Infection with HIV/AIDS are urgent medical problems worldwide with broad social, cultural, economical, political, ethical and legal implications.[1] Prevention indisputably is the most important objective. In the absence of a vaccine - or an effective chemotherapeutic agent, only weapon available for combating this dreadful infection is prevention by community awareness and health education.[2]

Health personnel have the dual responsibility of providing care and counseling to people with HIV/AIDS and educate individuals and community about the facts related to HIV/AIDS.

They must take appropriate precautions to prevent the spread of the infection in other patients and among themselves; act as a role model for their community by providing compassionate and respectful care; and educate individuals and groups about HIV/AIDS.[2]

Keeping this in mind the present study was carried out among class III and Class IV workers of Govt. Medical College & Hospital, Nagpur to assess their knowledge and attitude towards HIV/AIDS. These people form an important contact point with the masses and they are the ones who can best educate individuals and groups about the facts related to HIV/AIDS. Their ignorance can act as an impediment in the care of AIDS patients which may pose a great problem in future. Also, these are the people who can build the right platform wherein doctors and experts on HIV can provide further knowledge.

Material and methods

Present study is a cross sectional study carried out among Class III and Class IV employees working in Govt. Medical College and Hospital, Nagpur, to assess their knowledge and attitude towards HIV/AIDS. Total sample size was 250 of which 176(70.4%) were Class III and 74 (29.6%) were Class IV employees. The individuals were interviewed personally using a predesigned questionnaire in Marathi. The questionnaire comprised of questions on different aspects of AIDS like etiology, modes of transmission, preventive measures etc. According to the number of correct answers given a scoring system was developed and score obtained by each study subject were calculated.

Observations

Source of Information: Of the 250 study subject 18(7.2%) had never heard/read about AIDS and hence were excluded from further analysis leaving us with a total of 232. The main source of information was television in 78%, followed by newspapers in 54.3% and doctors in 43.5%. Other sources of information were radio, friends and others in 38.8%, 20.7% and 17.2% of study subject respectively.

Knowledge of etiological agent: 57.3% of the study subjects knew about the viral etiology of AIDS, 15.6% answered that it is caused by a germ while 11.5% said that the causative agent is a bacteria. Contaminated food, water and air were implicated by 5.2%, 4.9% and 3.8% of study subjects respectively, 1.7% study subjects did not know about the etiological agent.

General information of study subjects regarding AIDS is seen in [Table - 1]. 92.7%, 89.7%, 85.8% & 72.4% respondents respectively were aware that unprotected sex, blood & blood products, vertical transmission, and infected syringes and needles can transmit AIDS. However, only 42.2% knew that sharing tooth brushes and razors can also transmit AIDS. Sharing utensils, hand shaking/hugging, mosquito bite and social kissing were considered as modes of transmission by 32.8%, 27.6%, 37.5% and 44.8% of respondents respectively. Use of condoms, use of gloves, use of disposable needles and syringes and having a single faithful partner as preventive measurers were known to 72.4%, 68.8%, 61.6% and 54.7% of study subject respectively. However, only 45.3% were aware about non availability of vaccine for AIDS.

In all there were 20 questions on knowledge regarding AIDS, and scoring was done by allotting one mark for each correct answer. Class III employees scored considerably better than Class IV employees. 74.2% of Class III employees scored between 15-20, 23.9% between 7-15 and 1.7% between 0-7. However in case of Class IV employees only 16.2% scored between 15-20, majority (54.1 %) scored between 7-15 and 29.7% scored between 0-7.

Study subjects had a general negative attitude towards patients with AIDS. 81.9% considered AIDS to be a major public health problem. 62.5% and 56.8% respectively were of the opinion that every patient should be tested on admission and AIDS patients should be strictly isolated. 53.4% and 44% respectively said that they would agree to have lunch or dinner with someone with AIDS and they would be able to touch and care for someone with AIDS. 223(96.1%) study subjects, said that they wanted to learn more about AIDS.

Discussion

The key position of health care workers in the education of patients and the community at large and the great influence this group has on public opinion that they have optimal knowledge and sound attitudes based on appropriate facts.[3] From the results of our study it is clear that despite the increasing mass-media focus on AIDS many study subjects are misinformed or confused regarding various aspects on HIV/AIDS. Also negative attitudes and biases towards AIDS patients persisted. Future educational activities should address these deficits in knowledge explicitly. Although, the risk of infection following occupational exposure is low, employee fear is considerable.[4],[5] The fact that there is no cure and no vaccine against AIDS has caused great apprehension and fear amongst the Hospital employees.[6] Confidence has to be created amongst them that by taking adequate measures to prevent and control infection, HIV/ AIDS can automatically be prevented. Repeated information aimed at health personnel is still needed, the ultimate goal for such compaigns being behavioral change and the adoption of the safest possible techniques.

It is important that health care professionals dispel the fears and misconceptions currently prevailing with regard to HIV infection and AIDS. It is only thus that they can fully discharge their duties not only with respect to HIV infected persons and persons with AIDS, but to the society as a whole. The results of this study may be of utility in formulating effective in service training and other education programmes to increase knowledge regarding AIDS and to correct specific areas of misinformation for Class III and IV hospital employees the time to act is now; the place to act is our work place-hospital.

Summary

The present cross sectional study was carried out to assess the basic knowledge and attitude of class III and Class IV hospital employees (n=250) regarding HIV/AIDS. Of the 250 study subjects 232(92.8) had heard or read about AIDS. Chief sources of information were television, newspapers and doctors. Though the study subjects had some factual knowledge about HIV/AIDS, certain misconceptions and myths persisted. They were also found to have a biased and negative attitude towards people with AIDS. 223(96.1%) study subjects said that they would like to learn more about HIV/AIDS. The results of this study indicate that action is needed to increase the level of knowledge of this group so that they reject biased information and myths relating to AIDS and thus carry out their duties effectively and help in forming an enlightened opinion against AIDS.

References

1. World Health Organization - Guidelines on AIDS and first aid in the workplace. Published by the World Health Organization in collaboration with the International Labour Office and the league of Red Cross and red crescent Societies, 1990 WHO Geneva.  Back to cited text no. 1  
2. World Health Organization AIDS in South East Asia - No time for complacency, 1993, WHO Geneva.  Back to cited text no. 2  
3. Brattebo G, Wisborg T, Sjursen H. Health workers and the Human Immunodeficiency virus Knowledge, ignorance and behaviour. Public health 1990;104:123-130.  Back to cited text no. 3 [PUBMED] 
4. Gellert GA, Maxwell RM, Higgins KV, Barnard R, Page B. AIDS knowledge occupational precautions and public education activities among Law Enforcement officers and first responders. Public Health Policy 1994;15:460-469.  Back to cited text no. 4 [PUBMED] 
5. Marcus R. CDC cooperative Needle stick surveillarance Group: Surveillance of health care workers exposed to blood from patients infected with Human Immunodeficiency Virus. New Eng J Med. 1988;319:1118-1123.  Back to cited text no. 5  
6. National AIDS control organization -Training modules on prevention of transmission of HIV in Hospitals - Prevention and control of HIV and AIDS - 1994, Government of India, Ministry of Health and Family welfare.

Tibdewel SS, Wadhva SK
Dept. of Pharmacology, Govt. Medical College, Nagpur,

Correspondence Address:
Tibdewel S S
Dept. of Pharmacology, Govt. Medical College, Nagpur