INTRODUCTION:

Human Immunodeficiency Virus (HIV) infection and Acquired Immune Deficiency Syndrome (AIDS) are serious global public health issues with millions of people getting newly infected every year. HIV continues to be a major health issue, having claimed more than 32 million lives so far. Globally, by the end of 2018, there were approximately 37.9 million people living with HIV, 770 000 people died from HIV-related causes and 1.7 million people were newly infected. An estimated 0.8 % of adult aged 15-49 years worldwide are living with HIV ¹. India had around 21.40 lakhs people living with HIV/AIDS in the year 2017 and 69,000 AIDS related death in 2017. Mizoram had the highest adult prevalence of 2.04%, followed by Manipur at 1.43 % and Nagaland 1.15% ².

A study conducted by Hasham Akram Choudhary, Rana Azher Ali and Shareen Altaf on “Knowledge, Behaviour and Attitudes regarding HIV/AIDS among undergraduate students in an Irish University” revealed that young people (15-24 years old) are of international concern in the HIV/AIDS epidemic group and are labeled as “at risk group”. Young women are the most vulnerable group where 64% of them are living with HIV worldwide ³.

A study done by M. Bazargan et al 2000 shows that college students are engaged in high risk behavior that place them at risk of human immunodeficiency virus (HIV) infection. The college campus provides students with a sense of new independence, self- determination and strong peer pressure to experiment with a variety of sexual behavior ⁴.

A study conducted by Sriram Chandramohan and Jain Raj. R 2014 revealed that out of 400 students, 35(8.75%) were not aware about the cause and spread of HIV, 33(8.25%) were unaware of the signs and symptoms of HIV 25(6.25%) were not aware about the preventive measures of HIV. There were lots of misconceptions which existed among the college students towards HIV/AIDS ⁵.

Due to the highest prevalence of HIV/AIDS among the youths, there is a need to assess the knowledge and attitude of students regarding the cause, spread and prevention of the disease which will help the investigators to plan for a health education program for the students.

OBJECTIVES OF THE STUDY:

1. To assess the knowledge and attitude towards HIV/AIDS among undergraduate students of selected colleges.

2. To find out the correlation between level of knowledge and attitude towards HIV/AIDS among undergraduate students of selected colleges.

3. To determine the association of knowledge and attitude with selected demographic variables towards HIV/AIDS among undergraduate students of selected colleges.

RESEARCH HYPOTHESIS:

1. There will be a significant correlation between knowledge and attitude towards HIV/AIDS among the undergraduate students.

2. There will be a significant association between selected demographic variables and the study findings.

MATERIALS AND METHODS:

The study design was a descriptive research design. It was done in three selected general education colleges in Dimapur, Nagaland. The sample size was 362 undergraduate students. The students who were willing to participate were selected by using consecutive sampling technique. The sample size was determined based on the pilot study findings. The study was approved by the Research Committee of the Nursing college. A self-administered structured questionnaire was used for assessing the knowledge and attitude towards HIV/AIDS. The instrument used for data collection comprised of two parts. Part one consisted of the demographic variables like gender, age, religion, geographical location, educational status and marital status, while part two consist of knowledge questionnaire and attitude statements. Validity of the tool was obtained from four nursing experts and the validity index was .95 for knowledge questionnaire and 1 for attitude scale. Pilot study was conducted among 1^st Year B. Sc nursing students and it was found that 66.6% had adequate knowledge and 75% had good attitude and students did not have any confusion regarding the questions. Prior permission was obtained from the authority and informed written consent were obtained from the participants after assuring anonymity and confidentiality. The data was analyzed using descriptive and inferential statistics

RESULT WITH DISCUSSION:

Table I: Distribution of demographic data of the participants (n=362)

S. No	Demographic variables	Frequency	Percentage
1	Gender
	a) Male	208	57.4%
	b) Female	154	42.54%
2	Age
	a) 18 – 20 years	206	56.90%
	b) 21 – 25 years	153	42.2%
	c) 26 years and above	3	0.82%
3	Educational status
	a) BA	206	56.90%
	b) BSC	129	35.6%
	c) BCA	9	2.48%
	d) BCOM	18	4.97%
4	Religion
	a) Christian	350	96.6%
	b) Hindu	8	2.2%
	c) Muslim	1	0.27%
	d) Others	3	0.82%
5	Marital status
	a) Married	1	0.27%
	b) Unmarried	361	99.72%
6	Geographical location
	a) Rural	195	53.86%
	b) Urban	167	46.13%

Table 1: The above table shows that out of 362 undergraduate students, 208 (57.4%) were male and majority of the students were between the age group 18-20 years i.e., 206 (56.90 %). 206 (56.90%) were BA students, 350 (96.6%) were Christians, 361 (99.72%) were unmarried and 195 (53.86%) of the students were residing in Rural area.

Figure1: Distribution of participants based on Knowledge regarding HIV/AIDS

Figure 1 shows that majority of the participants had adequate knowledge. The result of a study conducted by Andrew P.O, Bhuiyan A, Mawson A, Buxbaum SG, Sung JH and Shahbazi M (2018) with a total of 400 undergraduate students showed that 386 students (96.5%) had good knowledge about HIV and AIDS ⁶. This study supports our present research as the study reveals a good level of knowledge similar to the present study which shows adequate knowledge.

Figure 2: Distribution of participants based on attitude regarding HIV/AIDS

Figure 2 shows that the majority of the participants had positive attitude. A study conducted by Geraldine. J. Kikwasi, Sophia. R. Lukwale and Eleuther. A. Mwageni (2017) with a total of 391 undergraduate students, reported that (22.3%) have negative attitude towards HIV and AIDS. There was also a trace of neutral attitude that accounted to 12.8% of respondents and positive attitude of 65.0% ⁷. Hence, this study supports our present research findings.

Figure 3: Correlation between knowledge and attitude of participants regarding HIV/AIDS

Figure 3: Scatter diagram showing the correlation between knowledge and attitude of the participants towards HIV/AIDS. Pearson Correlation Coefficient (r) was found to be +0.2. This reveals that there is a weak positive relationship between knowledge and attitude scores of the participants regarding HIV/AIDS.

Table 2: Association between knowledge with selected demographic variables of participants regarding HIV/AIDS

S. No.	Demographic Variables	Level of knowledge			Chi Square Calculated	df	Chi Square Tabulated	p Value
S. No.	Demographic Variables	Adequate	Moderate	Inadequate	Chi Square Calculated	df	Chi Square Tabulated	p Value
1	Gender				0.38	2	5.99	>0.05
	c) Male	77	62	69
	d) Female	59	50	45
2	Age				10.15	4	9.49	*<0.05
	d) 18 – 20 years	74	60	72
	e) 21 – 25 years	61	53	39
	f) 26 years and above	-	3	-
3	Educational status				25.22	6	12.59	*<0.05
	e) BA	56	74	76
	f) BSC	68	35	26
	g) BCA	8	3	7
	h) BCOM	4	2	3
4	Religion				7.41	6	12.59	>0.05
	e) Christian	132	112	106
	f) Hindu	3	4	2
	g) Muslim	-	-	1
	h) Others	-	-	2
5	Marital status	135	114	112	1.64	2	5.99	>0.05
	c) Married
	d) Unmarried	1	-	-
6	Geographical location				1.32	2	5.99	>0.05
	c) Rural	78	61	56
	d) Urban	57	54	56

*p < 0.05 is significant **p < 0.01 is highly significant

Table 2: Shows the association between knowledge with selected demographic variables. The demographic variables like gender, religion, marital status and geographical location shows that there is no association with knowledge. Hence, the null hypothesis is not rejected whereas, age and the educational status shows that there is a significant association with knowledge at the level of p Value of < 0.05. Hence, null hypothesis is rejected. Prince. O. Andrew et.al, 2018 conducted a study in which they reported that there was no signiﬁcant association between the knowledge of the male and female of undergraduate students regarding HIV and AIDS ⁶. This study supports our present study as there is no association between gender and knowledge of the students.

Table 3: Association between attitude with selected demographic variables of participants regarding HIV/AIDS

S. No.	Demographic variables	Attitude			Chi square calculated	Df	Chi square tabulated	P value
S. No.	Demographic variables	Positive	Neutral	Negative	Chi square calculated	Df	Chi square tabulated	P value
1	Gender				11.9	2	5.99	*<0.05
	e) Male	141	63	4
	f) Female	129	23	2
2	Age				3.06	4	9.49	> 0.05
	g) 18 – 20 years	159	43	4
	h) 21 – 25 years	122	25	6
	i) 26 years and above	3	-	-
3	Educational status				22.51	6	12.59	*<0.05
	i) BA	163	42	1
	j) BSC	105	23	1
	k) BCA	13	3	2
	l) BCOM	5	3	1
4	Religion				0.85	6	12.59	>0.05
	i) Christian	278	65	7
	j) Hindu	7	2	-
	k) Muslim	1	-	-
	l) Others	2	-	-
5	Marital status				0.25	2	5.99	>0.05
	e) Married	1	-	-
	f) Unmarried	285	71	5
6	Geographical location				0.25	2	5.99	>0.05
	e) Rural	156	36	3
	f) Urban	132	31	4

*p < 0.05 is significant **p < 0.01 is highly significant

Table 3: Shows the association between attitude with selected demographic variables. The demographic variables like age, religion, marital status and geographical location shows that there is no association with attitude. Hence, the null hypothesis is not rejected whereas, gender and the educational status shows that there is a significant association with attitude at the level p value of <0.05. Hence, null hypothesis is rejected. This finding is consistent with the study conducted by Geraldine J. Kikwasi, Sophia R. Lukwale and Eleuther A. Mwageni, 2017 where they reported that out of 391 students (male 250 and female 151), the female students 92 (65.2%) had slightly more positive altitude than male 162 (64.8%) towards HIV/AIDS ⁷. This study supports our present study as there is significant association between attitude and gender of the undergraduate students.

LIMITATIONS:

The limitations of the study were lack of equal distribution of students pursuing different course of study, lack of control of exposures to extraneous variables like newspapers, internet, magazine, television, etc., participants’ response of the self-administered questionnaire may be subjective and the study findings may not be generalizable since the study was done in one location.

CONCLUSION:

Through this study it was found that majority of the undergraduate students had moderate to adequate knowledge about HIV/AIDS while one-third had inadequate knowledge. Their attitude toward HIV/AIDS was good and female students were found to have more positive attitude towards HIV/AIDS than the male students. Therefore, there is a need to provide factual and precise knowledge on HIV/AIDS for undergraduate college students. There should also be a drive to increase education and awareness about HIV/AIDS in educational institutes. As a part of our research study in order to enhance their knowledge and develop positive attitude towards HIV/AIDS, health education was given to the students after the data collection.

REFERENCES:

1. WHO 2018 Reports on HIV/AIDS. https://www.who.int/news-room/fact-sheets/detail/hiv-aids

2. Times of India 2018. http://timesofindia.indiatimes.com/india/hiv-spread-declining-but-not-all-states-show-progress/articleshow/65816941.cms

3. Choudhary, H.A., Ali, R.A. and Altaf, S. Knowledge behaviour and attitudes regarding HIV/AIDS among undergraduate students in an Irish University, Pakistan. Available from: http://www.ejos.org/index.php?iid=2015-1-2.000andandjid=136andlng= International Journal of Surgery and Medicine 2015, vol-1-issue-2.

4. Bazargan, M., Kelly.E.M., Stein, J.A., et.al. Correlates of HIV risks-taking behaviour among African-American College students: The effect of HIV knowledge, motivation and behavioural skills in African-American College, Los Angeles California. Available from: http://www.ncbi.nih.gov/pmc/articles/PMC2608615/pdf/jnma00344-0053/ Journal of the National Medicine Association 2000, vol-92-issue-8.

5. Chandramohan, S. and Raj, R.J. “Awareness about HIV/AIDS among college students in Chennai, Tamil Nadu: A cross sectional study”. Available from: https://www.researchgate.net Review of Research Journal 2014, vol-3-issue-7.

6. Andrew P.O et al. HIV/AIDS Knowledge of Undergraduate Students at a Historically Black College and University. Available from: https://www.mdpi.com/2079-9721/6/4/98 Diseases 2018, vol-6-issue-4.

7. Kikwasi GJ et al. First year students attitude towards HIV and AIDS. Available from: https://scholar.google.co.in/scholar Global Journal of Health Science 2017, vol-9-issue-7.

Received on 11.01.2020 Modified on 31.01.2020

Asian J. Nursing Education and Research. 2020; 10(2):189-193.

DOI: 10.5958/2349-2996.2020.00041.5