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ORIGINAL ARTICLE
Year : 2018  |  Volume : 7  |  Issue : 3  |  Page : 162-167

HIV knowledge, attitude, and practices among nursing students in Guntur city


1 House Surgeon, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
2 Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India

Date of Web Publication17-Sep-2018

Correspondence Address:
Dr. Vikram S Bommireddy
Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JDRNTRUHS.JDRNTRUHS_11_18

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  Abstract 


Introduction: Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) has become one of the dreadful health problems in the world. An integrated approach is strongly suggested for creating knowledge, attitude, and awareness to control the spread of HIV/AIDS among healthcare workers.
Aim: The aim of this study was to assess the knowledge, attitude, and practices of nursing students toward provision of care for HIV/AIDS-affected people.
Materials and Methods: This cross-sectional study was conducted among students attending four nursing colleges in Guntur city, Andhra Pradesh. A self-administered semi-structured questionnaire was used to collect data regarding knowledge, attitude, and practices in provision of care for HIV patients. Of 1012 students, a total of 839 students agreed to participate in the study, of which 800 completely filled questionnaires were returned and subjected to statistical analysis. Data analysis was done using SPSS version 20 software and Chi-square tests were used to analyze the data.
Results: Approximately 96.37% of students were aware that sexual intercourse can spread HIV/AIDS, whereas only 47.75% had knowledge on spread of HIV through tattooing. In total, 37.25% erroneously believe that salivary contact can spread HIV/AIDS. Around 20.37% of the study participants reported that they would not prefer to care for HIV patients. Approximately 50.75% of females and 54.17% of males expressed their apprehension of being exposed to HIV/AIDS at work.
Conclusion: A majority of nursing students had adequate knowledge, and few students held discriminatory attitudes toward people with HIV/AIDS.

Keywords: Awareness, HIV/AIDS, knowledge, nursing students, practices


How to cite this article:
Reddy A, Bommireddy VS, Pachava S, Chandu VC, Yaddanapalli SC, Lodagala A. HIV knowledge, attitude, and practices among nursing students in Guntur city. J NTR Univ Health Sci 2018;7:162-7

How to cite this URL:
Reddy A, Bommireddy VS, Pachava S, Chandu VC, Yaddanapalli SC, Lodagala A. HIV knowledge, attitude, and practices among nursing students in Guntur city. J NTR Univ Health Sci [serial online] 2018 [cited 2018 Oct 18];7:162-7. Available from: http://www.jdrntruhs.org/text.asp?2018/7/3/162/241277




  Introduction Top


Trends in human immunodeficiency virus (HIV) epidemic have not been consistent across the world over the years, with substantial increase in HIV incidence till 1997 and a relative decline through 2000s.[1] In India, 2001–2003 was the period when HIV was at its peak prevalence with 0.38%. Since then, there has been a steady decline with the prevalence being 0.26% in 2015.[2] Undivided Andhra Pradesh and Telangana state were reported to be the states with the highest number of people with HIV (3.95 lakhs), making this part of south India the HIV capital of the country.[3] Social stigma remains the key reason in the inhibition of HIV-affected people from using HIV services.[4] This is despite the fact that there has been tremendous improvement in the number of antiretroviral therapy (ART) centers and the provision of HIV services in the country.[5] It is important in this context that health professionals from various domains of health care should have adequate knowledge regarding HIV to raise peoples' awareness on HIV and to reduce the associated social stigma.

Nurses are expected to perform a variety of roles such as caregiver, communicator, teacher, counselor, leader, change agent, manager, and research consumer in healthcare institutions whenever care is provided to the needy. They may be carried out simultaneously depending on the need of the subject in a particular situation and case. As a caregiver, nurses are expected to assist the convalescent's physical, psychological, developmental, cultural, and spiritual needs to attain the utmost possible level of health and wellness.

Currently, nurses are acknowledged as key players in health care by being predominant contributors in the evolving inter-professional team-based patient care.[6] Especially in India, nurses are regarded as the “sheet-anchor” in India's health system which intends to provide primary health care to every citizen regardless of their ability to pay.[7] There were 512 functional ART centers and 1080 link ART centers in India in 2015 among which nurses play an integral role in each of these centers.[5] In this regard, poor knowledge on HIV among nurses may also get reflected in the HIV-related knowledge of the society they serve in and the social stigma associated with HIV in those societies. With this background, the objectives of this study were to assess the knowledge, attitude, and practices in providing care for HIV patients among nursing college students in the city of Guntur, Andhra Pradesh.


  Materials and Methods Top


This cross-sectional study was conducted during November 2016 among students attending nursing colleges in Guntur city, Andhra Pradesh. Cluster random sampling was used in this study by randomly selecting four nursing colleges from the 18 existing nursing colleges in the city and all the students from the four selected colleges were included in the study which yielded a sample of 1012 students. Self-administered, semi-structured, pretested, and validated questionnaire was used to collect data regarding knowledge, attitude, and practices in provision of care for HIV patients. Pilot testing of the questionnaire was done among 30 students before the start of the study to check validity of the questionnaire, potential misconceptions, and feasibility of the study. The questionnaire was also checked for content validity by six experts in the field of Public Health Dentistry where one item with insufficient relevance as opined by the experts in the field was excluded from the questionnaire. The final questionnaire consisted of 25 questions, of which 9 questions were to assess the knowledge, 11 to evaluate attitude, and 5 questions for assessment of practice. All the data were collected in a room with minimum silence and sufficient ventilation, where students were instructed not to discuss the questions with their colleagues. The average time taken for completion of the questionnaire was 14 min. Informed consent was obtained from all the participating students before the administration of the questionnaire. Ethical approval for the study was obtained from the institutional ethical committee of SIBAR Institute of Dental Sciences. Of 1012 students, a total of 839 students agreed to participate in the study with the response rate being 80.92%. The final analysis was based on the 800 completely filled questionnaires after elimination of 39 incompletely filled questionnaires. Data analysis was done using SPSS version 20 software, and Chi-square tests were done to analyze data.


  Results Top


The study population comprised 82%females and 18% males. For the ease of comprehension, the results were presented separately for questions regarding knowledge, attitude, and practices of nursing students. [Table 1] shows gender-based differences in HIV-related knowledge scores. Significant differences in HIV-related knowledge were found between males and females, where females presented better HIV-related knowledge compared with males. There was a consistent increase in the knowledge score with increase in academic year. About 93.05% of students were aware that sexual intercourse can spread HIV/acquired immune deficiency syndrome (AIDS), whereas only 47.75% were having knowledge on spread of HIV through tattooing. Around 37.25% erroneously believe that salivary contact can spread HIV/AIDS.
Table 1: Questions regarding knowledge of nursing college students about transmission of HIV

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[Table 2] shows the attitude of the nursing college students toward various HIV-related questions. Slightly more than 50% of the study populations responded that they feel worried about caring for people with HIV/AIDS. Significant difference was observed between males and females in their willingness to work or assist with an operative procedure on patient with HIV/AIDS. More than 20% of study participants reported that they would not prefer to care for HIV patients. About 50.75% of females and 54.17% of males expressed their apprehension about being exposed to HIV/AIDS at work. Less than 40% of study participants reported asking for HIV status of patients in their medical history.
Table 2: Questions regarding attitudes of nursing college students with respect to HIV

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[Table 3] shows the reported practices of nursing students while providing care for HIV patients. Most of the students reported that they will refer the HIV positive in their workplace to HIV specialty center. A majority of the students answered that they treat all the patients as HIV-positive (63% males and 49% of females).
Table 3: Questions regarding practice of nursing college students regarding HIV

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  Discussion Top


All the patients who are HIV-positive are potential sources of disease transmission to healthcare providers. Healthcare workers therefore must have adequate knowledge not only to provide adequate care for the needy but also to safeguard themselves, and with this initiative this study was done among them. More than three-quarters of the participants were aware of most of the routes of transmission of HIV/AIDS. Tattooing as a potential source for spread of HIV/AIDS was not known to more than 50% of the study participants in this study. However, this was more when compared with a study done by Sharma et al.[8] among nursing students in Ludhiana, Punjab, with an awareness on tattooing found to be 18%. This could be due to the fact that tattooing is an uncommon practice in the study area.

In a study conducted by Goel et al.[9] only 1.05% and 2.1% of the nursing students were aware of the fact that HIV could not spread by urine and mosquito bite, respectively. In another study conducted by Sharma et al., 89% were aware that mosquito bite could not transmit HIV [8] and these results were similar to that obtained in this study where three-quarters of the participants were aware that mosquito bite and contact with urine could not transmit HIV/AIDS. Another important finding in this study was that almost 70% of the study participants were aware that HIV could be transmitted through breastfeeding which was only 39% in the study conducted by Sharma et al.[8] The high level of awareness among nursing students in this study is comparable with a study conducted by Kamath among nursing students from selected colleges in Dakshina Kannada.[10] Although there was considerably good knowledge regarding HIV in this study, a discriminating attitude toward HIV patients was evident among nursing students and similar results were also found in a study conducted by Dharmalingam et al. in Bangalore.[11] Concerns about acquiring the infection while providing care were also prevalent among healthcare workers from different domains including nursing in a study conducted by Kermode et al. in rural northern India.[12] Although the results obtained in this study demonstrate better knowledge regarding HIV/AIDS among nursing students compared with previous studies reported in the literature, the diminutive deficit of knowledge is a potential risk in the spread of HIV. Therefore, the knowledge among the nursing students should be full bodied and there should be no leaks in the pot of knowledge regarding the spread of HIV.

Around 75.5% of participants abide that it should be mandatory to know the HIV status of the partner before marriage, so that unwarranted transmissions can be avoided. About 50.75% of the participants felt worried about caring for people with HIV/AIDS. This could be due to the fact that the participants were not confident in handling people with HIV/AIDS, and it was evinced by the fact that 75.75%of the study participants reported that it was necessary to take extra infection control precautions for patients with HIV/AIDS. Approximately 60.5% of them reported that they were worried about touching persons with HIV/AIDS which are statistically significant. Erroneous beliefs like HIV transmission through mosquito bite and urine were still prevalent among nursing students which could result in apprehension of these healthcare providers and subsequent discriminating attitude toward HIV/AIDS patients. Therefore, nursing students require more training regarding the ways by which HIV can be and cannot be transmitted. Some of the participants believed that it was necessary to take extra infection control precautions when caring for patients with HIV/AIDS and believed that they should be nursed separately from other patients. These findings highlight a lack of understanding regarding the primary principle underlying standard/universal precautions. It is not necessary to isolate HIV-positive patients when universal infection control practices are used regardless of the medical history of the patient. About 50.1% of the participants reported that they wash and apply antimicrobials agent when they get a needle prick injury during work which is of minimal advantageous in cases with communicable diseases such as HIV and hepatitis. More than three-quarters of the subjects reported that they will refer patient to HIV specialty center when they disclose that he is HIV-positive which depicts their apprehension in treating or providing care to such patients. More than three halves of the participants have reported that would accept the fact and provide care and support to their partner, if the affected he/she is their husband/wife which reveals their positive attitude.


  Conclusion Top


The findings of this study conclude that there was considerably good knowledge regarding HIV, but negative attitudes were still prevalent among the students. Considering the key role nurses are expected to play in provision of healthcare services, special IEC activities should be undertaken to educate nursing college students.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Fettig J, Swaminathan M, Murrill CS, Kaplan JE. Global epidemiology of HIV. Infect Dis Clin North Am 2014;28:323-37.  Back to cited text no. 1
    
2.
Jacob KJ, Jacob SK, Praveen TS, George SB, Saranraj J. Sociodemographic and clinical profile of human immunodeficiency virus/acquired immunodeficiency syndrome patients visiting a tertiary care hospital in Kerala – A cross-sectional study. Int J Sci Study 2016;4:6-12.  Back to cited text no. 2
    
3.
India HIV estimations 2015. Technical Report. National AIDS Control Organization. Ministry of Health and Family Welfare, Government of India. Available from: http://www.naco.gov.in/sites/default/files/India%20HIV%20Estimations%202015.pdf [Last accessed on 6th September, 2017].  Back to cited text no. 3
    
4.
Mahajan AP, Sayles JN, Patel VA, Remien RH, Ortiz D, Szekeres G, et al. Stigma in HIV/AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS 2008;22(Suppl 2):S67-79.  Back to cited text no. 4
    
5.
Assessment of ART centers in India. National report. National AIDS Control Organization. Ministry of Health and Family Welfare, Government of India. Available from: http://naco.gov.in/sites/default/files/ART%20Assessment%20National%20Report-Final%2028092015.pdf. [Last accessed on 2017 Aug 10].  Back to cited text no. 5
    
6.
Salmond SW, Echevarria M. Healthcare transformation and changing roles for nursing. Orthop Nurs 2017;36:12-25.  Back to cited text no. 6
    
7.
Bhaumik S. Why is India short of nurses and what can we do about it? BMJ 2013;346:f4024.  Back to cited text no. 7
    
8.
Sharma SK, Kaur K, Kaur M. Awareness of HIV/AIDS among newly admitted nursing students. Nurs Midwifery Res J 2006;2:32-8.  Back to cited text no. 8
    
9.
Goel NK, Bansal R, Pathak R, Sharma HK, Aggarwal M, Luthra SC. Knowledge and awareness of nursing students about HIV/AIDS. Health Pop 2010;33:55-60.  Back to cited text no. 9
    
10.
Kamath N. Awareness on epidemiological factors of HIV/AIDS among nursing students in selected institutions in Dakshina Kannada. Nitte Univ J Health Sci 2016;6:20-3.  Back to cited text no. 10
    
11.
Dharmalingam M, Poreddi V, Gandhi S, Chandra R. Undergraduate nursing students' knowledge and attitude toward people living with human immunodeficiency virus/acquired immunodeficiency syndrome. Int J Adv Med Health Res 2015;2:22-7.  Back to cited text no. 11
    
12.
Kermode M, Holmes W, Langkham B, Thomas MS, Gifford S. HIV related knowledge, attitudes and risk perception among nurses, doctors, and other healthcare workers in rural India. Ind J Med Res 2005;122:258-64.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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