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Journal of the Academy of Hospital Administration

Awareness and Knowledge about hiv/aids Infection Among Patient Attendants at a Tertiary Care Hospital

Author(s): Farroq A. Jan, G.J. Qadiri, Qazi A. Qayoom, M.A. Shaheen, Z.A. Wafai, Suheel J. Sangin

Vol. 16, No. 1 (2004-01 - 2004-06)

Abstract

HIV epidemic is shifting from high risk population through bridge population (clients of sex workers and partners of drug users) to general population. Realizing the fact that infection is preventable and keeping in view the epidemiology of the disease, characteristics of the agent; the awareness and knowledge among public about the various aspects of disease causation will definitely minimize this disease menace. The study conducted among patient attendants at a tertiary care hospital located in urban setting identified gaps in knowledge about the disease in various groups e.g. females with low educational and socio-economic status. The groups having minimum awareness and knowledge about the disease need to be targeted by using appropriate education methods and aids in order to achieve the desired results of making the general population aware and knowledgeable so that they adopt safe practices, which will limit spread of this dreadful, stigmatized and life taking disease.


Introduction

HIV epidemic within two decades have emerged as one of the most serious health problem in India; 3.97 million people reported to be infected with HIV1. However varied cultural characteristic with reference to the sex related risk behaviors makes the estimation of HIV prevalence difficult. Of the HIV infections nearly 87% are contracted sexually and are transfusion associated and intravenous drug (IVD) use driven. Vertically transmitted infections make up the remaining2. Further AIDS epidemic in India is shifting from bridge population (clients of sex workers, STD patients and partners of drug users) to the general population which further complicates the issue. Keeping in view the epidemiology of the HIV disease, knowledge about the spread of HIV has critical impact on the prevention of acquired Immunodeficiency syndrome3. Thus it was found desirable to study the awareness and knowledge of AIDS among patient attendants attending a tertiary care hospital located in the urban setting, receiving patients both from urban and rural areas to a) disseminate education regarding prevention of HIV infection among the masses in India. b) help make modifications in the design/medium of education and in the target population

Materials and Methods

A cross-sectional study was conducted among patient attendants at Sher-i-Kashmir Institute of Medical sciences (SKIMS). A total of 1550 patient attendants were subjected to a predesigned and pretested questionnaire to assess the awareness and knowledge about AIDS. By awareness we meant having heard about AIDS and knowing that it is a disease. By knowledge we meant knowing about he various modes of spread of AIDS and various methods of its prevention. The questions were explained to participants in local language in detail to ensure complete comprehension. The investigators clarified the queries raised by the participants and at the end their misconceptions were removed and their knowledge improved. Finally proformas were analysed, data complied and inference drawn.

Results

Awareness among different groups i.e. sex, residence, income, education, can be seen in Table 1.

Males are marginally more aware than females; 87.26% as compared to 71.24% Awareness among rural females is less; 52.05% as compared to their counter parts in urban areas 85%. Awareness has a direct correlation with income i.e. 98.21% in income

Table 1: Awareness regarding AIDS

Category     Aware (n) % Not Aware (n) %
Sex   M 685 44.19 100 6.45
F 545 35.16 220 14.19
Residence Rural M 405 49.09 55 6.66
F 190 23.03 175 21.21
Urban M 295 40.69 30 4.13
F 340 46.90 60 8.28
Age 15-35 years M 450 39.47 85 7.45
F 445 39.04 160 14.04
36-50 years M 225 56.96 10 2.53
F 100 25.31 60 15.18
51-65 years M 10 66.66 5 33.34
F 0 0.00 0 0.00
65-80 years M 0 0.00 0 0.00
F 0 0.00 0 0.00
Income Above Rs.10,000 per month M 75 26.78 5 1.78
F 200 71.42 0 0.00
Rs.5,000-10,000 per month M 175 72.91 5 2.08
F 60 25.00 0 0.00
Rs.2,000-5,000 per month M 210 42.42 45 9.09
F 180 36.36 60 12.12
Rs. 2,000 per month M 195 46.98 35 8.43
F 35 8.43 150 36.14
120 failed to convey about income
Education Illiterate M 85 17.89 50 10.52
F 125 26.31 215 45.26
10th Standard M 200 60.60 25 7.57
F 95 28.78 10 3.03
Above 10th Standard M 255 57.30 10 2.25
F 175 39.32 5 1.12
Graduate M 120 50.00 0 0.00
F 120 50.00 0 0.00
Postgraduate M 40 66.66 0 0.00
F 20 33.33 0 0.00
Occupation Housewives   355 61.20 225 38.80
Business M 335 81.70 70 17.07
F 0 0.00 5 1.30
Service M 300 78.94 15 3.94
F 60 15.78 5 1.31
Student M 65 63.88 0 0.00
F 115 36.12 0 0.00

Group above Rs.10,000/mongh, 97.95% in group with income between Rs. 5,000-10,000mongh, 78.78% in income group between Rs. 5,000-5,000/month and 55.42% in group whose income is less than Rs. 2,00/month.

Awareness regarding AIDS is 44.21% in illiterates, 89.39% in those with education less than tenth standard, 96.62% in those with education between 10th standard and graduation and 100% among graduates and postgraduates.

Occupation again has influence on ones awareness. Awareness being 61.20% among housewives, 81.17% among business (non service) cadre, 94.73% among service group and 100% among students.

Most of the participants had heard about AIDS from electronic media as can be seen in table II.

Table II: Source from which heard about AIDS

Source from which Heard No. %
Television 805 51.9
Radio 650 41.9
Newspapers, Magazines, Pamphlets 260 16.7
From health workers 190 12.2
Friends 70 4.5
Husband 60 3.8
School teachers 30 1.9

Note: Most of the participants had heard about AIDS from more than one source [Total number of participants: 1,550]

Knowledge regarding AIDS in different groups is depicted in Table-3 11. 93% participants had the perception that AIDS spreads by living together, using common utensils, sharing towels etc. 82.16% males knew that AIDS spreads by sexual contact, while as only 54.24% females knew that AIDS spreads through this route. The fact that AIDS spreads by unsterile syringes and needles was known to 49.68% males while as only 39.86% females had knowledge about this route of transmission. 54.77% male participants knew that AIDS spreads by transfusion of blood, while as only 46.40% females had knowledge about this fact. Only 3.18% males and 7.84% females knew that AIDS spreads from mother to child. That condom gives protection against AIDS was known to 44.58% males and 24.18% females participants. Usage of dispo0sable/sterile syringes gives protection against AIDS was known to 42.03% of males and 23.52% of females. 45.22% of male participants knew that using screened blood gives protection against AIDS, while as only 44.44% of female participants had this knowledge. That AIDS is fatal was known to 77.07% of male participants and 47.05% of female participants. Only 1.6% of participants had information of a case among frinds, neighbors or workplace (in and outside valley).

Discussion

From the results it is clear that awareness is maximum among men, living in urban areas. Higher socioeconomic status and higher level of education has positive correlation with the level of awareness and education regarding AIDS. However there are still wide gaps in knowledge about AIDS both among urban as well as rural areas. There are socioeconomic barriers to health information about AIDS. Specific interventions targeted towards specific channels of communication will be of great help and are urgently needed.

In addition to the government’s fight against this dreaded disease, community and non-government voluntary organizations have a definite role to play. The activities consist of providing information on HIVB/AIDS, counseling to people who need information on AIDS, helping the victims in getting treated and conducting studies on the knowledge, attitude and practice of at risk groups4. The difference in the knowledge about AIDS among rural and rural and urban areas could be explained by the socio-economic and cultural differences, but this gap might be increasing; the reason being that most awareness activities are conducted in big cities. Non-government organizations in addition to governmental activities need to give coverage to underprivileged areas.

Table 3: Knowledge regarding AIDS

      Category Aware Not Aware
    N % N %
Cause of AIDS M 360 23.22 425 27.41
F 440 28.38 325 20.96
Does not spread from one person to another even by using common clothes, utensils etc. M 550 35.48 150 9.67
F 575 37.09 35 2.25
  85 males (5.48%) & 155 females (10%) had no concept
Spread by sexual contact M 645 41.61 140 9.03
F 415 26.77 350 22.58
Spread by unsterile syringes and needles M 430 27.74 355 22.90
F 355 22.90 410 29.67
Spread through unscreened blood M 430 27.74 355 22.90
F 60 3.87 7.5 45.48
Protection by using condoms M 350 22.58 435 28.06
F 185 11.93 580 37.41
Protection by using disposable/sterilized syringes M 330 21.29 455 29.35
Protection by using screened blood M 355 22.90 430 27.74
F 340 21.93 425 27.41
Disease is fatal M 605 39.03 180 11.61
F 360 23.22 405 26.12

A study conducted in Delhi, India has shown that despite their awareness of personal risks only four in ten used condoms sometimes during intercourse5. Another study conducted among Indian women, over thirteen different states in India have observed a strong association between AIDS awareness and knowledge and condom use6. Thus we need not only to increase cognitive and affective understanding of AIDS among masses but also to bring changes in their attitude and behavior. Bringing about a change in behavior is a gradual process; socioeconomic uplift and literacy are the recommended methodologies to achieve the change.

Proper dissemination of adequate and appropriate information through health education, giving extensive converge would help control the spread of AIDS in the valley. The priority areas would be rural areas and underprivileged groups in urban areas. Females need to be specially targeted. Female health education teams should be created which can make females aware about AIDS in these areas. Health awareness camps should be a more frequent feature; health educators who are already posted in various health centers need to be educated about AIDS and their role in prevention of this dreaded disease emphasized. Special attention be given to the groups who are not exposed to media like radio, television, newspapers. Traditional fold plays, personnel contact may be very helpful and encouraging in these groups.

References

  1. Country scenario, National Aids control organization, MOH&FW, GOI New Delhi: 1997-98
  2. 2. UNAIDS. Aids epidemic update: UNAIDS/WHO 2000, December 2000
  3. 3. Lal S S, Vasan RS, Sarma PS, Thankappan KR> Knowledge and attitude of college students in Kerla towards HIV/AIDS, sexually transmitted disease and sexuality. Natl Med J India 2000 Sep-Oct; 13(5): 231-6.
  4. 4. Okuyan M. Fight with AIDS in Turkey (in Turkish). HIV/AIDS HATAM (The publication of Hacettepe AIDS Treatment and research centre) 1998; 1:97-9.
  5. 5. Sachdev P AIDS/HIV and university students in Delhi, India: Knowledge, beliefsl attitudes and behaviour. Soc Work Health care 1998; 26(4): 37-57.
  6. 6. Balk D, Lahiri S. Awareness and knowledge of AIDS among Indian women: evidence from 13 states. Health Transit Rev 1997; 7 suppl: 421-65

Farroq A. Jan - Senior resident Hospital Administration
G.J. Qadiri - Professor and Head Hospital Administration
Qazi A. Qayoom - Postgraduate Hospital Administration
M.A. Shaheen - Postgraduate Hospital Administration
Z.A. Wafai - Postgraduate Prof Clinical Pharmacology
Suheel J. Sangin - Senior resident Surgery

Sher-i.Kashmir Institute of Medical Srinagar

Address for correspondence:
Dr. Farooq Ahmad Jan,
Senior Resident Institute of Medical Sciences,
Srinagar, Kashmir- 190 011

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