INTRODUCTION:

The cells of immune system after being infected by the HIV gets destroyed and their function gets impaired. According to WHO,AIDS is a term which applies to the most advanced stage of HIV infection^[1].

The first case of HIV infection was identified in the year 1986 in India and there was an explosive increase in human immunodeficiency virus since then^[2].India is experiencing major epidemic of HIV transmissions in high risk populations of commercial sex workers, intravenous drug users and commercial blood donors.

Evidences have also shown that there has been a greater rate of transmissions from the urban population to the rural population in India^[3].Even though the chances for transmission is quite high in case of heterosexuals, homosexual transmission is rather frequent in a large city like that of Bombay. However It is seen that women is considered to be highly vulnerable too^[4].

AIDS has been considered to be a disease largely of poverty^[5,6].The transmission of HIV can be through various means. Mainly through unprotected sexual intercourse, oral sex with infected person, sharing of contaminated needles. It can also be transmitted from a mother to her infant^[1].Education is considered as the key for prevention. Education is the best effective and cost-effective way for the prevention of HIV/AIDS^[7]

Knowledge, attitude and perception studies are used to measure the changes in human knowledge, perception and attitude in response to a particular intervention. AIDS is a disease which along with the patient also requires good cooperation from the doctors, nurses, other health care workers and hence good attitude, good knowledge and good perception can help improve patient’s perspective.

Michelle Kermode, et al conducted a study on HIV-related knowledge, attitudes and risk perception amongst nurses, doctors and other healthcare workers in rural India and found that a positive attitude was seen among the HCWs towards caring people with HIV/AIDS but was hindered by substantial concerns about providing care, most of them were scared about the risk of occupational exposure. The study concluded that there was a need for the development of programs necessary to promote occupational safety and also awareness training of HCWs^[2].

Knowledge attitude and practice study on HIV/AIDS among HIV patients, care givers and general population in the North eastern part of India.” And studied most of the HIV patient were illiterate, and most of them were engaged in transport/production industry. The majority of the medical staffs felt that the newly diagnosed HIV person, the first to talk with doctor concluded that a new strategy for prevention and treatment can be formulated by understanding the KAP of patients, health care workers and general population^[8].

The main aim of the this study is to evaluate the knowledge, attitude and perception towards HIV/AIDS among, nursing and healthcare professionals. The main objective of this study was to Improve the knowledge, attitude and perception towards HIV/AIDS among nursing and healthcare professionals. To provide structured education on disease and lifestyle modifications^[9].

MATERIALS AND METHODS:

The Study was carried out for a period of 9 months in tertiary care hospital

Study Instrument: KAP Questionnaire.

People were first selected for the study and following were the inclusion and exclusion criteria

Inclusion Criteria:

Volunteers meeting all the following criteria will be considered for enrollment in the study:

Nursing staff

Health care professionals

Exclusion Criteria:

HIV/AIDS patients

Healthcare professionals who are not willing or unable to give consent to participate I this study

METHOD:

A prospective data collection from the population included a series of questionnaire being answered by the nursing and other healthcare professionals which were used to assess their Knowledge, Attitude and Perception. Data collected from the questionnaire was then tabulated and scored in their respective charts.

Following initial data collection respondents were counseled regarding HIV disease, regarding the mode of transmissions, the risks, attitude changes and other myths they need to change in their life to provide a good care for patients challenging with HIV.

A month later the same respondents were asked to refill the questionnaire and were asked to answer. The results were further tabulated against their respective columns to measure the changes in Knowledge, attitude and perception score among the respondents.

Kap questionnaire:

The questionnaire form contains questions regarding patient knowledge of, attitude of, and perception about the diseases and treatment.

Finally the documented questionnaire is evaluated for the final outcome.

The study was conducted after obtaining informed consent from the patient. This study was approved by the Ethics committee IEC/DOPV/2015/03.

Data Analysis:

The obtained data were carefully tabulated, scored and categorized in accordance to their respective categories. Data analysis was further done using software such as Microsoft Excel 2010 and prism graph pad ver.6.T test was used to find the significance.

DISCUSSION:

Counselling is the core element in HIV/AIDS patients

Where in psychological issues are considered the integral part for the patient management. Patient’s social stigma, fear of rejection, depression should be managed with consistency and professionalism. Counselling mainly consists of two aims: HIV transmission prevention and supporting the affected individual.

The above two mentioned aims of counselling is vital as the spread of HIV can definitely be prevented by certain changes in the behavior.

Demographics:

Of the 150 questionnaires100 were returned. The response rate tended to be better among the nurses and pharmacists (student pharmacists) compared to the doctors. of the respondents selected 48 were male while 52 were female. (Table-1).There were more respondents in the age group from 36-40(Table-2).

The majority of respondents were nurses (48) pharmacists (including student pharmacists) 26, 14 were doctors, 7 laboratory workers, 5 others (ophthalmic technicians, multi-purpose workers, op technicians) (Table-3).

KAP scores:

The average knowledge score before counselling was found to be 7.98 (±1.52), following counselling the knowledge score was found to be 9.43 (±0.71) of a total maximum score of 10 (Table-5). The average Attitude score before counselling was found to be 3.24(±1.07) the same attitude score when calculated after counselling was found to be 4.49 (±0.69) of a maximum score of 5 (Table-6). The mean perception score before counselling was found to be 3.17(±1.09), following counselling the perception score was found to be 4.53 (± 0.62), of a maximum score of 5 (Table-7)

A paired T test done to analyze the difference in KAP before and after counselling showed a significant difference (with p<0.0001*) between these two scores confirming the importance of change in Knowledge, attitude and perception scores following counselling.

Patients response to various questions asked in the questionnaire were compared before and after counselling to see some significant changes as a report of proper Knowledge, attitude and perception

RESULTS:

The following results were obtained when the data were collected from patient

Table 1:Gender distribution

Gender	No. of respondents	% of respondents
Female	48	48%
Male	52	53%

Table 1 showing the gender distribution

Table-2 Age distribution

Age	No. of respondents(n=100)	% of respondents
30-35	33	36%
36-40	36	40%
41-45	15	16%
45-49	06	6%

Table-2 showing that there were more respondents in the age group from 36-40

Table-3 Occupation distribution

Occupation	No. of respondents (n=100)	% of respondents
Nurse	48	48%
Pharmacist	26	26%
Doctors	14	14%
Labworkers	7	7%
Others	5	5%

Table -2 showing that the no. of nurse respondents were more

Table-4 kap score before and after counselling

Study parameter	Before counselling	After counselling	Changes in percentage
Knowledge	7.98(±1.52)	9.43(±0.71)	18.2%
Attitude	3.24(±1.08)	4.49(±0.64)	38.6%
Perception	3.17(±1.10)	4.53(±0.63)	42.9%

Table-3 showing the gradual change in the percentage of respondent’s KAP after counselling

Significance of changes in mean knowledge score

Table-5 Mean knowledge score

Pre counselling	Post counselling	P value
7.98	9.43	<0.0001*

There is an extremely significant (P<0.0001*) values were obtained when compared between pre counselling and post counselling phases of respondent’s knowledge score.

Table-6 Mean attitude score

Pre counselling	Post counselling	P value
3.24	4.49	<0.0001*

There is an extremely significant (P<0.0001*) values were obtained when compared between pre counselling and post counselling phases of respondent’s attitude score.

Table-7 Mean perception score

Pre counselling	Post counselling	P value
3.17	4.53	<0.0001*

There is an extremely significant (P<0.0001)* values were obtained when compared between pre counselling and post counselling phases of respondent’s perception score.

Categorization of score amongst respondents before and after counseling (n=100)

Table-8 Classifying KAP score

	Before		After
KAP	Poor	Good	Poor	Good
Knowledge	34	66	28	72
Attitude	58	42	37	63
Perception	65	35	44	56

Table showing the categorization of score amongst respondents before and after counselling.

CONCLUSION:

The knowledge, attitude and perception towards HIV/AIDS among, nursing and healthcare professionals was evaluated and it was found that the knowledge scores were quite satisfactory but most of them had a negative attitude and perception towards HIV patients. The knowledge, attitude and perception towards HIV/AIDS among nursing and healthcare professionals were improved after counselling and a structured education on disease and lifestyle modifications were provided.

Abbreviations:

HIV- Human Immunodeficiency Virus

AIDS-Acquired Immunodeficiency Syndrome

KAP-Knowledge, Attitude, Perception

HCWs-Health Care Workers

WHO-World Health Organization

REFERENCES:

1 WHO:HIV/AIDS online Q and A. Available at: http://www.who.int .Accessed by 2015.

2 Michelle Kermode, Wendy Holmes, Biangtung Langkham, Mathew Santhosh Thomas, Sandy Gifford HIV-related knowledge, attitudes and risk perception amongst nurses, doctors and other healthcare workers in rural India. Indian J Med Res. 122(3);2005:258-264.

3 Bollinger RC, Tripathy SP, Quinn TC. The human immunodeficiency virus epidemic in India. Current magnitude and future projections. Medicine(Baltimore). 74(2);1995:97-106.

4 Nandi J, Kamat H, Bhavalkar V, Banerjee K. Detection of human immunodeficiency virus antibody among homosexual men from Bombay. Sex transm Dis. 21(4);1994: 235-236.

5 Jenny A. Higgins, Susie. Rethinkinggender, heterosexual men and women’s vulnerability to HIV/AIDS. Am J Public Health.101(4); 2011: 585.

6 R. A., Holtgrave, D. R., DiClemente, R. J., Wingood, G. M., and Gayle, J. A. Social capital as a predictor of adolescents' sexual risk behavior: A state-level exploratory analysis ... Social capital, poverty and income inequality as predictors of gonorrhea, syphilis, Chlamydia and AIDS case ratesi n the United States. Sex transm infect. 79(1); 2003: 62-64.

7 Stephen B. Thomas, and Sandra Crouse Quinn, Med. The Tuskegee Syphilis Study,1932 to 1972:Implications for HIV Education and AIDS Risk Education Programs in the Black Community.AM J Public Health. 81(11); 1991: 1498-1505.

8 L.P Meena, S K Pandey, M Rai, Anju Bharti, Shyam Sunder. Knowledge, attitude and practices(KAP) study on HIV/AIDS among HIV patients, care givers and general population in north eastern part of India. International Journal of Medical Science and Public Health. 2(1); 2013:36-42.

9 Sarah Chippindale, Lesley French.HIV counselling and the psychological management of patients with HIV or AIDS.BMJ 2001.doi:10.1136/bmj.322.7301.1533.

Received on 15.06.2016 Modified on 24.06.2016

Research J. Pharm. and Tech 2016; 9(9):1403-1406.

DOI: 10.5958/0974-360X.2016.00271.7