Evaluating health knowledge: an alternative approach

Health campaigns concerned with HIV and AIDS confront two important barriers: the stigmatized nature of the disease and cultural values that exacerbate the taboo nature of the information disseminated. The use of surveys in HIV and AIDS research requires respondents to provide descriptions of sexual acts and body parts as measures of their knowledge. Focus groups and interviews require respondents to speak publicly about these topics. Although many young people know about HIV and AIDS, they may not have the vocabulary to express their complete knowledge either textually or verbally. This article describes an alternative approach designed to evaluate HIV and AIDS knowledge among 587 adolescents in Mexico, where the number of official cases of AIDS has increased steadily since 1981. Participants stratified on sex and social class were required to draw modes of HIV transmission. The drawings were categorized into drawings of objects and persons, focusing on behaviors or cognitions, with a relational or contextual emphasis. The utility of this method for measuring knowledge about HIV infection and AIDS in education campaigns and evaluation research is discussed.