RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA, BANGALORE
SYNOPSIS OF DISSERTATION
“A STUDY OF KNOWLEDGE, ATTITUDE AND PRACTICES (KAP) OF COLLEGE STUDENTS REGARDING HIV INFECTION AND ITS PREVENTION IN MANDYA DISTRICT”
SUBMITTED BY
Dr. RANGASWAMY H V POST GRADUATE STUDENT
DEPARTMENT OF COMMUNITY MEDICINE ADICHUNCHANAGIRI INSTITUTE OF MEDICAL SCIENCES, B.G.NAGARA – 571448 Rajiv Gandhi University of Health Sciences, Karnataka Curriculum Development Cell
CONFIRMATION FOR REGISTREATION OF SUBJECTS FOR DISSERTION
Registration No :
Name of the candidate : DR. RANGASWAMY.H.V
Address : ROOM NO 47, KALPATARU BHAVANA, AIMS,
B.G.NAGARA
Name of the institution : Adichunchanagiri Institute of Medical Sciences,
B.G. Nagara- 571448
Course of study and subject : MD(COMMUNITY MEDICINE)
Date of admission to course : 6/7/2009
Title of the topic : A STUDY OF KNOWLEDGE, ATTITUDE AND
PRACTICES(KAP) OF COLLEGE STUDENTS
REGARDING HIV INECTION AND ITS PREVENTION
IN MANDYA DISTRICT
Brief resume of the intended work : Attached
Signature of the student :
Guide name : DR. SURESH LANKESHWAR, M.D., PROFESSOR
AND HEAD, DEPARTMENT OF COMMUNITY
MEDICINE, A.I.M.S., B.G.NAGARA.
Remarks of the guide : SYNOPSIS IS PREPARED AS PER ACCEPTED
STANDARD AND REQUIREMENT.
Signature of the Guide :
Co-Guide Name :
Signature of the Co-Guide :
HOD Name : DR. SURESH LANKESHWAR, M.D.,
Signature of the HOD
Principal Name : DR.MOHAN. M.E., M.D.
Principal Mobile No. : 9448088888
Principal E-mail ID : [email protected] Remarks of the Principal :
Principal Signature : RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,
BANGALORE
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1 Name of the Candidate and DR.RANGASWAMY.H.V. Address(in block letters) ROOM NO 47, KALPATARU BHAVANA, A.I.M.S., B.G.NAGARA-571448
2 Name of the Institution ADICHUNCHANAGIRI INSTITUTE OF MEDICAL SCIENCES, B.G.NAGARA-571448
3 Course of study and subject M.D. (COMMUNITY MEDICINE)
4 Date of admission to course 6-7-2009
5 Title of the topic “A STUDY OF KNOWLEDGE, ATTITUDE AND PRACTICES(KAP) OF COLLEGE STUDENTS REGARDING HIV INECTION AND ITS PREVENTION IN MANDYA DISTRICT”
6. Brief resume of intended work: 6.1 Need for the study ANNEXURE-I 6.2 Review of literature ANNEXURE-II 6.3 Objectives of the study ANNEXURE-III
7. Material and methods: ANNEXURE-IV
7.1 Source of data
7.2 Method of collection of data(including sampling No procedure, if any)
7.3 Does the study require any investigations or interventions to be conducted on patients or NA other animals? If so please describe briefly. 7.4 Has ethical clearance been obtained from your institution in case of 7.3 8. List of reference(About 4-6) ANNEXURE-V
9. Signature of candidate
10. Remarks of guide 11. Name & Designation of (in block letters)
11.1 Guide Dr. SURESH LANKESHWAR, M.D., PROFESSOR AND HEAD DEPARTMENT OF COMMUNITY MEDICINE A.I.M.S., B.G.NAGARA
11.2 Signature
11.3 Co-Guide(if any)
11.4 Signature:
11.5 Head of Department Dr. SURESH LANKESHWAR, M.D., PROFESSOR AND HEAD DEPARTMENT OF COMMUNITY MEDICINE A.I.M.S., B.G.NAGARA
11.6 Signature:
12 12.1 Remarks of the Chairman & Principal
12.2 Signature:
ANNEXURE-I
6.1 INTRODUCTION AND NEED FOR THE STUDY:
Acquired Immunodeficiency Syndrome (AIDS) is a newly emerged health problem since
1980. It is a fatal illness caused by a retrovirus known as Human Immunodeficiency Virus (HIV). By breaking down the body’s immune system, it makes victim vulnerable to life threatening opportunistic infections, neurological disorders and unusual malignancies. The special feature of HIV infection is that once a person is infected, he is infected for life. AIDS refers only to the last stage of the infection.1
The prevalence of HIV infection in the world was 33.2 million in 2007. The new infections occurring are 2.5 million and deaths due to AIDS are about 2.1 million every year.1
The first AIDS case was reported on June 5th of 1981. The CDC reported cluster of
Pneumocystis Carinii Pneumonia(PCP) in 5 homosexual men in Los Angeles. The task force set up in 1981 for naming introduced the term ‘AIDS’ in July 1982.2
The first case of HIV infection from India was reported at Chennai in 1986. India falls under pattern III of HIV epidemic.2 In India epidemic shifts from the highest risk group to bridge population and then to general population. The prevalence of HIV infection is 2.5 million in India.1
Karnataka is one of the 9 high burden states in the country.1 The prevalence of Karnataka is around 2.5 lakhs. The rate of prevalence is 0.86%.3
MODES OF TRANSMISSION
HIV viruses are present in body fluids of infected persons blood, semen, vaginal secretions and breast milk etc
The main routes of transmission of HIV infection are:
Sexual route (heterosexual, homosexual, bisexual)
Transfusion of contaminated blood and blood products
Use of contaminated needles and instruments and
Mother to child (vertical).
Exposure to infected fluid (blood, semen, vaginal secretions and breast milk) leads to a risk of contracting infection by an healthy individual. Worldwide, the major route transmission is heterosexual (75%).4
In the context of no effective vaccine against HIV prevention at present and no medication to cure the disease; WHO recommends 3 objectives:
(1) To prevent HIV infection
(2) To reduce personal and social impact of HIV infection and care for those already infected with HIV and for those who have AIDS.
(3) To unify national and international efforts.5
HIV is percolated into general population. In this context, it is essential to educate college students who are future citizens and contribute to 50% of HIV burden to bring down prevalence. For the past so many years HIV awareness programmes are being conducted by NACO and State AIDS
Prevention Societies (SAPS). Lot of information is being given to public through press and mass media. NGOs are actively involved in this endeavour; more than in any other National Programmes. School AIDS Education Programmes (SAEP) and College AIDS Education Programmes (CAEP),
Red Ribbon clubs in colleges and AIDS Day celebrations etc. are part of such efforts.
Hence the present study is undertaken in an attempt to assess the knowledge, attitude and practices of HIV prevention among college students of Mandya district.
ANNEXURE-II
6.2. REVIEW OF LITERATURE
The best way of HIV prevention is change of behaviour. It is directed towards giving right knowledge of routes of HIV spread. It is important to change the attitudes of student population towards safe sex, safe methods of blood transfusion, safe injection practices and also about safe parenthood. Many studies have been conducted regarding the knowledge, attitude and practice of
HIV prevention among college students is given below:
Lone De Neergard in his study about ‘Adolescents: Knowledge, Attitude and Practice’ states that it is not enough for adolescents to know facts about AIDS; they also have to be motivated to apply the knowledge when it matters.
The main tactics are,
- Make such education is life oriented, not death oriented
- Minimize fear
- Minimize discrimination.6
Sudha RT and others in a study on ‘Awareness, Attitudes, and Beliefs of the general public towards HIV/AIDS in Hyderabad, a capital city in 2004 from south India’ conclude that 89.32% of males were more aware of HIV/AIDS compared to 71.39% of females. Approximately 88.35% of literates were aware of the infection compared to the awareness of infection in 12.73% of persons with low literacy. 7
In a compilation of research studies undertaken in the Vijayawada Division, South central railways about ‘ Knowledge, Attitude, Behavioural Practices in the community’ the inference drawn was that the respondents were aware of the modes of transmission of HIV through mother to child during pregnancy or delivery, but were not aware of transmission through breast milk.8
A baseline study of 2005: ‘HIV/AIDS Knowledge, Attitudes and Practices in India revealed that 85% of general population had heard of AIDS, 67% are aware. More people had heard about
AIDS than about HIV.9
In a study conducted by Lal SS, Vasan RS in September 2000 it was found that all the students had heard about AIDS. Only 45% knew that AIDS is not curable. Only 34% were aware of the symptoms of STDs, and 47% knew that STDs are associated with an increased risk of AIDS.10
Another study conducted by Fisher JD and Movish SJ in AIDS Education and Prevention,
1990 infers that the students’ current level of AIDS-knowledge were found to be relatively high though their attitudes towards prevention were in the minimal range.11
In a study conducted by Bazargan M and others on ‘Correlates of HIV risk taking behaviours among African-American college students‘ The information, motivation and behavioural skill model of AIDS-preventive behaviour was employed to delineate the roles of HIV/AIDS knowledge, experiences with attitudes towards condom use, peer influences, perceived vulnerability, monogamy and behavioural skills.12
Mallika Mitra Biswas in her study ‘Gender differences in knowledge, attitudes, and prevention of HIV/AIDS among youth in West Bengal, India states that 75% had heard of
HIV/AIDS, there are gender differences in awareness and practices 34% male respondents and only
15% of female youth could correctly identify three routes of HIV transmission.13
ANNEXURE-III
6.3 OBJECTIVES OF THE STUDY
1. To assess the knowledge, attitude and practices regarding HIV infection and its prevention in college students of Mandya district.
ANNEXURE –IV
MATERIAL AND METHODS
Study Design : Cross sectional study
Study area : Mandya District, Karnataka State
Study period : 12 months from January 2010 to December 2010
Study subjects : College students both male and female
Inclusion Criteria : College students who are willing for the study.
Exclusion criteria : College students who are not willing to participate in the study.
Methods of collection of data:
1. Personnel interview technique using pretested questionnaire-(Annexure-VI)
Sampling method: Stratified random sampling.
Assessment of KAP of college students regarding HIV infection and its prevention: Assessment will be done by using pretested proforma (Annexure-VI)
SAMPLE SIZE ESTIMATION: The present study is a qualitative study.
A pilot study was conducted involving college students to assess proportion of students having good knowledge regarding HIV and its prevention, which showed only 10% of college students having good knowledge regarding HIV prevention, where as 90% of college students having poor knowledge about HIV and its prevention.
Based on pilot study, the following formula is used for estimating the sample size (n). n = 4pq/l2…………………………….. (For 95% confidence limits).
Where n = sample size.
When p = proportion of students having good KAP about HIV and its prevention.
q = proportion of college students who are having poor knowledge about HIV prevention.
l = allowable error (10% of p). n = 4x10x90 = 3600
12
Final sample size including sample attrition (5%) = 3600+5% of 3600.= 3780
SAMPLING PROCEDURE:
Stratified random sampling technique will be used.
Estimated sample size is 3780.
STEP 1: All the different faculty( courses) related colleges(Medical college, Engineering college,
Nursing college, Pharmacy college, PU college , Degree college and B.Ed colleges) in Mandya district will be listed.
STEP 2: The faculty( courses )related colleges will be made into different strata(Groups) Medical ,
Engineering, Nursing , Pharmacy , PU ,Degree and B. Ed colleges) --- total 7 strata.
STEP3: Since the estimated sample size is 3780, to have proper representation from each strata of faculty(courses) colleges, 540 from each strata(3780/7) will be selected statistically, as mentioned in table no 1.
Table No.1
Strata of colleges and sample size
Sl. No Strata Study subjects
1 Medical college 540
2 Engineering college 540
3 Pharmacy college 540
4 Nursing college 540
5 PU college 540
6 Degree college e 540
7 B. Ed college 540
Total sample size 3780
Statistical methods: Percentage, Proportion and χ2 test.
ANNEXURE-V
REFERENCES
1. Park K. Park’s textbook of Preventive and Social Medicine. 20th ed. Jabalpur: M/s Banarsidas Bhanot; 2009. 2. Wikipedia[Internet]. Origin of AIDS, the free encyclopaedia[cited Aug 02].
Available from: http://en.wikipedia.org/wiki/Origin_of_AIDS.
3. NACO and SACS. HIV Sentinel Surveillance-2008, An overview and sampling
method.[CD-ROM].
4. Wilkins EGL. Human immunodeficiency virus infection and human acquired
immunodeficiency syndrome. In: Nicholas A, Nicki RC, Brain RW, editors.
Davidson’s Principles and Practice of Medicine, 20th ed. Churchill Livingston:2006,
P.381
5. Jonathan mann. Global AIDS Prevention and Control.In: WHO Geneva and
Pergaman Press: Oxford. 1988 p.8-9
6. Lone De Neer Gaard. Adolescents: Knowledge, Attitudes, and Practices. In: AIDS
Prevention and Control. WHO Geneva and Perguman Press: Oxford.1988
7. Sudha RT, Vijaya DT, Lakshmi V. Awareness, Attitudes and beliefs of the general
public towards HIV/AIDS in Hyderabad a capital city from South India. Indian J
Med Sci. 2005 July 7; 59(7): 307-316
8. South Central Railways, Vijayawada Division[Internet], [cited on 2009 July 30].
Available from:http://www.unifem.org.in/PDF/KABP 9. Baseline survey 2005. HIV/AIDS knowledge, Attitudes and practices in
India[Internet],[cited 2009 July 30]. Available from http://bing.com
10. Lal SS, Vasan RS, Sarma PS, Thankappan KR. Natl Med J India [serial on the
Internet]. 200 Sp-Oct[cited 2009 Oct 22][1 screen]. Available
from:http://www.ncbi.nlm.nih.gov/pubmed/111900550
11. Fisher JD, Misovich SJ. AIDS Educ Prev. 1990 Winter; 2(4):322-37. Available
from:http://www.ncbi.nlm.nih.gov/pubmed/2288814
12. Bazargan M,Kelly EM, Stein JA, Husain BA, Bazargan SH. Correlates of risk taking
behaviours among African-American college students: the effect HIV knowledge.
Natl Med Assoc[serial on the internet]. 200 Aug [cited 2009 Oct 22];92(8):391-440.
Available from:http://www.ncbi.nlm.nih.gov/pubmed/10992684.
13. Mallika Mitra Biswas, Sona Sethi, Lobani Jana, Kakali Bhattacharya. Gender
differences in knowledge, attitudes and prevention of HIV/AIDS/STI among youth
West Bengal, India [serial on the Internet], [cited on 2009 Oct 22 ]. Available
from:http://alpha.confex.com/alpha/132/tec SECTION B
ANNEXURE-VII
SUMMARY OF THE PROJECT:
HIV infection is a preventable and chronic manageable condition. At present no effective vaccine is available for prevention of HIV infection. Various drugs which are available can only prolong the illness but cannot cure the disease. Therefore efforts in this regard are through life skill education and decision making with respect to behavioural change. The right period of imbibing such values in life is adolescence and youth, where 50% of HIV transmission is at this juncture only. As college students are in transitional stage, and also in the threshold of building career and starting family in future, they are the target group for such activities like life skill education and decision making. Presently HIV prevalence is reaching almost 1% causing alarming growth of HIV infection burden in our country. Hence in the present study an effort will be made to assess knowledge, attitude and practice of college students regarding HIV infection and its prevention. The results of the study may throw light about the current status of their knowledge regarding HIV and its prevention, which will help for measures to be taken for primary prevention of HIV infection.
PROFORMA APPLICATION FOR ETHICS COMMITTEE APPROVAL
SECTION – A
“A STUDY OF KNOWELDGE, ATTITUDE AND PRACITCES (KAP) OF COLLEGE a. Title of the study STUDENTS REGARDING HIV INFECTION AND ITS PREVENTION IN MANDYA DISTRICT.” b. Principal investigator (Name & Dr. RANGASWAMY H V Designation) P.G. in COMMUNITY MEDICINE c. Co investigator (Name & Designation) NIL d. Name of Collaborating department/ NIL institutions e. Whether permission has been obtained from the head of the collaborating departments/institutions NA SECTION B – Summary of the project ANNEXURE – VII SECTION C – Objectives of the study ANNEXURE – III SECTION D – Methodology ANNEXURE – IV a. Where the proposed study will be STATISTICALLY SELECTED undertaken COLLEGES OF MANDYA DISTRICT KARNATAKA STATE b. Duration of project 12 months c. Nature of subject
Does the study involve adult patients? No Does the study involve children? No Does the study involve normal volunteers? Yes Doses the study involve Psychiatric No patients?
Does the study involve pregnant women? No d. If the study involve healthy volunteered 1. Will they be institute students? Yes
2. Will they be institute employees? No No 3. Will they be paid? 4. If they are to paid, how much per Not applicable session? e. Is the study a part of a multicentral trail? No f. If yes, who is the coordinator?(Name and designation) Not applicable Has the real been approved by the ethics committees of the other centers? If they study involves the use of drugs, please indicate whether, 1. The drug is marketed in India for the indication in which it will be used in the study. 2. The drug is marketed in India for the indication in which it is proposed to be used. 3. The drug is marketed in India, but not for the indication in which it is proposed to be used. 4. Clearance from the Drugs Controller of India has been obtained for. - Use of drug in healthy volunteers - Use of drug in patients for a nes indication - Phase one and two clinical trails - Experimental use in patients and healthy volunteers. g. How do you propose to obtain in the drugs to be used in the study? Not applicable - Gift from a drug company - Hospital supplies - Patients will be asked to purchase - Other sources (Explain) h. Funding (if any) for the project None Please state - None - Amount - Source - To whom payable i. Does any agency have a vested interest in No the outcome of the project? j. Will the data relating to subjects/Controls Yes be stored in a computer? k. Will the data analysis be done by: - The researcher? The researcher - The funding agency? l. Will technical /nursing help be required from the staff of hospital. If yes, will it interfere with their duties? Not applicable Will you recruit other staff for the duration of the study? If yes, give details of 1. Designation 2. Qualification 3. Number 4. Duration of employment m. Will informed consent be taken? If yes, Yes
Will it be written informed consent No Will it be oral consent? Yes Will it be taken from the subject them Yes selves? Will it form the legal guardian? No If no, give reasons: n. Describe design, methodology and techniques Annexure IV (use a separate sheet)
Date Chairman PG Training – Cum – Research Committee
AIMS, B.G.Nagara – 571 448 ANNEXURE-VI
PRE-TESTED QUESTIONAIRE ABOUT HIV INFECTION AND ITS PREVENTION
1. Have you heard of HIV? : Yes/No
2. Have you heard of AIDS? : Yes/No
3. Is there difference between HIV/AIDS : Yes/No
4. Is it a new disease? : Yes/No
5. Is it contagious? : Yes/No
6. Do you know what unsafe sexual behaviour is? : Yes/No
7. Do you know 4 routes of HIV transmission : Yes/No
8. Can it be preventable by safe sexual practices? : Yes/No
9.Does it spread through unsafe sex? : Yes/No
10.Does untested blood transfusion, unsterile needle pricks can cause HIV? : Yes/No
11.Does HIV infected pregnant can transmit infection to her infant? : Yes/No
12.Can HIV infection be preventable? : Yes/No
13. If yes, how?
a)...... b)......
c) ...... d) ......
14.Does AIDS is curable? : Yes/No
15.Do you know what ICTC is? : Yes/No
16.Do you know what services are available at ICTC? : Yes/No
17.Do you know where ICTC’s are located? : Yes/No
18. Is any vaccine available to prevent HIV infection to occur? : Yes/No
19. Does life skill education in colleges can change the risky behaviour? : Yes/No
20.Do you believe that in social isolation HIV infected? : Yes/No
21.Are you of the opinion that touching, eating with, sharing cloths with an HIV infected spread
the disease? : Yes/No
22.Do you know HIV is a virus? : Yes/No
23.Do you know HIV/AIDS present only in human beings? : Yes/No
24. Do you know that HIV infected is a healthy stage? : Yes/No
25.Do you know AIDS is a diseased stage? : Yes/No
26.Do you know that there is a treatment to prolong the life span of HIV infected? : Yes? No