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Indian Journal of Community Medicine

Evaluation Of Impact Of Health Education Regarding HIV/AIDS On Knowledge And Attitude Among Persons Living With HIV

Author(s): Sanjay Sangole, B.V. Tandale, P.S. Bagde, D.M. Thorat

Vol. 28, No. 1 (2003-01 - 2003-03)

Department of P.S.M., Indira Gandhi Medical College, Nagpur

Keywords: Impact, Health education, HIV/AIDS, Knowledge, Attitude

Research question: What is the effect of health education on persons living with HIV?

Objective: The evaluate the effect of sex education and HIV/AIDS prevention on knowledge and attitude of persons living with HIV.

Setting: Patients attending counselling centre of Indra Gandhi Medical College, Nagpur.

Study design: Cross-sectional.

Participants: HIV positive persons.

Sample size: 78 HIV positive persons out of 242 screened.

Study variables: HIV status, source of information, educational status, knowledge about modes of transmission, attitude of subjects before and after counselling.

Statistical analysis: Proportions and tests of significance applied wherever required.

Results: Out of 242 patients screened, 82 were found HIV positive and of these 78 attended post-test counselling. The sources of information on HIV and AIDS for most (64.1 %) of them were friends and relatives and majority of them received wrong information. Majority of the subjects were illiterate and education affected the level of knowledge related to HIV/AIDS. There was significant effect of sex education and education regarding transmission and prevention of HIV/AIDS on knowledge and attitude of persons living with HIV (HIV positives).


AIDS is a dreaded disease. The first case of HIV in India was reported in 1986 from Madras1. At present, there is neither drug treatment for cure of disease nor any effective vaccine to prevent disease. Hence, health education i.e. IEC (Information, Education and Communication) activities bringing about behavioural changes in community, promoting healthy sexual behaviour and preventing the risky ones is the best possible solution to the problem of AIDS.

Material and Methods:

This study was carried out on 78 persons living with HIV and attending HIV/AIDS counselling center between the period from 16th August to 31 December 2001, voluntarily or referred by other clinical departments. All 78 study subjects underwent pre-test counselling first in which their knowledge and HIV related behavior was assessed and this information was noted on a predesigned proforma; and then knowledge regarding HIV/AIDS causation, modes of transmission and prevention, was imparted. With their consent blood samples were collected and sent to Microbiology Deptt. of IGMC, Nagpur for HIV testing. HIV positive patients were called to collect reports and when they came to AIDS counselling center post-test counselling was done. All persons who tested HIV positive were asked to attend the center again for assessing their knowledge and attitude regarding HIV/AIDS. Out of total 242 patients screened for HIV, 82 were found to be positive and out of these 78 attended post-test counselling. For assessment of knowledge 12 questions were asked, for correct answer (response) one mark was given and for incorrect answer zero mark was given. Their knowledge and attitude about HIV/AIDS before imparting sex education (pre-test counselling) and after sex education was analysed and effect of sex education on HIV/AIDS prevention was assessed.

Results and discussion:

Out of total 78 subjects 68 were males and 10 were females. Majority were in age group 21-40 years.

Table I: HIV/AIDS: Source of informations.

Source No. %
Friend 50 64.10
Relatives 10 12.82
TV 9 11.54
Health Worker 5 6.41
Radio 2 2.57
Doctor 1 1.28
Newspaper 1 1.28

As shown in Table I friends and relatives were the main sources of information for HIV/AIDS. Majority of them had given wrong information. Wrong information will affect the knowledge and attitude.

Table II: Educational status and score for knowledge before counselling.

Education 0 - 4
5 - 8
9 - 12
No. % No. % No. % No. %
Illiterate = Primary 54 85.7 1 14.3 1 12.5 56 71.8
Middle + High School 07 11.1 2 28.6 2 25.0 11 14.1
SSC, HSC, Degree/Diploma 02 3.2 4 57.2 5 62.5 11 14.1
Total 63 100 7 100 8 100 78 100

2 = 43.24, d.f. = 4, p<0.001

Majority of the subjects were illiterate i.e. 41(52.56%), followed by primary i.e. 15(19.23%) Educational status affected the level of knowledge and this was statistically significant.

Table III: Knowledge of study subjects transmission & prevention of HIV/AIDS before and after counselling.

Questions Before counselling After counselling
Correct answer Incorrect answer Correct answer Incorrect answer
What is HIV? 10 68 30 48
Waht is AIDS 10 68 47 31
Is AIDS a fatal Disease? 12 66 50 28
Modes of Transmission
Mother to Child 05 73 41 37
Sexual route 15 63 50 28
Through blood transfusion 10 68 43 35
Through Infected needles 10 68 42 36
No transmission via casual contact such as hugging, shaking hands, sharing foods, glasses, seats etc 22 56 50 28
Modes of prevention
Using condoms 12 66 46 32
Avoiding multiple sexual partners 18 60 43 25
Using disposable needles 05 73 42 36
Receiving blood after screening 05 73 33 45
Total 134 802 517 419
Mean marks before counselling 1.71, t= 76.71
Mean marks after counselling 6.62, p< 0.001

Knowledge of study subjects regarding transmission and prevention of HIV/AIDS before and after counselling is shown in Table III. All 78 study subjects got total 134 marks for correct answers. Majority i.e. 22 subjects had given correct answer that there is no transmission via casual contacts such as hugging, shaking hands etc. Incorrect answers for modes of transmission from mother to child, modes of prevention by using disposable needles, screening blood before transfusion were given by 73 subjects. What is HIV and what is AIDS was answered correctly by only highly educated persons (HSC, Degree/Diploma holders).

After pre-test counselling when sex education, education about HIV/AIDS prevention was imparted, there was change in knowledge.

All 78 study subjects got total 517 marks. Majority of study subjects i.e. 50 answered correctly for questions - is AIDS a dreaded disease, modes of transmission by sexual route and no transmission by casual contacts. Similarly, Ravish HS et al2 reported in their study that 72.5% study subjects knew that sexual route was the most common route of transmission, followed by transmission through contaminated needles and blood transfusion.

Effect of counselling on knowledge before and after sex education was compared and this was found to be significant. Similarly, Pratinidhi AK et al3reported effect of sex education on AIDS prevention among IX standard and XI standard students. There was increase in marks in post training as compared with pre training.

Table IV: Attitude of study subjects regarding HIV/AIDS before & after counselling.

Questions Before counselling After counselling
Correct answer Incorrect answer Correct answer Incorrect answer
Will you donate your blood 55 23 70 08
Will you receive blood before screening 46 32 54 24
Will you provide your shaving blade, tooth brush etc. to others 14 64 66 12
Will you have sex without a condom 12 66 30 48
Will you avoid sexual contacts with multiple partners 18 60 56 22
Will you keep away from habits like taking alcoohol, smoking and IV drugs 8 70 44 34
Will you improve your nutritional status 2 76 64 14
Will you take necessary treatment for any minor ailments 25 53 66 12
Will you visit counselling regularly 10 68 70 8
Total 190 512 520 182
mean marks before counselling 2.43 t= 49.34    
mean marks after counselling 6.66 p< 0.0001    

All study subjects had 190 marks before sex education while 520 marks after sex education for correct responses for attitude regarding HIV and AIDS. Major change in attitude was observed that - they will not donate their blood (correct response in 70), they will not provide their shaving blade and tooth brush to others (correct response in 66) and poor response was observed in area like, will you avoid sex without condom (Incorrect response in 48). When asked for the reason for it, majority of study subjects answered that use of condom will hamper their sexual pleasure. Areas where the knowledge and attitude were found to be poor even after sex education indicates need of frequent and regular education because majority of study subjects reported that they had forgotten, so could not answer correctly. Similarly, Gattani PL et al4 reported that though majority of patients had knowledge about prevention of STDs by use of condom 59.32% patients never used condom. Thakare SB5 reported that only 8.92% had knowledge of HIV and only 5.53% knew the role of condom in prevention of HIV.

Thus, effect of sex education and HIV/AIDS prevention on attitude of study subjects was found significant. Deborah Holtzman et al6observed that less than 9% adults were actually using condom to prevent STIs (Sexually transmitted infections), while 90.9% had knowledge that condoms are highly or somewhat effective in prevention of HIV.


Significant effect of sex education regarding transmission and prevention of HIV/AIDS was found on knowledge and attitude of persons living with HIV (HIV positives). Still there were lacunae in knowledge and attitude for many areas. Source of information about HIV/AIDS and literacy status of study subjects also affected knowledge and attitude.


The aim of sex education, education about HIV/AIDS prevention is to help the person understand, accept and cope with the diagnosis and prevent serious reactions such as suicide or long term intractable depression6. This education should be continuous and ongoing process. Persons living with HIV should visit counselling center frequently and regularly so there will be complete change in knowledge and attitude regarding HIV/AIDS. All patients should be imparted education about HIV/AIDS transmission and prevention.


  1. John TJ, Babu PG, Jayakumari H, Simoes EA. Prevalence of HIV infection in risk groups in Tamil Nadu, India (letter), Lancet 1987; 1: 160-1.
  2. Goel NK, Kaur N, Singh G, Kaur P. An explorative "KABP" study on AIDS among nursing professionals. Indian Jr. Prev. Soc. Med. 1999; 30(2): 79-83.
  3. Pratinidhi AK, Gokhale RM, Karad SR. Evaluation of sex education and AIDS prevention project in secondary schools of Pune city. Indian Journal of Community Medicine 2001; XXVI(3): 155-61.
  4. Gattani PL, Dalvi SD, Kusneniwar GN, Gurav YK. Study of STD patients attending STD clinic at Govt. Medical College, Hospital, Aurangabad with special reference to socio-demographic variables and high risk behavior. Souvenir, XXIX Annual Conference of Indian Association of Preventive and Social Medicine, Wardha. Feb 15-17, 2002: 73.
  5. Thakare SB et al. Awareness among patients attending HIV/AIDS counselling center in rural India. Souvenir. XXIX Annual Conference of Indian Association of Preventive and Social Medicine, Feb 15-17, 2002: 113.
  6. The impact of Voluntary Counselling and Testing. A global review of the benefits and challenges. UNAIDS. Geneva, Switzerland 2001: 53.
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