1. INTRODUCTION:

Adolescence is the second decade of life (13–19 years) and is a period of both physical as well as psychological development. This is a phase of experimentation and risk that includes early sexual debut, sexual coercion and violence, trafficking, and substance abuse. Along with these, other factors such as the lack of knowledge about HIV/AIDS, inaccessibility to healthcare services and commodities, lack of education and life skills, and early marriage have increased their vulnerability to HIV/AIDS. Another reason for their vulnerability is the lack of the sex education and prevention of sexually transmitted diseases, besides risk factors such as child trafficking, child labour migrant population, child sex abuse, and coercive sex with older persons.[1].

Programme mangers and policy makers have often recommended that schools can act as the center point for disseminating information and education on HIV/AIDS. In India, there is a wide gap between the inputs in the HIV/AIDS curriculum for schools and the actual education that is imparted. Adolescents’ and young people represent a growing share of people living with HIV Worldwide. Since adolescents comprise a major part of reproductive group also, so they are likely to play a significant role in determining the future growth pattern of India’s population and economy. Thus, it is crucial that investment in terms of finances, research, and developmental policies be done to improve their well being.[2]

As per the report of UNICEF in 2017, about 1.8 million adolescents’ between the ages of 10 and 19 were living with HIV Worldwide. Adolscents account for about 5 percent of all people living with HIV infections. The regions with the highest numbers of HIV positive adolescents’ are sub- Saharan Africa and South Asia. Of the 1.8 million adolescents’ living with HIV, about 1.5 million (85 percent) live in Sub-Saharan Africa.[3]

As per report of NACO In 2015, India is estimated to have around 86 (56-129) thousand new cases of HIV infections, showing 66% decline in new infections from 2000 and 32% decline from 2007, children (above 15 years) accounted for 12% (10.4 thousand) of total new infections while the remaining (75.9 thousand) were among adults (15 + years).[4]

WHO reported in (2013) that more than 2 million adolescents were between the ages of 10 and 19 years are living with HIV, and many do not receive the care and support that they need to stay in good health and prevent transmission. The failure to support effective and acceptable HIV services for adolescents has resulted in 50% increase in reported AIDS related deaths in this group compared with the 30% decline seen in the general population.[5]

According to UNAIDS, (November 2009) globally, there are 33.4 million people are living with HIV/AIDS, 31.3 million adults,15.7 million women, 2.1 million children are living with HIV/AIDS and 2.7 million cases are newly detected, 2.0 million deaths of HIV/AIDS patients, child AIDS deaths (2008) 0.28 million. [6]. In 2015, UNICEF and UNAIDS, with partnership with other international health and development partners launched ALL IN! To end adolescent AIDS.[7] Based on the above reports this study was conducted with the following objectives: (1) assess the pre-interventional knowledge score regarding preventive measures of HIV/ AIDS among adolescents, (2) assess the post interventional knowledge score regarding preventive measures of HIV/AIDS among adolescents, (3) compare between the pre-interventional and the post –interventional level of knowledge regarding preventive measures of HIV/AIDS among adolescents and (4) associate the Pre-interventional knowledge scores regarding the preventive measures of HIV/AIDS with the selected demographic variables.

2. MATERIALS AND METHODS:

2.1. Research Approach, design, setting and population:

The research approach used for the present study is quantitative approach. A pre-experimental research one group pre-test and post-test design was used to evaluate the effectiveness of the structured teaching programme for the present study. Present study was conducted at St. Georges Higher Secondary School, Bhopal, MP, which is located on the Karondth Bypass Road near BMHRC Hospital Bhopal. The populations of the study are the adolescents of the St. Georges Higher Secondary School, Bhopal, MP. The samples of the present study were 60 adolescents who are studying in the St. Georges Higher Secondary School Bhopal, MP. Data collected was analyzed using stratified Random sampling technique.

2.2. Development of Tool for Data Collection:

Structured knowledge questionnaire to collect the demographic data of adolescents This section consists of 10 multiple choice options, deals with demographic variables such as, age, standard, religion, fathers occupation, family income, habits, family pattern, previous knowledge, source of media, socioeconomic status.

Structured knowledge Questionnaire on prevention of HIV/AIDS among adolescents. This section has 7 sub–sections with 30 multiple choice questions to assess the knowledge of adolescent regarding the prevention of HIV/AIDS, introduction and general awareness questions, it includes, mode of transmission, risk factors, signs and symptoms, diagonosis, treatment and prevention.

Structured teaching plan on prevention of HIV/AIDS among adolescents. Detail description has given in description of structured teaching programme.

2.3. Section D: Flash Cards on prevention of HIV/AIDS among adolescents:

Flashcards on prevention of HIV/AIDS among adolescents was developed on the basis the review of literature and the objectives. The investigator prepared the flashcards on the prevention of HIV/AIDS among adolescents including seven sections such as Introduction and general awareness questions, Mode of transmission, Risk factors, Signs and symptoms, diagnosis, treatment and prevention.

2.4. Validity of instrument:

To ensure the content validity of the prepared tool, it was submitted to 9 experts. Among these twelve experts, 8 were nursing expert and one statistician.

2.5. Reliability:

The Reliability was established from data of 10 samples by parallel method. Using these values Karl Pearsons” correlation co-efficient was computed.

2.6. Data collection procedure:

Formal permission was obtained from the concerned authorities to conduct the study and adolescent’s students were selected for the same purpose. On the first day (30-1-2013), the investigator approached the selected students and rapport was established by self introduction and informed written consent was obtained from the students to confirm their willingness to participate in the study. The researcher conducted the Pre-intervention with self knowledge questionnaire. On the same day structured teaching programme on HIV/AIDS was administered by lecture method with and was told that after a period of one week again the same self knowledge questionnaire will be conducted. On 7th day (06-02-2013) post -intervention was conducted for the same samples.

2.7. Analysis of the data:

Analysis and interpretation of the data collected from the 60 samples of adolescents. Differential and inferential statistics were used for the analysis. Findings revealed that the pre-test knowledge score was 9.83 and SD was 4.307, whereas during post-test the mean score was 21.65 and SD was 3.55. Chi Square applied for association of demographic variables with pre-interventional scores. The findings were interpreted and analysed and presented with the help of the tables and graphs.

3. RESULTS:

3.1. Description of demographic variables of subjects:

With regard to the age of the adolescents, most 34(36.7%) belongs to the age group of 13-15 years, whereas 26(43.3%) were in the age group of 16-18 years. While considering the sex of the adolescents, majority 37(61.7%) of them are males, whereas 28(38.3) are females. In relation of the adolescents, all of the categories were equally qualified 15(25%). Regarding religion, majority 38(63.3%) adolescents belonged to Hindus, 18(30%) to Christianty where as 4(6.3%) were Muslims.

Regarding fathers occupation, majority 29(48.3), of the adolescents were government employees, whereas 21 (35%) were private employees and 10(16.7%) were with self business. With regard to family income, majority 20 (33.3%) were having income between Rs. 1000-5000, 16 (26.7%) having an income of Rs.10001-150000 and > Rs.15001 wheras 8(13.3%) were having income between Rs.5001- Rs.10000.

With regard to the family pattern majority 41(68.3%) were from Hindus, 16(26.7%) were from Christians, 3 (5.0%) were form Muslims.

Regarding habits, 65 (39%) were not possessing healthy behaviour, 16 (21.7%) were with substance abuse, and 5 (8.3%) were with smoking.

In relation to the source of information, majority 23 (38.3%) of the adolescents were with media, 21.7(13%) were had family members, 8 (13%) were from friends and 7 (11.7) were with health personnel.

3.2. Structured knowledge on prevention of HIV/AIDS among adolescents in pre interventional level of knowledge:

Assessment of the level of knowledge among adolescents regarding prevention of HIV/AIDS in Pre-test prior the implementation of structured teaching programme, majority 32 (53%) of the adolescents had poor knowledge and 28 (47%) had average knowledge regarding prevention of HIV/AIDS.

3.3. Assessment of knowledge among adolescents regarding HIV/AIDS post -interventional level of knowledge:

Assessment of the level of the knowledge among adolescents’ regarding prevention of HIV/AIDS post -interventional level of knowledge among adolescents regarding prevention of HIV/AIDS. While in post-test, after the implementation of structured teaching programme mostly 41 (68%) of the adolescents had good knowledge, 18 (30%) had average knowledge and 1 (2%) have inadequate knowledge regarding prevention of HIV/AIDS.

While in post-test after the implementation of structured teaching programme most of 41(68 %) of the adolescents had good knowledge, 18(30%) had average knowledge and 1(2%) have inadequate knowledge regarding prevention of HIV/AIDS.

3.4. Comparison of pre-interventional and post–interventional level of knowledge regarding prevention of HIV/AIDS:

Comparison of pre-interventional and post–interventional level of knowledge score of adolescents regarding prevention of HIV/AIDS: The data were compiled and analyzed:

Table 1. Mean and Standard Deviation of Adolscents (N=60)

S. No.

Groups

Mean

S.D

Mean difference

t -value

Pre-test

Post-test

9.83

21.65

4.307

3.550

11.82

19.878 *

P<0.001

Data presented in table 1, shows that the pre-interventional mean score of adolescents regarding prevention of HIV/AIDS was 9.83 whereas standard deviation was 4.307. The post- interventional mean score of adolescents regarding prevention of HIV/AIDS was 21.65 and standard deviation 3.550.

Comparison of level of pre-intervention and post-interventional knowledge score of the adolescents regarding prevention of HIV/AIDS, shows that during pre-intervention majority 32(53%) of the adolescents had poor knowledge and 28(47%) had average knowledge regarding prevention of HIV/AIDS and none of them have good knowledge on prevention of HIV/AIDS. Further, during post–intervention mostly 41(68%) of the adolescents had poor knowledge, 18(30%) had average knowledge and 1(2%) have good knowledge regarding prevention of HIV/AIDS. Hence it can be interpreted that structured teaching programme was effective as the level of knowledge of the adolescents have increased.

3.5. Assessment of pre-test knowledge associated with selected demographic variables:

Association of pre-test knowledge scores with the selected demographic variables in terms of age, gender, educational status, religion, father’s occupation, income, habits, family pattern, source of information and socio-economic status. There was no significant association between the pre-test level of knowledge score of the adolescents with their demographic variables regarding age, gender, educational status, religion, occupation habits, family income family pattern and sources of information regarding prevention of HIV/AIDS and family income status at 0.05, hence researcher concludes that as the calculated value of chi is less than tabulated value of chi hence, H₂ hypothesis is not accepted.

4. DISCUSSION:

Result of the study indicate that among 60 adolescents’ regarding the level of knowledge scores of pre and post test reveals that during pre-test 47% of the adolescent group had average knowledge and 53% of the adolescent had poor knowledge regarding prevention of HIV/AIDS. Further, during post-test 30% of the adolescent group had average knowledge and 68% of the adolescent had good knowledge and 2% percent had poor knowledge regarding prevention of HIV/AIDS. The mean pre–test score of adolescents regarding prevention of HIV/AIDS was 9.83, standard deviation was 4.307. The post- interventional mean score of adolescents regarding prevention of HIV/AIDS was 21.65, standard deviation was 21.65. Hence it can be interpreted that structured teaching programme was effective as the level of knowledge of the adolescents have increased.

A quasi- experimental study with single group pre-test and post-test design was conducted to assess the effectiveness of structured teaching programme on prevention and control of HIV/AIDS among the adolescent girl students of Sri Muktsar Sahib. A total no of 50 adolescent girls were chosen as study subjects with the help of random sampling technique.

In pre-test majority 29(58%) of subjects secured average knowledge scores followed by 20(40%) who were having poor knowledge scores. Only 1(2%) subjects have secured very poor knowledge score. None of the subjects had good or very good level of knowledge in the pre-test. After the administration of structured teaching programme, the level of knowledge scores of the subjects increased as a result of the post-test almost half of the subjects 26(52%) achieved good level of knowledge score followed by 18(36%) who attained very good level of knowledge. Only 6(12%) were having average level of knowledge score, hence administration of the STP was very effective on adolescent girls regarding prevention and control of HIV/AIDS.

5. CONCLUSION:

This chapter had dealt with the analysis and interpretation of the data collected from the 60 samples of adolescent’s. Differential and inferential statistics were used for the analysis. Findings revealed that the pre-test knowledge score was 9.83 and SD was 4.307, whereas during post-test the mean score was 21.65 and SD was 3.55. Chi Square applied for association of demographic variables with pre-interventional scores. The major findings of the study reveals that increase in post test knowledge score indicate development of positive knowledge regarding prevention of HIV/AIDS. Overall analysis shows the effectiveness of structured teaching programme.

6. ETHICAL STANDARDS:

Prior permission was obtained from the concerned authorities of Pragyan College of Nursing, Bhopal, MP and formal permission was obtained from the Principal and other authorities of the St. Georges Higher Secondary School, Bhopal, MP to conduct the study. Oral consent was taken from each student and then instruction has given to each student prior to their inclusion as sample in the study. Privacy, confidentiality and anonymity was maintained.

7. REFERENCES:

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2. Patrica, B and Christine, M (1999) Textbook of oncological Nursing. 2^nd Edition. Mosby Elsevier, Newyork.

3. Basvanthapa, TB (2003) Medical Surgical Nursing. First edition, New Delhi, India

4. Dewit, SC and Keanes (1992) Essentials of Medical Surgical Nursing. 3^rd edition, London, Philadelphia

5. Daniels et. al. (2007) Contempory Medical Surgical Nursing. First edition, Thomas Publishers, Haryana

6. Gulani, KK (2008) Community Health Nursing. 8^th edition, New Delhi

7. Golwala, SA and Golwala, AF (1951). Medical Surgical Nursing. 21^st Edition. Mumbia, India

8. Ms Rajbhanu et. al (2007). A descriptive study to assess the knowledge on HIV/AIDS among adolescents in selected schools at Pudicherry. Pondicherry Journal of Nursing.Vol 2, Page no 31-33.

9. Subashree, N (2009) Assessment of knowledge and attitude on AIDS among adolescents at Thriruninravur, Chennai. A publication of Holistic Nursing and Health Society. Volume 3, page no.22-24.

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12. Pelzer, K Nzewi, E, and Mohan K (2004). Attitdes towards HIV – antibody testing and people with AIDS among university students in India, South Africa and United States. Indian Journal of Medical Sciences, 58, 95-108. Retrieved from EBSCO host database.

13. Godbole, S, Mehendale, S (2005) HIV\AIDS epidemic in India; risk factor, risk behavior and strategies for prevention and control. Indian Journal of Medical Research. Vol. 121. pp.356-368.

14. Capoor, (2006) Adolescent and young peoples issues and concerns in south asia, challenges ahead. Ahmedbad. Center for Health Education Training and Nutrition Awareness

Received on 03.01.2020 Modified on 31.01.2020

Int. J. of Advances in Nur. Management. 2020; 8(2):133-137.

DOI: 10.5958/2454-2652.2020.00031.1