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  Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 40  |  Issue : 1  |  Page : 35-41
 

Human immunodeficiency virus/acquired immunodeficiency syndrome knowledge level and implications for health promotion program on high school students at Banjarbaru city


1 Department of Administration Health Policy and Health Promotion, Medical Faculty, Lambung Mangkurat University, Banjarbaru, Indonesia
2 Department of Enviromental Health, Medical Faculty, Lambung Mangkurat University, Banjarbaru, Indonesia
3 Department of Public Health, Medical Faculty, Lambung Mangkurat University, Banjarbaru, Indonesia
4 Department of Maternal and Child Health, Medical Faculty, Lambung Mangkurat University, Banjarbaru, Indonesia

Date of Web Publication10-May-2019

Correspondence Address:
Mr. Fauzie Rahman
Department of Administration Health Policy and Health Promotion, Public Health Program, Medical Faculty, University of Lambung Mangkurat, Banjarbaru
Indonesia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijstd.IJSTD_28_15

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   Abstract 

Introduction: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) cases were found in South Kalimantan; until June 2012, based on residence, the cases include 164 people of Banjarmasin, 54 people of Banjarbaru, and 141 people of Tanah Bumbu. Although the number of cases in Banjarbaru is not as high as in the city of Banjarmasin, there remains a concern that the case did not increase and may even be pressed. Aims: This study aimed to describe adolescents' knowledge about HIV-AIDS and the implications on the health promotion program among the senior high school students in Banjarbaru in an effort to prevent HIV-AIDS. Materials and Methods: This research used quantitative design with descriptive statistic test. The respondents were senior high school adolescents in Banjarbaru. Respondents were selected by purposive sampling technique with the inclusion criteria, such as willing to be a respondent, a native person of Banjarbaru, grade XI–XII, can cooperate and communicate well, and physically and mentally healthy. Results: The result of this research showed as many as 308 respondents (96%) had a high level knowledge. Statistical test showed there were no correlation between level of knowledge about HIV /AIDS with attitudes toward people living with HIV/AIDS (PLWHA (p=0,813). Conclusions: Optimal support be required as the efforts to reduce HIV/AIDS cases from various network.


Keywords: Banjarbaru, health promotion program, human immunodeficiency virus/acquired immunodeficiency syndrome, knowledge, senior high school students


How to cite this article:
Rahman F, Marlinae L, Sari AR, Ramadhani MS, Putri AO. Human immunodeficiency virus/acquired immunodeficiency syndrome knowledge level and implications for health promotion program on high school students at Banjarbaru city. Indian J Sex Transm Dis 2019;40:35-41

How to cite this URL:
Rahman F, Marlinae L, Sari AR, Ramadhani MS, Putri AO. Human immunodeficiency virus/acquired immunodeficiency syndrome knowledge level and implications for health promotion program on high school students at Banjarbaru city. Indian J Sex Transm Dis [serial online] 2019 [cited 2019 Nov 14];40:35-41. Available from: http://www.ijstd.org/text.asp?2019/40/1/35/257886



   Introduction Top


Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in Indonesia in the youth group tends to increase time to time.[1] Based on statistics, nationally HIV/AIDS cases in Indonesia until March 2013 found the highest cases (15,213) at the age of 20–29 years and 1412 adolescent cases (15–19 years).[2] Although the number of cases found in adolescents is not as high as those found in cases aged 20–29 years, it needs to be a concern in adolescence, with the aim of early prevention of the incidence of HIV/AIDS.

Cumulative reports of HIV cases found in South Kalimantan until June 2012 amounted to 276 people and 71 new cases of HIV. While reports of cumulative AIDS cases are found in South Kalimantan until June 2013 amounted to 225 people, and new cases of AIDS by 43 people. Based on residence until June 2012, HIV-AIDS cases found in South Kalimantan include 164 people of Banjarmasin, 54 people of Banjarbaru, and 141 people of Tanah Bumbu. Although the number of cases in Banjarbaru is not as high as in the city of Banjarmasin, there remains a concern that the case should not increase and should even be pressed in adult and adolescent groups.

HIV-AIDS problem occurs not only in adults but also risk in adolescents. Transmission of HIV in adolescents in Indonesia primarily occurs through unprotected sexual intercourse, as many as 2112 (58%) cases. Other modes of transmission are through a syringe (syringe use interchangeable) in drug users in 815 (22.3%) cases and through blood transfusion in 4 (0.10%) cases. An efforts through education or counseling about the behavior of contracting HIV/AIDS have been done, and the result showed education or counseling have a significant impact on increasing adolescent knowledge about HIV/AIDS and sexual behavior among adolescents as the minimal number of adolescents aged 15-24 years who have a comprehensive understanding of HIV/AIDS has only reached 20.6% of the target of 85%.[3]

Based on the above background, the author intends to analyze the common knowledge in adolescents, especially in high school students about HIV-AIDS and the knowledge level of HIV-AIDS in the community and the implications of adolescent health promotion programs so that it will have an impact on the awareness of youth to avoid HIV-AIDS and maintain the relationships.


   Materials and Methods Top


This research used quantitative design to analyze the knowledge of adolescents in Banjarbaru on HIV-AIDS.[4] The respondents were senior high school students in Banjarbaru. Respondents were selected by purposive sampling technique with the inclusion criteria such as willing to be a research respondent, is a native of Banjarbaru, grade class XI–XII, can cooperate and communicate well, and physically and mentally healthy.

A structured questionnaire has been used in this study. The questionnaires used were of two types, namely a questionnaire relating to the characteristics of the respondents and a questionnaire relating to respondents' knowledge about HIV-AIDS and how it was transmitted. The questionnaires were tested beforehand to determine the validity and reliability. Tests were conducted on a group 8 who have a similarcharacteristics to the group of respondents in the research. The data were analyzed by descriptive statistic test (univariate data) through the table of distribution and frequency to know the overview of characteristics and knowledge level of respondents about HIV/AIDS.


   Results and Discussions Top


The overview of knowledge level of respondents about human immunodeficiency virus/acquired immunodeficiency syndrome

Based on the results of this research, the knowledge level of respondents about HIV-AIDS can be observed as shown in [Figure 1]. [Figure 1] shows that as many as 308 of the 320 respondents (96%) had a good knowledge about HIV/AIDS whereas only 12 people (4%) had a poor knowledge. In this study, the distribution of the knowledge level of respondents by sex can also be observed. Distribution of respondents' knowledge level by sex is shown in [Table 1].
Figure 1: Category level of knowledge

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Table 1: Knowledge level of respondents by gender

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From [Table 1], it can be concluded that, in general, respondents of either sex (male or female) most have a high level of knowledge about HIV/AIDS. Of the 96% of the respondents who had a high level of knowledge, 36% (114 people) were male and 60% (194 people) were female. A high level of knowledge about HIV/AIDS was influenced by several things. Previous knowledge about HIV/AIDS of respondents was found by the mass media (78%) as the highest provider, and by the health workers at 11%, and the lowest provider was from the family amounting to 3%. The distribution of information about HIV/AIDS is shown in [Figure 2].
Figure 2: Distribution giving preliminary information regarding human immunodeficiency virus-acquired immunodeficiency syndrome

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The high percentage of mass media's role in providing early information about HIV/AIDS also affects the use of mass media in providing more resources about HIV/AIDS among adolescents in Banjarbaru. The role of mass media has a high influence in giving information about HIV-AIDS which has been evidenced by the high percentage of the use of television in providing such information. Based on the results of the research, television becomes a source of information for 65% of the respondents about HIV/AIDS and radio becomes a source of information in 2% of the respondents. This result concurs with Rodiyah's research (2007) that information about HIV/AIDS can be obtained from various sources, and most of the sources were obtained from television. A complete picture about the source of information on HIV/AIDS is shown in [Figure 3].
Figure 3: Human immunodeficiency virus-acquired immunodeficiency syndrome resources

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A high level of knowledge was demonstrated by about 70%–75% of the respondents which was depicted by the survey that the respondents knew that HIV stands for human immunodeficiency virus and AIDS stands for acquired immunodeficiency syndrome. Furthermore, approximately, 91% of the respondents knew that HIV is a virus that attacks the immune system and will lead to AIDS. A high level of knowledge about HIV did not make them to have a high level of knowledge about AIDS as well. Based on the research, about 50% of the respondents did not know that AIDS is a collection of symptoms that arise as a result of a decrease in the immune system. However, in general, 86% of the respondents know that AIDS is a collection of symptoms that are caused by a virus and 93% of the respondents know that AIDS is a disease that attacks the immune system. The picture of the level of knowledge about AIDS is shown in [Figure 4].
Figure 4: Knowledge level of respondents regarding acquired immunodeficiency syndrome

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AIDS is a set of symptoms caused by the immune system are obtained becaused of HIV infection. AIDS is not a disease, but the symptoms of a disease caused by infection with various types of microorganisms such as bacterial, viral, fungal, and even the onset of malignancy due to decreased patient endurance.[5] If a person has been infected with HIV, the symptoms of HIV/AIDS are as follows: (1) body weight decreased by more than 10% in 1 month; (2) chronic diarrhea that lasts for more than 1 month; (3) prolonged fever of more than 1 month; (4) and impairment of consciousness and neurological disorders.

Level of knowledge about the early symptoms when a person is infected with HIV-AIDS, in general, has not shown good results. This is evidenced from 66% of the respondents who know that the early symptom of HIV-AIDS is weight loss of more than 10% in 1 month. Further, less than 50% of the respondents had a low level of knowledge of the early symptoms. Picture of the level of knowledge about the early symptoms of HIV-AIDS is shown in [Figure 5].
Figure 5: Early symptoms of human immunodeficiency virus-acquired immunodeficiency syndrome sufferers

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[Figure 5] showed that the knowledge about early symptoms of HIV-AIDS that is weight decreased more than 10% in 1 month increased amounted to 66%. Symptoms of chronic diarrhea that lasts more than 1 month only by 53%. Symptoms of prolonged fever of more than 1 month by 46%. While the respondents' awareness of the symptoms of loss of consciousness and neurological disorder as part of the early symptoms of HIV-AIDS was very low at 24%.

Respondents' knowledge level regarding the mode of human immunodeficiency virus/acquired immunodeficiency syndrome transmission

In this research, the knowledge level of respondents included modes of transmission, symptoms, and how to prevent HIV/AIDS. The research results of the distribution of respondents' knowledge about the transmission of HIV/AIDS based on the type of body fluid is shown in [Figure 6].
Figure 6: Transmission of human immunodeficiency virus-acquired immunodeficiency syndrome by the type of body fluids

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[Figure 6] shows that the level of knowledge was quite high; it was observed that as much as 222 respondents (69%) knew that tears could not transmit HIV-AIDS and as much as 187 respondents (58%) knew that sweat could not transmit HIV-AIDS. High level of knowledge about HIV-AIDS transmission through semen could be as many as 283 respondents (91%). While as many as 187 respondents (38%) and 96 respondents (30%), respectively, had a low level of knowledge that urine and saliva could not transmit HIV-AIDS. The low level of knowledge about modes of transmission through the transmission media to be one of the causes of approximately 20 respondents (6%) chose to stay away from people with HIV-AIDS, approximately 178 respondents (49%) chose to keep their distance, fearing contagion, and only about 144 respondents (45%) who chose to remain friends.

According to eMedicine Health (2010), HIV does not spread through casual contact such as preparing food, sharing towels and blankets, or by pool, telephone, or toilet seats. Virus does not pass through contact with saliva, unless contaminated with blood. When compared with the results of the existing research, the knowledge of adolescents about transmission media of HIV/AIDS needs to be improved so that the attitude to stay away and keep distance with PLWHA can be minimized to avoid stigma and discriminatory actions.[6] Based on the research results, the attitude of the respondents if they have family living with HIV 49% would keep their distance, citing fears of contracting HIV-AIDS, and 6% would stay away from PLWHA. The picture of the respondents' attitude toward PLWHA is shown in [Figure 7].
Figure 7: Respondents attitude against people living with human immunodeficiency virus-acquired immunodeficiency syndrome

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Respondents' attitude toward people living with HIV/AIDS (PLWHA) may arise regarding the ignorance of the pattern of HIV transmission and the estimated risk of contracting. Given the pattern of transmission of HIV or HIV transmission, as mentioned above, it can be reported that there are people who have high-risk behaviors of HIV infection. Transmission of HIV in adolescents in Indonesia primarily occurs through unprotected sexual intercourse as many as in 2112 (58%) cases. Several studies revealed that more adolescents under the age of 18 years had sex. Other modes of transmission are found through a syringe (syringe usage interchangeably) as much as 815 (22.3%) drug users and through blood transfusion in as muchas4 (0.10%) cases.

Based on the results of this research, it can be observed that 320 respondents with approximately 226 respondents (71%) knew that one of the groups included in the high-risk groups of contracting HIV/AIDS is drug-injecting drug users. Risk behaviors of HIV/AIDS infection among women and men (keep changing the sexual partner) in unprotected sexual intercourse (condom), people who commit unnatural sexual intercourse, such as through anal intercourse and oral sex.

Based on the results of the study, it can be observed that a total of 287 respondents (90%) knew that unsafe sex is one of the modes of transmission of HIV-AIDS and 303 respondents (95%) knew that abuse of drugs with the use of intravenous drug needles together or alternately is one mode of transmission of HIV-AIDS. Detailed data about the level of knowledge about HIV transmission and AIDS are shown in [Figure 8].
Figure 8: Mode of transmission of human immunodeficiency virus-acquired immunodeficiency syndrome

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Level of knowledge about HIV-AIDS in general about the risk factors that can be a way of transmission of HIV-AIDS as sexual intercourse with HIV (98%), unprotected sexual intercourse (90%), injecting drug use (95%), and HIV-contaminated blood transfusion (92%) in general were included in the knowledge that high because it was on a percentage above 90%. However, knowledge about the use of nonsterile dental practice can transmit HIV-AIDS is very low level of knowledge that was only about 98 respondents (31%). As for the level of knowledge about human waste can't transmit HIV-AIDS was low, about 132 respondents (43%). As mentioned earlier, HIV virus does not spread through casual contact such as preparing food, sharing towels and blankets, or by pool, telephone, toilet seats, or tears.[7]

Various health organizations worldwide including Indonesia also recommend ways to prevent the above issues in an effort to decrease the risk of becoming infected with HIV-AIDS. Based on the existing research results, with a high level of knowledge about HIV-AIDS prevention by respondents, the expected risk of becoming infected with HIV-AIDS can be minimized.[7] Preventive methods include the ABCD approach recommended in Indonesia as follows:[7] (1) A or Abstinence, i.e., delaying sexual activity, do not perform sexual activity before marriage; (2) B or Be faithful, i.e., mutually faithful to their partner after marriage; (3) C or Condom, i.e., the use of condoms for those who undertake risky sexual behaviors; and (4) D or Drugs, i.e., do not use drugs primarily to prevent injecting drug use and needle together. Prevention efforts are also done by providing IEC (communication, information, and education) on HIV/AIDS to the community for not doing risky behavior, especially in adolescents.

Relationship between respondents' knowledge level with the number of human immunodeficiency virus/acquired immunodeficiency syndrome incidence in Banjarbaru

The survey results revealed that as many as 308 respondents (96%) had a high level of knowledge whereas approximately 12 respondents (4%) had a low level of knowledge. However, data on the incidence of HIV/AIDS among adolescents in Banjarbaru in this research activity were not obtained so that the relationship between the level of knowledge of adolescents at senior high school students in Banjarbaru with HIV/AIDS events could the level of knowledge of adolescents at senior high school students in Banjarbaru with HIV/AIDS events could not be analyzed further because of the limitations of the research, so that the results of research on the level of knowledge described in descriptive and generally associated with the number incidence of HIV/AIDS Banjarbaru.

The reports of HIV cases in South Kalimantan until June 2012 amounted to 276 people and new cases of HIV to 71 people. While reports of cumulative AIDS cases founded in South Kalimantan until June 2013 amounted to 225 people, and new cases of AIDS by 43 people. HIV/AIDS cases found in South Kalimantan based on residence until June 2012 include 164 Banjarmasin people, 54 Banjarbaru people, and 141 Tanah Bumbu people. Although the number of cases in Banjarbaru is not as high as in the city of Banjarmasin, there remains a concern that the case should not increase and may even be pressed in adult and adolescent groups. The incidence of HIV/AIDS in Banjarbaru was not as high as in Banjarmasin, one of which can be affected by a high level of knowledge among adolescents about HIV/AIDS. The high level of knowledge of a person closely related to his/her behavior has to be taken into account, because with the high-level knowledge, he has a reason and basis for determining an option. Health behavior is motivated by the needs of individual psychology to reduce anxiety caused by the threat of the disease, one of the psychological needs of their own, namely the application of knowledge to health.[8]

Mechanic in Sari (2011) noted that one of the ten types of variables that determine health behaviors was knowledge. Cumming in Sari (2006) mentions one of the various factors that influence health-related behaviors were things related to knowledge about the disease, and in this case one of them was HIV/AIDS.[8] Knowledge and behavior are closely related. In terms of knowledge of the benefits and adverse effects something that will shape the attitude, then it will appear on the attitude of intent. Intentions will then determine whether the activity will be carried out or not so that the better knowledge about HIV/AIDS, the better behavior. Behavior is also influenced by other factors such as culture, values, beliefs, rules, and norms. Attitude does not always end up with behavior. Based on this research, by looking at the level of knowledge of senior high school students in Banjarbaru, we expect that adolescents also have good behavior to prevent an increase in the incidence of HIV/AIDS.[8]

Relationship between attitudes toward knowledge level in people living with human immunodeficiency virus/acquired immunodeficiency syndrome

Attitudes of respondents who avoid and keep a distance with PLWHA is a poor attitude so that this attitude should not be realized if they are dealing directly with PLWHA. If the attitude toward PLWHA is associated with the level of knowledge about HIV-AIDS, shown in [Table 2].
Table 2: Results of test statistics

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Based on the results of statistical tests, the level Based on the results of statistical tests, there was no correlation between the level of knowledge about HIV-AIDS with attitudes toward PLWHA with P = 0.813 (>0.05), It is clear that the higher level of knowledge did not guarantee that their acceptance attitude toward PLWHA would be good.

Based on the research that there was no relationship between the level of knowledge of the attitude of acceptance toward PLWHA, the formation and change of attitude will be determined by two factors, namely internal factors (the individual) which is how an individual response the enviroment so that not all who come to be accepted or rejected and external factors are circumstances that exist outside the individual who is a stimulus for shaping and changing attitudes. The formation of attitudes is influenced by three factors, namely, the effect of such social and cultural norms, individual personality traits, and information that has been received by the individual. Based on the above description, rejection attitude toward PLWHA in a way to keep a distance and stay away from PLWHA is not always influenced by a person's level of knowledge. The attitude of rejection or stigma and discrimination against PLWHA can also be caused by the information that has been obtained, social and cultural influences, as well as the personality of the individual.


   Conclusions Top


Based on the results, some conclusions are as follows:

  1. A total of 308 people (96%) had a good knowledge about HIV/AIDS, and only 12 (4%) had a poor knowledge. The reason for a good knowledge was the respondents (78%) knew about HIV/AIDS from mass media
  2. Based on the results of this research, a total of 287 respondents (90%) knew that unsafe sex is one way of transmission of HIV-AIDS and 303 respondents (95%) knew that the abuse of drugs by needle-injecting drug users together or alternately is one way of transmission of HIV/AIDS. The respondents also had a high level of knowledge about how to prevent HIV/AIDS. This was evident from each item how HIV/AIDS prevention included in the research questionnaire was answered correctly by the respondents as a whole with a percentage above 90%
  3. The incidence of HIV/AIDS in Banjarbaru was not as high as in Banjarmasin about HIV-AIDS. Level of knowledge of a person closely related to his/her behavior has to be taken, because with the high-level knowledge, he has a reason and basis for determining an option. Based on this research, it can be observed that there was no relationship between the level of knowledge with an attitude of acceptance toward PLWHA. An attitude of rejection toward PLWHA by the way keep your distance and stay away from PLWHA are not always influenced by the level of one's knowledge. The attitude of rejection or stigma and discrimination against PLWHA can also be caused by the information that has been obtained, the influence of social and cultural, as well as the personality of the individual.


Recommendations

Based on the research results, suggestions are as follows:

  1. Optimum support is required as the efforts to reduce HIV/AIDS cases from various parties, such as support in peer education and serve the access to health-care services for adolescents
  2. Health promotion programs are needed in schools to help increase knowledge of students describing the symptoms of HIV/AIDS to prevent stigma and discrimination against PLWHA.


Acknowledgments

Great appreciation and gratitude are addressed to the Health Office of Banjarbaru city and the respondents who have given the information to complete the data of this research. Thanks to Medical Faculty of Lambung Mangkurat University which have helped in research activities to collect the research data.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Supratiwi P. 45% of people with HIV/AIDS is young generation; 2012. Available from: http://www.antaranews.com. [Last cited on 2013 Mar 14].  Back to cited text no. 1
    
2.
Directorate General of Disease Control and Environmental Health, The Ministry of Health of the Republic of Indonesia. Statistics Cases of HIV/AIDS in Indonesia was Reported Up To December, 2012; 2013. Available from: http://www.spiritia.or.id/stats/statcurr.pdf. [Last cited on 2012 Mar 11].  Back to cited text no. 2
    
3.
Yuliantini H. The Knowledge Level of HIV/AIDS and Adolescent Attitudes Toward Premarital Sexual Behavior in High School “X” in East Jakarta. Faculty of Nursing, University of Indonesia; 2012.  Back to cited text no. 3
    
4.
Brannen J. Mixing Methods: Qualitative and Quantitative Research. Aldershop: Ashgate Publishing Limited; 1992.  Back to cited text no. 4
    
5.
Murtiastutik D. Textbook of Sexually Transmitted Infections. Surabaya: Airlangga University Press; 2008. p. 211-43.  Back to cited text no. 5
    
6.
Tran MA. HIV/AIDS; 2008. Available from: http://www.emedicinehealth.com/hivaids/page11_em.htm. [Last cited on 2010 Apr 23].  Back to cited text no. 6
    
7.
Mei TC. Level of Knowledge and Attitudes of Private and Public High School Students on HIV/AIDS in the City of Medan in 2010. Thesis, Medical Faculty, University Of Northern Sumatra, Medan; 2010.  Back to cited text no. 7
    
8.
Sari D. Overview Knowledge, Attitudes and Behaviors Regarding HIV/AIDS in Medical Education Program Student University Tanjungpura. Thesis, Medical Faculty, University of Tanjungpura, Pontianak; 2011.  Back to cited text no. 8
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8]
 
 
    Tables

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