have heard about?
Some Preliminary Findings
A. Sexual Knowledge and HIV/AIDS Education
Of those answering the questionnaire, 84,7% received their sexual
knowledge from friends, and 20,3% through the media. Only 15,3%
received sex education from their parents. This confirms the claim
of many Bulgarian educators that sex is still a taboo subject
in most Bulgarian families. (Our finding is, by the way, almost
identical to an early study conducted by the Bulgarian ministry
of health in 1995. It found that only 14,8% of the student talked
about sexual concerns with their parents.) The fact that only
13,6% learned anything about sex from their teachers, reflects
the general absence of sex education from Bulgarian schools, where
students are taught a total of only two hours on the biological
differences between the sexes. There is a total lack of formal
education with regard to the psychological and social aspects
of sex. As a result, Bulgarian adolescents feel abandoned by their
elders as far as their own sexual problems are concerned. Their
sexual knowledge is still obtained "in the streets".
Fig. 1: Sources of Sexual Knowledge
Knowledge about HIV/AIDS is obtained in a quite different way.
Most Bulgarians learn about it from the media, since friends and
peer groups are largely uninformed due to a lack of intensive
government campaigns. Again, parents and schools play a very modest
role, illustrating once again the inadequacy of formal sex education.
There is one relative difference between our target groups, however:
Persons with bisexual and homosexual behavior receive more AIDS
information from their friends and peer groups.
Fig. 2: Sources of Information about HIV Infection and AIDS
B. AIDS Prevention in Bulgaria and Public Perception
The general public in Bulgaria has been repeatedly irritated by
confusing messages about AIDS: Modest government efforts have
been undermined by contradictory reports in the mass media and
by various journalistic horror scenarios that failed to become
true. In spite of all that, only a small minority in our sample
(6,6%) felt underinformed about AIDS. Nevertheless, it seems that,
in actual fact, the majority is hardly as well informed as it
believes. Thus, it is striking to note that few actually change
their risky behavior. For example, 66,7% of the iv drug users
believe themselves to be well informed, but only a few practice
"safe sex" or "safe use". Moreover, fewer
persons with exclusively heterosexual behavior consider themselves
well informed (50%) in comparison with the other target groups
(drug use: 66,7%, homosexual behavior: 60%, bisexual behavior:
60%). This can only mean that the latter groups get their information
not from public campaigns, which are still mostly directed at
the heterosexual majority, but from friends and peers. Finally,
although a majority feels sufficiently informed, 66,5% maintain
nevertheless that there is not enough AIDS information and AIDS
counseling in Bulgaria.
Fig. 3: Self-assessed Level of Information about AIDS
Conclusion
The contradiction between feeling well informed on the one hand
and, on the other, believing the information to be inadequate,
suggests that Bulgarians, inside or outside of any particular
target group, have a different concept of AIDS prevention and
expect future prevention campaigns to be different from what has
been offered so far. In particular, it seems that AIDS prevention
in Bulgaria should be more specifically tailored to specific groups.
Fig. 4: How do you rate the quality of the now available AIDS information and counseling services?
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