© Borgis - New Medicine 1/2004, s. 20-23
Ewa Zimna-Walendzik, Piotr Grzybowski, Ewa Nowacka, Franciszek Szatko
Knowledge of HIV/AIDS Problems Among Łódź high school Students
Department of Hygiene and Epidemiology, Medical University of Łódź, Poland
Head of Department: Prof. Andrzej Grzybowski MD, PhD
Summary
Aim. The aim of the present study was to assess adolescents´ knowledge of HIV/AIDS problems.
Material and method. The study was conducted on a representative group of 698 high school students aged 17-20 years from Łódź high schools of various educational profiles. The study material used to assess the adolescents´ knowledge of HIV/AIDS was based on the questionnaire data collected from student respondents.
Results. The questionnaire to diagnose the HIV/AIDS knowledge comprised questions of different levels of difficulty. The students´ knowledge at the elementary level was estimated as good: with over 75% of correct answers. The advanced questions concerning the HIV retrovirus activity mechanisms and the epidemiological status were answered correctly mostly by the comprehensive high school students (62%) as compared with the vocational and technical high school students (about 46% of correct answers). More than 90% of the adolescents know the routes of HIV transmission; however an alarming fact of identification of blood donation with the possibility of HIV infection has been noted. The basic source of the adolescents´ knowledge of HIV/AIDS problems are media (80-90%), teachers (40-60%) and parents (25-40%)
Conclusion. The level of knowledge of HIV/AIDS depends on a school profile. Media are the main source of information for the students. There is a necessity of close cooperation between researchers and educators to work out the substance of the media presented programs.
INTRODUCTION
Young people are the largest group among the HIV and the AIDS patients and are susceptible to the greatest hazards. According to the Children´s Rights Convention and in cooperation with the WHO, the international educational societies have made decisions concerning health promoting programs on the HIV/AIDS issue. They assume that such programs should be an indispensable part of all school activities and should offer students reliable information and assistance in gaining the knowledge and skills necessary to make appropriate choices and types of behaviour reducing the risk of HIV infection and transmission (1, 2, 3). The educational-preventive activities in Poland only to some extent have taken into account the needs of that part of the population. The educational classes known as ´Family life education´ are treated in many schools as an optional subject and are not completed or the students do not attend them at the full consent of their own parents (4).
The lack of effective HIV pharmaceutical preparations as well as of vaccine stimulating the HIV retrovirus immunity, makes the educational activities promoting safe life style the only chance to limit HIV infections and AIDS incidence (5). In order to control the efficiency of the proposed education, the contents and update of the knowledge of HIV/AIDS infection expansion mechanisms have to be systematically monitored. The aim of the present study is to assess the knowledge level of a selected group of adolescents with an attempt to answer the following questions:
– What is the adolescents´ awareness of the sources and routes of infection, risk factors, preventive methods and treatment?
– What is the knowledge of the selected students on HIV mechanisms and effects?
– What is the important information source on those hazards and on the ways to avoid them?
MATERIAL AND METHOD
The study comprised 698 students aged 17-20 years from Łódź high schools of various educational profiles: 208 from comprehensive high schools, 277 from vocational high schools and 213 from technical high schools. The study was based on an anonymous auditory questionnaire developed for the study purpose by the Department of Hygiene and Epidemiology, Medical University of Łódź. The study was conducted on a randomly selected representative group of high school students at the age range of 17-20 years. The questionnaire was verified by a pilot trial of 25 students. The results were assessed statistically; the c2 independence test was also used with the significance level established at p<0.05.
RESULTS
The questionnaire assessing the HIV/AIDS knowledge was composed of 48 information units.
The questions were divided into 2 groups of different difficulty levels. Those concerning the course of infection, the mode of HIV dissemination and the factors increasing infection risk were qualified as elementary, the remaining questions, concerning mainly the HIV activity mechanisms and the HIV/AIDS epidemiological status were qualified as advanced. Table 1 compares the percentage of correct answers given by students of various teaching profiles to questions concerning the HIV/AIDS epidemiology. The knowledge level of the students was high, irrespective of the school profile. The only problem referred to the question whether more men or women in Poland had AIDS symptoms and the majority of students were not able to give the correct answer.
Table 1. Percentage of student respondents providing correct answers to questions on HIV/AIDS epidemiology.
| Questions | Correct answers in different school profiles (%) |
| comprehensive high schools | vocational high schools | technical high schools |
Only men suffer from AIDS
Number of AIDS cases steadily grows
At present more men than women have AIDS in Poland
HIV infection affects only some ethnic groups | 98.6
87.0
26.9
88.0* | 96.8
82.7
27.4
71.8* | 99.6
87.3
26.8
68.1* |
* statistically significant difference (p <0.05).
The questions on the pathogenesis of HIV infection seemed to pose a problem, especially for the students of vocational and technical high schools (Table 2).
Table 2. Percentage of correct answers on the pathogenesis of HIV retrovirus infection.
| Substance of questions | No of students (%) |
| comprehensive high schools | vocational high schools | technical high schools |
| HIV virus may inhabit human body 5 or more years before detection | 89.9 | 80.9 | 78.9 |
| Adjunctive T cells stimulate body defense against the virus | 51.9* | 25.3* | 24.9* |
| HIV virus imitates T cells of immune system | 33.7 | 27.8 | 29.6 |
| HIV virus carrier with no infection (symptoms cannot infect others) | 83.7* | 67.9* | 65.3* |
| HIV virus carrier will remain infectious for lifetime or until effective drugs appear | 94.7 | 91.7 | 92.5 |
* statistically significant difference (p <0.05).
Table 3 presents answers to the questions concerning the mode of HIV dissemination. The percentage of correct answers in this group was the highest. Over 90% of adolescents know about the routes of HIV infection. They are aware that contacts with infected non-disposable hypodermic needles and infected sperm create potential infection risks. However, fewer subjects knew about the likelihood of infecting a baby during pregnancy and delivery by an HIV infected mother. Among the adolescents from the technical high schools the correct answer was given by only 58.7% of the respondents. An alarming fact was also noted that a significant group of students, over 90%, believe that blood donation may cause HIV infection. Only 5% of the subjects stated that this was impossible.
Table 3. Students´ knowledge on HIV transmission routes.
| Questions | Correct answers in different school profiles (%) |
| comprehensive high schools | vocational high schools | technical high schools |
| Proven routes |
Sexual contact
sperm
non-disposable hypodermic needle
during pregnancy and delivery | 98.1
99.5
81.7*
98.1 | 92.8
95.3
70.0*
94.2 | 99.1
98.1
58.7*
93.9 |
| Low probability routes |
| during blood donation | 6.2 | 5.1 | 5.3 |
| Unlikely routes |
air
drinking water
kitchen utensils
meal served by HIV infected person
handshake | 95.2
88.5
93.3
92.8
95.7 | 91.3
75.1
82.3
85.2
90.6 | 93.4
73.7
87.8
85.0
92.5 |
* statistically significant difference (p <0.05).
The assessment of the level of knowledge and life styles of Polish adolescents aged between 15 and 17 years conducted in 1998 under the WHO supervision (6, 7, 8) showed that young people held false opinions on HIV/AIDS infection, particularly on the route of virus transmission. According to the authors of the report such beliefs resulted from an incomplete knowledge in the 1980s and 1990s when cases of HIV infection occurred in a small group of blood recipients (7). The knowledge of unlikely routes of HIV infection is also of high importance. Our research shows that every tenth student assumes that HIV infection may be contracted through a meal or a handshake shared with an infected person.
Table 4 compares the students´ knowledge of the clinical symptoms of HIV infection. Over 70% of the subjects associate HIV infection with fatigue, about 60% with fever and chills, about 40-50% know that HIV infection may be manifested as skin lesions, profuse night perspiration and chronic cough. The knowledge of those symptoms is similar in all students, irrespective of their school profile. However, the questions whether the HIV infected persons may have abnormal appetite, increased body mass, constipation, increased hair growth were answered correctly by a greater number of comprehensive high school students as compared with those from vocational and technical high schools (p<0.05).
Table 4. Percentage of students according to correct answers to questions on symptoms of HIV infection.
| Questions | Correct answers in different school profiles (%) |
| comprehensive high schools | vocational high schools | technical high schools |
| Fatigue | 74.5 | 76.5 | 70.4 |
| Fever and chills | 57.2 | 61.0 | 59.6 |
| Skin lesions | 52.9 | 46.0 | 41.8 |
| Profuse night perspiration | 44.7 | 53.8 | 45.5 |
| Chronic cough | 38.0 | 49.5 | 39.9 |
| Abnormal appetite | 55.8* | 43.0* | 45.5* |
| Increased body weight | 56.3* | 50.5* | 42.3* |
| Constipation | 29.8* | 18.8* | 18.3* |
| Increased hair growth | 55.8* | 48.0* | 39.4* |
* statistically significant difference (p <0.05).
The percentage of correct answers to elementary and advanced questions is illustrated in Figure 1.
Fig. 1. Percentage of correct answers to elementary and advanced questions according to school profile.
The knowledge level of students from respective school types concerning basic subject range was comparable. According to the grading scale of assessment score developed by Daniluk-Kula and Gładysz (9), conventionally assigning the percentage values to individual evaluation marks, it may be assumed that the elementary knowledge of the adolescents is ´good´. The students of comprehensive high schools showed more thorough knowledge of the HIV/AIDS problems. Correct answers to the advanced questions were provided by about 62% of comprehensive high school students whereas only 46% of those from vocational and technical high schools were able to answer the questions appropriately. The results prove a limited scope of knowledge delivered to students by various educators as well as limited syllabuses of biology and ecology courses in vocational and technical high schools. Owing to their thorough HIV/AIDS knowledge the comprehensive high school students were granted ´satisfactory´ marks and the remaining students received ´unsatisfactory´ marks.
The questionnaire assessment indicates that media are the basic source of the HIV/AIDS knowledge (80-90% of subjects) (Table 5). About 60% of the comprehensive high school students and about 50% students of other school types profit during classes from instruction provided by teachers. An insignificant role of parents in increasing health awareness of adolescents is a disquieting fact. Only about 40% of comprehensive high school students and about 25% students of other school types indicate their parents as an HIV/AIDS information source. Every third subject receives information from their friends. Therefore the educational activities of the teachers at the Department of Hygiene and Epidemiology and of the Medical University students significantly increase the medical knowledge and promote a healthy life style during obligatory hygiene and epidemiology classes. Similar conclusions have been reported by other authors (10, 11, 12, 13, 14) indicating that adolescents willingly participate in classes conducted by medical students. The studies showed that medical students can be excellent teachers to high school students and create favourable atmosphere to discuss the HIV/AIDS problems.
Table 5. Important sources of HIV/AIDS information for students.
| Information source | No of students (%) |
| comprehensive high schools | vocational high schools | technical high schools |
| Parents | 42.2* | 22.7* | 25.8* |
| Teachers | 62.9 | 49.5 | 48.4 |
| Medical University teachers and students | 68.7* | 61.0* | 54.5* |
| Employees of Regional Admi-nistration Unit for Control of Epidemics and
Hygiene Promotion | 5.2* | 14.8* | 5.6* |
| Priest, religion teacher | 13.5 | 17.7 | 23.9 |
| Friends | 36.5 | 33.6 | 36.6 |
| Media | 90.4 | 81.2 | 87.7 |
* statistically significant difference (p<0.05).
CONCLUSION
1. The HIV/AIDS knowledge levels are different and depend on the school profile. The comprehensive high school students present the highest level of knowledge. There is an urgent need to promote health education in vocational high schools.
2. Media are the basic source of the HIV/AIDS knowledge for high school students. Therefore it is necessary for researchers and educators to cooperate closely with the media, so that the latter would provide reliable information of high educational value.
Piśmiennictwo
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