Original Article

Effectiveness of structured teaching programme

on transmission and prevention of human
immunodeficiency virus/acquired immune deficiency
Downloaded from http://journals.lww.com/ijst by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

syndrome among adolescent girls in Lowry Memorial

High School, Bengaluru
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 07/03/2024

Nanbur Stephen, Nanle Joseph Gusen, Patience Ringkat Kumzhi, Bonji Gaknung, Dauda Abimiku Auta1,
Lydia B. Bulndi2, Champion Mbursa3, Vasantha P. Kumari3, Nannim Nanvyat4
Department of Nursing Sciences, Faculty of Medical Sciences, University of Jos, Plateau State, 1Department of Nursing
Sciences University of Benin Teaching Hospital, Benin City, 4Department of Zoology, Applied Parasitology Unit, Faculty
of Natural Sciences, University of Jos, Jos, Plateau State, Nigeria, 2Department of Nursing Sciences, Lincoln University
College, 47301 Selangor, Malaysia, 3Department of Paediatric Nursing, Faculty of Nursing Sciences, Rajiv Gandhi
University of Health Sciences, Bengaluru, Karnataka, India

Address for correspondence:

Mr. Nanbur Stephen, Department of Nursing Sciences, Faculty of Medical Sciences, University of Jos, P. M. B 2084, Jos,
Plateau State, Nigeria. E‑mail: [email protected]

Abstract
Background: Adolescence is a critical stage in human development. Most young people become sexually active during
adolescence and are more likely to have multipartner and unprotected sex with high‑risk behavior that predisposes them
to sexually transmitted infections such as human immunodeficiency virus (HIV). Objectives: The objective of the study
was to evaluate the effectiveness of a structured teaching programme on transmission and prevention of HIV/acquired
immune deficiency syndrome (HIV/AIDS) among adolescent girls. Methods: An evaluative research approach was adopted,
in which a preexperimental, one group pre‑ and post‑test research design was used to evaluate the effectiveness of the
structured teaching programme on transmission and prevention of HIV/AIDS among adolescent girls studying at Lowry
Memorial High School, Bengaluru. A self‑administered structured questionnaire was used for data collection. Data were
presented in frequency tables and statistical graphs (bar charts) and analyzed using descriptive statistics (mean, standard
deviation) and inferential statistical methods (Chi‑square and paired “t”‑tests) using SPSS version 21. Results: The findings
of the study revealed that the mean percentage difference in the pre‑ and post‑test knowledge scores was statistically
significant at 5% level (P < 0.05). The overall mean post‑test knowledge score of adolescent girls on transmission and
prevention of HIV/AIDS was 88.83%. It is apparently higher compared to the pretest knowledge score, which was 67.67%
with enhancement of 21.16%. This implies that the structured teaching programme was effective in gaining knowledge
of adolescent girls regarding transmission and prevention of HIV/AIDS. Conclusion: Our study suggests that structured
teaching programme enhanced the knowledge of the adolescent girls on transmission and prevention of HIV/AIDS. We,
therefore, recommend that structured teaching programmes on transmission and prevention of HIV/AIDS should be
encouraged among adolescents and youths to reduce the spread of HIV infection.

This is an open access article distributed under the terms of the Creative
Commons Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows
others to remix, tweak, and build upon the work non‑commercially, as long as the
author is credited and the new creations are licensed under the identical terms.
For reprints contact: [email protected]
Access this article online
Quick Response Code:
How to cite this article: Stephen N, Gusen NJ, Kumzhi PR,
Website: Gaknung B, Auta DA, Bulndi LB, et al. Effectiveness of structured
www.ijstd.org teaching programme on transmission and prevention of human
immunodeficiency virus/acquired immune deficiency syndrome
among adolescent girls in Lowry Memorial High School, Bengaluru.
DOI:
Indian J Sex Transm Dis 2020;41:73-82.

10.4103/ijstd.IJSTD_102_17 Submitted: 24‑Oct‑2017

Accepted: 01‑Jul‑2018 Published: 26-Mar-2018

© 2018 Indian Journal of Sexually Transmitted Diseases and AIDS | Published by Wolters Kluwer - Medknow 73
 Stephen, et al.: Effectiveness of structured teaching program on transmission and prevention of human immunodeficiency virus/acquired immune deficiency syndrome

Key words: Adolescent girls, knowledge, structured teaching programme, transmission and prevention of human
immunodeficiency virus/acquired immune deficiency syndrome

INTRODUCTION and nonavailability of curative drugs and/preventive

vaccines create hindrance in every sphere of life.[5]
Adolescence has been defined by the WHO as a period
of life between 10 and 19 years. It is variously described
Downloaded from http://journals.lww.com/ijst by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

The rate of HIV infection is rapidly increasing and more

as neither children nor adults, but growing up years. It
number of people are getting ill and dying from AIDS.
is also a period of critical life junction when opinions
Trends in HIV incidence show important difference
and attitudes are formed. These are formative years when
between the regions of the world with more than 95% of
the maximum physical, psychological, and behavioral
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 07/03/2024

new cases remaining in the developing countries. The HIV/

changes take place. These are also a time of explorative
AIDS epidemic continues to spread with alarming rates in
and widening horizons and a time to ensure “health” in
many parts of Southeast Asia and the number of reported
all‑round development.[1]
cases continues to increase.[3]
Approximately one‑fifth of the world’s population comprises
In India, young people in the age group 15–24 years
adolescents. India has one of the fastest growing youth
comprise almost 25% of the country’s population.
populations in the world. In India, there are 200 million
However, they account for 31% of the AIDS burden
adolescents comprising over one‑fourth of the entire
in 2009. Well‑known factors such as peer pressure,
population; out of which, girls below 19 years of age
increasing levels of social interaction with the opposite
constitute 22% of the female population.[2] Adolescence is a
sex, and even household factors such as broken families
period fraught not only with mental and physical transitions
and poverty, contribute to increased sexual activity and
but also with issues that prematurely catapult young people
into adulthood. Adolescent girls face poverty, child or forced promiscuity. In a conservative society where sex‑related
marriage, pregnancy at a young age, risk of HIV infection, issues constitute a taboo for discussion, young people are
and violence, often without the benefit of an education. hindered from actively seeking counseling regarding sexual
Adolescent girls are at high risk for sexual and reproductive health. Social ostracism and disease‑associated stigma have
health problems in India.[2] created an attitude of negativity and shame in the minds
of young people. This results in lack of knowledge about
The acquired immune deficiency self‑protective measures, leading to silent spread of the
syndrome (AIDS) (sometimes called “slim disease” or “a disease. Despite these worrisome statistics, some Indian
wasting disease”) is a fatal illness caused by retrovirus states have banned sex education in schools, following
known as the human immunodeficiency virus (HIV) protests from legislators that it would have a negative
which breaks down the body’s immune system, leaving the impact on the vulnerable minds of school students.
victim vulnerable to a host of life‑threatening opportunistic Widespread ignorance about the disease is still prevalent,
infections, neurological disorders, or unusual malignancies. even among youth belonging to the affluent sections of
The danger of HIV infection is that: once infected, it is the society.[6]
likely that the person will remain infected for life. The
term AIDS refers only to the last stage of HIV infection. At present, there are 2.47 million people infected with
AIDS can be termed as our modern pandemic, affecting HIV in India and India accounts for over 13% of all
both industrialized and developing countries.[3] HIV‑infected individuals in the Asian region. [4] Until
now, the total number of AIDS cases reported in India is
HIV/AIDS has emerged as the single most formidable 5,310,000 (WHO) with majority people in the age group
challenge to public health, human rights, and development of 20–45 years. About 35% of HIV cases in India are
in the new millennium. The WHO and UNAIDS at the among the 15–24 years age group. The males and females
end of 2008 estimated that 33.4 million people were are equally accountable for the spread of the disease. As
living with HIV in the world. That same year, some 2.7 per estimation, adult HIV prevalence among men is 0.36%
million people became newly infected, and 2.0 million while among women, it is 0.25%.[7]
died of AIDS, including 280,000 children. Approximately
5.2 million people in low‑ and middle‑income countries Karnataka, a diverse state of Southwest India, has a
were receiving HIV antiretroviral therapy at the end of population of around 53 million out of which 253,000
2009.[4] people are HIV positive. Its capital city Bengaluru, formally
famous as the garden city, has around 23,877 HIV‑positive
HIV infection is indeed a unique disease: Its association people out of 96,189 total populations. The HIV prevalence
with behaviors that are not easily accepted by the society; rate in Bengaluru for adult general population is 0.29%, for
fears of transmission to others; its multisystem affection; men is 0.36% as well as for women is 0.22%; as per the

74 Indian Journal of Sexually Transmitted Diseases and AIDS Volume 41, Issue 1, January-June 2020
 Stephen, et al.: Effectiveness of structured teaching program on transmission and prevention of human immunodeficiency virus/acquired immune deficiency syndrome

provisional HIV Sentinel Surveillance‑2010 by Karnataka A study was conducted on impact of sex education
State AIDS Prevention Society.[8] on HIV knowledge and condom use among adolescent
females in the Dominican Republic. Data were analyzed
The routes of HIV transmission in Karnataka have been from 1608 female adolescents. Results noted that
established as: sexual – 78.56%, perinatal – 2.49%, respondents who reported receiving sex education were
blood transfusion – 3.23%, infected syringe and 1.72 times more likely to have high HIV/AIDS knowledge
needles – 0.57%, and others not specified – 15.15%.[9] than respondents who reported not receiving sex
Downloaded from http://journals.lww.com/ijst by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

education (confidence interval [CI]: 1.36–2.18, (p< 0.05).

A cross‑sectional study was conducted on adolescents’ Respondents who reported receiving sex education were
knowledge and awareness about HIV/AIDS in Bangladesh. 2.52 times more likely to report currently using condom
A multistage cluster sampling technique was used to than respondents who reported not receiving sex education
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 07/03/2024

select the sample. Data from 3362 female adolescents (CI: 1.65–3.85, p< 0.05). The study concluded that sex
was analyzed. The study found that a large proportion education program would be effective in increasing HIV/
of adolescents were not aware of sexually transmitted AIDS knowledge and condom use in young women.[14]
diseases and AIDS. More than half (54.8%) of the
adolescents never heard of AIDS and only one‑tenth of A quasi‑experimental study was conducted to assess the
them had moderate knowledge on AIDS in terms of mode knowledge, attitudes, and self‑efficacy of senior secondary
of transmission and prevention. Useful and fruitful mass school students toward people living with HIV in Vinnitsa,
media campaigns regarding the health consequences of Ukraine. A nonequivalent control group design with
sexually transmitted diseases including HIV/AIDS was pre‑ and post‑test components was employed on randomly
strongly suggested for creating awareness on the spread of selected sample of 15–16‑year‑old students from two
HIV/AIDS among adolescents in Bangladesh.[10] secondary schools (intervention and control). In addition,
3 months of follow‑up questionnaire was administered
A cross‑sectional study was done to determine the in both schools to assess longevity of the intervention.
knowledge of HIV/AIDS and sexual practices of adolescents Results indicated significantly higher knowledge, attitudes,
in Benin City, Nigeria. Using the systematic sampling and self‑efficacy scores among students in the intervention
method, 852 students consented to participate, giving a school than in the control school (standard deviation [SD]
response rate of 92.6%. An overwhelming majority of the 96.2 vs. 82.6, respectively, P < 0.01; 24.4 vs. 21.7,
adolescents were aware of HIV/AIDS but only 16.2% knew respectively, P < 0.01; 21.9 vs. 20, respectively,
the cause of the disease. The submission report revealed P < 0.01). The study concluded that HIV education
that kissing, living with infected persons, and sharing program considerably improved students’ knowledge,
their utensils leads to infection was the indication of attitudes, and self‑efficacy, and promoted positive changes
their ignorance. The study concluded that the knowledge in the participants, and therefore, it is suggested that the
of the studied population was poor and required better study should be extended to more schools to multiply its
information for the youths on HIV/AIDS.[11] effects.[15]

Young people in many parts of the world have been A study on HIV/AIDS prevention through peer education
denied sex and health education in schools because and support in secondary schools in South Africa was
parents and other authorities fear it encourages early conducted to provide accurate information about HIV/
sexual activity. However, there is compelling evidence AIDS that could prevent high‑risk behavior among
from studies conducted around the world and in many adolescents. A quasi‑experimental design involving an
different cultures that, in fact, sex education encourages experimental and control group, as well as pre‑ and
responsibility. Knowledgeable young people tend to post‑assessments, was used to evaluate the impact of the
postpone intercourse, or if they do have sex, they take program on high‑risk behavior of learners, aged between
precautionary steps such as use of condoms.[12] 13 and 20 years. The results showed that the percentage
of learners in the experimental group who were sexually
A study was conducted on impact of health education experienced remained unchanged over 18 months. In
program on knowledge about AIDS and HIV transmission contrast, a significantly increased percentage of learners in
among students of secondary schools in Buraidiah City, the control group were sexually experienced after the same
Saudi Arabia. The results of this study suggested that period. The study suggested peer education in contributing
this type of health education program on AIDS for to the prevention of HIV/AIDS amongst adolescents.[16]
students greatly and significantly improved their scores
in general knowledge of AIDS views on its transmission A nationwide cross‑sectional survey was carried out to
and misperception of AIDS. Hence, they recommended a assess the knowledge, attitudes, and beliefs about HIV/
continuous health education program for secondary school AIDS among the Malaysian young adults. A total of 1075
students.[13] young adult respondents aged 15–24 years participated in

Indian Journal of Sexually Transmitted Diseases and AIDS Volume 41, Issue 1, January-June 2020 75
 Stephen, et al.: Effectiveness of structured teaching program on transmission and prevention of human immunodeficiency virus/acquired immune deficiency syndrome

the survey and the response rate were 82.2%. The results METHODOLOGY
indicated that HIV/AIDS knowledge among the respondents
The research design selected for the study was one group
were moderate, with a mean knowledge score of 20.1 out
pre‑ and post‑test, preexperimental research design. The
of 32 points. The greater majority had adequate knowledge
independent variable was STP and dependent variables
of the major routes of HIV transmission. Only few were
were knowledge scores in pre‑ and post‑tests.
aware of other modes of transmission such as tattooing,
piercing, sharing personal items, and breastfeeding from
Downloaded from http://journals.lww.com/ijst by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

The sample of this study comprised 50 adolescent girls in

an infected mother. The greater majority knew that HIV is
not transmitted by mosquito bites, sharing meals, casual the age group of 11–18 years, studying at Lowry Memorial
contact, and using public swimming pools and toilets. High School, Bengaluru. Purposive sampling technique was
Misconceptions about HIV/AIDS exist among young used to draw the sample for the study.
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 07/03/2024

adults. Education and intervention programs are needed

to increase the level of knowledge and awareness on HIV/ The tool developed and used for data collection was
AIDS.[17] self‑administered structured questionnaire. Eight experts
validated the tool using, the Lawshe’s content validity
A cross‑sectional descriptive study was conducted using criteria and the content validity index of the tool was
a questionnaire with closed‑ended questions to assess found to be 0.9862. The reliability of the tool was also
knowledge and attitudes toward HIV/AIDS among senior established by Spearman–Brown prophecy formula (r) and
secondary school pupils and trainee teachers in Udupi the value of “r” was 0.9726. Thus, the tool was found to
district, Karnataka, India. A total of 990 pupils and 46 be valid, reliable, and suitable for evaluating the knowledge
trainee teachers were involved in study. However, there of adolescent girls on transmission and prevention of HIV/
were many misconceptions about transmission and AIDS.
prevention and 16.9% of pupils were found to possess
very little knowledge of HIV/AIDS. It was found that The structured teaching programme consisted of various
24.3% of pupils and 6.3% of trainee teachers thought aspects on transmission and prevention of HIV/AIDS. The
there was a cure and 27.4% of pupils and 14% of trainee teaching plan was organized in sequence and continuity.
teachers thought there was a vaccine to prevent HIV Teaching plan was prepared with a view to enhance the
infection. About 98.5% of pupils and all the trainee knowledge of adolescent girls regarding transmission and
teachers expressed the necessity of formal sex education. prevention of HIV/AIDS.
The pupils, who were reassessed after receiving a talk
and hand out showed significant improvement in their A pilot study was conducted, from November 23, 2016
knowledge and a change in attitude (P < 0.01). The to December 03, 2016 as a part of the main study; the
mass media are important in disseminating knowledge on tool was found to be comprehensible, feasible, and
HIV/AIDS in India, but due to the lack of interpersonal acceptable.
approaches to the education system, knowledge is
inadequate and misconception exists.[18] Data collection procedure for the main study began from
December 12, 2016 to January 04, 2017, after obtaining
The fight against HIV/AIDS has to happen on two main permission from the Vice president and Head Master of
fronts – Prevention and Care. To prevent the spread of Lowry Memorial High School, Bengaluru, and informed
AIDS, we have to educate the people on how to prevent consent from each participant. The researcher personally
infection. Poverty alleviation and development are also explained the need and assured them of the confidentiality
important programs that will limit the spread of HIV of their responses.
infection. Government cannot fight this battle alone.
Government can provide health and welfare services, The pretest was administered before structured teaching
conduct development programs, and provide information. programme; posttest was administered 8 days after the
It is also the responsibility of every individual to support teaching plan, using the same self‑administered structured
the fight against HIV/AIDS. Public education by health questionnaire. The response rate was 100% in both
personnel should aim to get as many people as possible pre‑ and post‑test.
to educate them about prevention and issues such as
nondiscrimination and support for people living with HIV/ The data gathered were analyzed using  SPSS (IBM
AIDS.[5] SPSS Statistics for Windows, Version 21.0. Armonk, NY:
IBM Corp). Descriptive statistics (mean and standard
This study was designed to evaluate the effectiveness deviation) were used in data summarization, while paired
of structured teaching program on transmission and “t”‑test and Chi‑square test were computed to test the
prevention of HIV/AIDS among adolescent girls in Lowry hypothesis. Data were also presented in graphical forms
Memorial High School, Bengaluru, India. such as bar charts.

76 Indian Journal of Sexually Transmitted Diseases and AIDS Volume 41, Issue 1, January-June 2020
 Stephen, et al.: Effectiveness of structured teaching program on transmission and prevention of human immunodeficiency virus/acquired immune deficiency syndrome

RESULTS Table 1: Sociodemographic characteristics of

respondents (n=50)
Table 1 depicts that among 50 respondents, 30% of them
Characteristics Category Respondents,
were 17–18 years old; another 30% were 15–16 years; frequency (%)
20% were 13–14 years; and 20% were 11–12 years old. Age (years) 11–12 10 (20)
The mean age was 14.9 years. In terms of religion, a *Mean age=14.9 years 13–14 10 (20)
larger number (46%) were Christians as compared to 15–16 15 (30)
Downloaded from http://journals.lww.com/ijst by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

34% Hindus; 12% Muslims; and 8% from other religion. 17–18 15 (30)
More than half of respondents (54%) were from joint Religion Hindu 17 (34)
family, followed by 12% from extended family and the Muslim 6 (12)
remaining (22%) were from nuclear family. A larger Christian 23 (46)
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 07/03/2024

number of them (38%) were in the second ordinal Others 4 (8)

position in the family; followed by 24% in the third Type of family Joint 27 (54)
ordinal position; 22% in the first ordinal position; and Nuclear 11 (22)
16% in the fourth ordinal position. Most of them (60%) Extended 12 (24)
had qualified higher secondary education as compared to Ordinal position in the First 11 (22)
family Second 19 (38)
20% who had secondary education and another 20% with
Third 12 (24)
middle school educational qualification. Most (56%) of
Fourth 8 (16)
them had both male and female friends, followed by 24%
Educational level Middle 10 (20)
had only female friends and 20% had only male friends.
Secondary 10 (20)
The major source of information for the respondents about Higher secondary 30 (60)
HIV/AIDS was from mass media (36%) followed by 26% Friendship Male 10 (20)
from friends, 24% through contact with health personnel, Female 12 (24)
and 14% from family. Both 28 (56)
Source of information Mass media 18 (36)
Table 2 and Figure 1 indicate the overall mean percentage Family 7 (14)
knowledge score of post‑ and pre‑test which reveal Friends 13 (26)
that the posttest mean percentage knowledge score was Contact with 12 (24)
found higher (mean percentage knowledge score 88.83% health personnel
and SD = 1.88) when compared to the pretest mean
percentage knowledge score which was 67.67% with SD Table 4 and Figure 2 shows that the pre‑ and
of 2.31. post‑test knowledge scores of respondents by age were
subjected to Chi‑square test. There exists a significant
The mean percentage knowledge enhancement score association between age and knowledge level of
was 21.16% with SD of 0.42. There exists a statistical respondents both in pretest (χ2 = 12.8*, P < 0.05) and
significance in the enhancement knowledge score, posttest (χ2 = 13.09*, P < 0.05).
indicating positive impact of the intervention program.
Table 5 shows that there exists a nonsignificant
Table 3 indicates that the overall mean of the posttest association between religion and knowledge level in both
knowledge score 40.02 (88.83% and SD = 1.88) was pretest (χ 2 = 0.53, P > 0.05) and posttest (χ 2 = 5.63,
found to be apparently higher when compared to pretest P > 0.05) evaluation of knowledge on transmission and
mean knowledge score value which was 21.06 (67.67% prevention of HIV/AIDS.
and SD = 2.31). The mean knowledge enhancement score
was 18.96 (21.16% and SD = 0.42). Table 6 shows that the pre‑ and post‑test knowledge
scores of respondents by educational level were subjected
The statistical paired “t”‑test implies that the difference to Chi‑square test. There exists a nonsignificant association
in the pre‑ and post‑test value was found statistically in pretest (χ 2 = 5.91, P > 0.05) and a significant
significant at 5% level (P < 0.05) with a paired association in the posttest (χ 2 = 10.78*, P < 0.05)
“t”‑test value of 51.20 at 49 degree of freedom. There between educational level and knowledge of respondents
exists a statistical significance in the enhancement on transmission and prevention of HIV/AIDS.
of knowledge score, indicating positive impact of the
intervention program. Hence, the research hypothesis DISCUSSION
is accepted. The structured teaching programme on
transmission and prevention of HIV/AIDS was effective Sociodemographic characteristics
among adolescent girls studying at Lowry Memorial High The sociodemographic characteristics of respondents
School Bengaluru. revealed that most of them (60%) were above

Indian Journal of Sexually Transmitted Diseases and AIDS Volume 41, Issue 1, January-June 2020 77
 Stephen, et al.: Effectiveness of structured teaching program on transmission and prevention of human immunodeficiency virus/acquired immune deficiency syndrome

Table 2: Overall mean percentage knowledge scores of pre‑ and post‑test on transmission and
prevention of human immunodeficiency virus/acquired immune deficiency syndrome among
respondents (n=50)
Aspects Number of items Maximum score Range of scores Mean score Knowledge score
Mean percentage SD
Pretest 45 45 18–25 21.06 67.67 2.31
Posttest 45 45 37–43 40.02 88.83 1.88
Downloaded from http://journals.lww.com/ijst by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

Enhancement 18.96 21.16 0.42

SD=Standard deviation

Table 3: Paired t‑test values between pre‑ and post‑test on transmission and prevention of human
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 07/03/2024

immunodeficiency virus/acquired immune deficiency syndrome among respondents (n=50)

Aspects Maximum score Range of scores Mean score Knowledge score Paired t‑test
Mean (%) SD
Pretest 45 18–25 21.06 67.67 2.31 51.20
Posttest 45 37–43 40.02 88.83 1.88 P<0.05
Enhancement 18.96 21.16 0.42
SD=Standard deviation

90 of the respondents had obtained information regarding

transmission and prevention of HIV/AIDS through mass
80
media (36%), friends (26%), and health personnel (24%).

A similar study was conducted to assess the current

70
levels of knowledge about AIDS among secondary school
students in India. A questionnaire was administered
Mean knowledge score (%)

60
to 336 ninth and tenth graders (mean age, 15 years) in
three rural and three urban schools in Haryana States.
50 Majority of the students (85%) had heard of HIV/AIDS.
The study also supported to determine the common
88.83
40 sources of information regarding HIV and its prevention
method which showed that the peer group influence was
67.67
30 greater; whereas, textbooks were also important sources of
information.[19]
20
Assessment of knowledge of adolescent girls
10
21.16 regarding transmission and prevention of
human immunodeficiency virus/acquired
0 immune deficiency syndrome
Pre-test Post-test Enhancement
The study confirmed that the overall mean knowledge
Pre-test Post-test Enhancement
score in pretest was 67.67%, which is moderate. This
shows that the adolescent girls had some knowledge
Figure 1: Overall pre- and post-test and enhancement mean knowledge
regarding transmission and prevention of HIV/AIDS
scores on transmission and prevention of human immunodeficiency
virus/acquired immune deficiency syndrome before the study. Although many adolescent girls partly
understand general information on HIV/AIDS, they
14 years (between 15 and 18 years) and the do not have a clear knowledge about risk factors and
mean age was 14.9 years. A larger number of the pathophysiology, signs and symptoms, mode of HIV
respondents (46%) were Christians; followed by transmission, diagnostic and preventive measures.
Hindus (34%). More than half of the respondents (54%)
were from joint family, and significant proportion (38%) The findings of this study are on par with a cross‑sectional
were in second ordinal position. study aimed to assess HIV/AIDS‑related knowledge and
sources among 2668 senior high school students in
Most of the respondents (60%) had qualified higher China. The results revealed that the level of HIV/AIDS
secondary education, and most of them had (56%) knowledge was 6.8% for low, 29.6% for moderate, and
both male and female friends. A significant number 63.7% for high. Strengthening and improving information

78 Indian Journal of Sexually Transmitted Diseases and AIDS Volume 41, Issue 1, January-June 2020
 Stephen, et al.: Effectiveness of structured teaching program on transmission and prevention of human immunodeficiency virus/acquired immune deficiency syndrome

Table 4: Association between age and knowledge level of respondents on transmission and prevention
of human immunodeficiency virus/acquired immune deficiency syndrome (n=50)
Age Sample (n) Knowledge level of respondents
Pretest Posttest
Inadequate n (%) Moderate n (%) Moderate n (%) Adequate n (%)
11–12 10 8 (80) 2 (20) 8 (80) 2 (20)
13–14 10 5 (50) 5 (50) 4 (40) 6 (60)
Downloaded from http://journals.lww.com/ijst by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

15–16 15 13 (86) 2 (14) 6 (40) 9 (60)

17–18 15 14 (93) 1 (7) 8 (53) 7 (47)
Total 50 40 10 26 24
χ2 12.8* 13.09*
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 07/03/2024

*Significant at 5% level. χ2 (0.05, 6 df)=12.49

Table 5: Association between religion and knowledge level of respondents on transmission and
prevention of human immunodeficiency virus/acquired immune deficiency syndrome (n=50)
Religion Sample (n) Knowledge level of respondents
Pretest Posttest
Inadequate n (%) Moderate n (%) Moderate n (%) Adequate n (%)
Hindu 17 14 (82) 3 (18) 8 (47) 9 (53)
Muslim 6 5 (83) 1 (17) 5 (83) 1 (17)
Christian 23 17 (74) 6 (26) 12 (52) 11 (48)
Others 4 3 (75) 1 (25) 4 (100) 0
Total 50 39 11 29 21
χ2 0.53 NS 5.63 NS
χ2 (0.05, 6 df)=12.49. NS: Not significant

Table 6: Association between educational level and knowledge level of respondents on transmission
and prevention of human immunodeficiency virus/acquired immune deficiency syndrome (n=50)
Educational level Sample (n) Knowledge level of respondents
Pretest Posttest
Inadequate n (%) Moderate n (%) Moderate n (%) Adequate n (%)
Middle 10 8 (80) 2 (20) 8 (80) 2 (20)
Secondary 10 5 (50) 5 (50) 4 (40) 6 (60)
Higher secondary 30 26 (87) 4 (13) 17 (57) 13 (43)
Total 50 39 11 29 21
χ2 5.91 NS 10.78*
*Significant at 5% level. χ2 (0.05, 4 df)=9.49. NS: Not significant

sources by means of health education would help create Another study was conducted on knowledge among senior
more awareness on HIV/AIDS among adolescents. [20] secondary school pupils in Udupi district, Karnataka,
The present study is also supported by a cross‑sectional India. In conformity to this study, the study found that
correlation study conducted on knowledge of adolescents many adolescents had misconceptions about transmission
in Kathmandu, Nepal. Majority of the adolescents had and prevention. About 16.9% of pupils possess very little
a moderate level of overall HIV/AIDS knowledge, but knowledge of HIV/AIDS and 27.4% thought that there is a
inadequate knowledge in the areas of mode of transmission vaccine for preventing HIV infection.[5]
and prevention of HIV/AIDS.[21]
Effectiveness of structured teaching
These findings are also consistent with a study conducted programme on transmission and prevention
on adolescents’ level of knowledge about HIV/AIDS of human immunodeficiency virus/acquired
among 208 high school students. Results showed that the immune deficiency syndrome
participants’ mean age was 15.5 years; 57.2% were female. The study found that there was a considerable improvement
About 24.5% reported a “good” level of knowledge, 67.3% of knowledge after the structured teaching programme, and
“fair” level of knowledge, and 8.2% “deficient” level of the enhancement in knowledge was statistically established
knowledge. Educational strategies need to be implemented as significant. The overall mean percentage knowledge score
in improving knowledge on transmission and prevention in the pretest was 67.67% and 88.83% in the posttest; with
of HIV/AIDS.[22] 21.16% mean percentage knowledge enhancement. This

Indian Journal of Sexually Transmitted Diseases and AIDS Volume 41, Issue 1, January-June 2020 79
 Stephen, et al.: Effectiveness of structured teaching program on transmission and prevention of human immunodeficiency virus/acquired immune deficiency syndrome

100
high significant association with knowledge score in the
93 pretest; whereas, age, educational level, and friendship
Age
90 had high significant association with knowledge score in
86
the posttest. There was no significant association found
80 80
80 between religion, ordinal position in the family, and source
of information about HIV/AIDS, in both pre‑ and post‑test.
70
Downloaded from http://journals.lww.com/ijst by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

60 60 Results established that the higher the age of respondents,

60
the higher the level of knowledge regarding transmission
53
50 50 and prevention of HIV/AIDS and the association between
Respondents(%)

50 47
age and knowledge level was found to be statistically
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 07/03/2024

40
40 40 significant in both pretest (χ 2 = 12.8*, P < 0.05) and
posttest (χ2 = 13.09*, P < 0.05).
30
Another study was conducted on adolescents to assess
20 20
20 their knowledge about HIV/AIDS in Karachi, Pakistan.
14
The study found adolescent girls with poor knowledge in
10 7 the age group of 15–19 years (adjusted odds ratio [AOR]
= 1.74; 1.22, 2.50) and low socioeconomic status of the
0
Inadequate Moderate Moderate Adequate family (AOR = 1.61; 1.09, 2.39), which shows that there
Pre-test Post-test was a significant association between age and knowledge
score; and also between socioeconomic status of the family
11-12 13-14 15-16 17-18
and knowledge score. This supports the present study, in
Figure 2: Association between age and knowledge level of respondents which majority of the respondents (60%) belong to the
on transmission and prevention of human immunodeficiency age group of 15–18 years; and 53.3% of those in this age
virus/acquired immune deficiency syndrome group had adequate knowledge in the posttest; which is
higher compared to 40% of those in the younger age group
implies that the structured teaching programme led to a had adequate knowledge in the posttest.[25]
significant gain in knowledge; which may have an impact
in preventing the spread of HIV/AIDS. A similar study was Furthermore, a study was conducted to assess the
conducted in Mumbai, India, to assess the effectiveness of knowledge and attitude of senior secondary school
planned teaching programme regarding prevention of HIV pupils toward HIV/AIDS in Udupi District of Karnataka,
infection on knowledge gain among school adolescents. India. The study found a significant improvement in
In conformity to the findings of this study, the planned the knowledge, and change in attitude among 98.5% of
teaching programme was found to be effective in gaining pupils; after receiving a talk and hand out about HIV/
knowledge on prevention of HIV infection among secondary AIDS (P < 0.01). This shows that there is a significant
school adolescents.[23] association between the educational exposure and
knowledge scores.[5] This supports the present study, in
A study conducted to assess the effectiveness of various which a significant association was found between the
Information, Education, and Communication in improving educational level of respondents and their knowledge
awareness and reducing stigma related to HIV/AIDS scores in posttest (χ2 = 10.78*, P < 0.05).
among school‑going teenagers in Haryana, India, in which
significant differences in the knowledge score was found A similar study was conducted to determine the
between pretest (60%) and posttest (72%) after the knowledge regarding prevention of HIV infection,
education program.[19] This is on par with the present study especially with reference to sociodemographic variables,
where the gain in knowledge after the structured teaching among middle‑class high school students in New Delhi,
programme was found to be statistically significant. Another India. The study found that increasing age, low
study conducted on effects of rapid peer‑based HIV/AIDS socioeconomic status, and rural residence were important
educational intervention on knowledge of high school factors influencing the knowledge.[26] This study did not
students in Arab country, similarly reported that, the mean explore residential and socioeconomic variables, but
knowledge score of respondents was improved from 65% in age, educational level, and friendship were found to
pretest to 82% in posttest with an enhancement of 17%.[24] be significant factors in influencing the knowledge of
adolescents on transmission and prevention of HIV/AIDS.
Association between sociodemographic
variables and knowledge scores There was a significant change found between the
In this study, age and type of family were found to have pretest (67.67%) and posttest (88.83%) knowledge scores,

80 Indian Journal of Sexually Transmitted Diseases and AIDS Volume 41, Issue 1, January-June 2020
 Stephen, et al.: Effectiveness of structured teaching program on transmission and prevention of human immunodeficiency virus/acquired immune deficiency syndrome

regarding transmission and prevention of HIV/AIDS 2. Joensuu H, Vehtari A, Riihimäki J, Nishida T, Steigen SE, Brabec P,
among adolescent girls, at 0.05 level of significance, with et al. Risk of recurrence of gastrointestinal stromal tumour after
surgery: An analysis of pooled population‑based cohorts. Lancet
a paired “t”‑test value of 51.20, (P < 0.05). Hence, the
Oncol 2012;13:265‑74.
stated research hypothesis was accepted, since there was
3. Park K. Text Book of Preventive and Social Medicine. 20th ed.
a significant improvement (21.16%) in the knowledge Jabalpur: M/s Banarsidas Bhanot; 2014. p. 264‑65, 298‑309.
scores of adolescent girls, after conducting the structured 4. WHO. Topical Overview: HIV/AIDS; March, 2008. Available from:
teaching programme. http://www.msn.com/dicussion/. [Last accessed on 2015 Apr 20]
Downloaded from http://journals.lww.com/ijst by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

5. Vichara, Special feature. Joint Publication of Karnataka State

A similar quasi‑experimental study was conducted in AIDS Prevention Society and Karnataka Health Promotion Trust.
8th ed. Karnataka Health Promotion Trust. Bangalore: 2007. p. 4‑5,
Akwa Ibom State, Nigeria, to examine the effect of HIV/
10‑12.
AIDS preventive health education on students toward
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 07/03/2024

6. Aghanwa HS. HIV/AIDS and Indian youth (1980 – 2008). J Soc

HIV/AIDS prevention. Results of the study also indicated Aspects HIV/AIDS 2009;6: 1-4.
a significant effect of the intervention on students’ 7. Sharma K, Udit P, Charan M. HIV epidemic in India. J Indian
knowledge toward preventive measures (F = 234.27 Acad Appl Psychol 2012;4:83‑7.
P < 0.01*).[27] 8. Karnataka AIDS Prevention Society. HIV Sentinel Surveillance;
2010.
Another study was conducted in Mumbai, India, to 9. Pradhan BK, Sundar R, Natesh G. Socio‑economic impact of
HIV/AIDS in Karnataka, India. UNDP, 2006. New Delhi. PP. 256.
evaluate the impact of school‑based HIV/AIDS education
10. Rahman MM, Kabir M, Shahidullah M. Adolescent knowledge
for adolescents. The pretest was administered to 2919
and awareness about AIDS/HIV and factors affecting them in
students. Only 50% of the students knew that HIV/AIDS Bangladesh. J Ayub Med Coll Abbottabad 2009;21:3‑6.
is transmitted sexually. After the intervention, 95% of 11. Wagbatsoma VA, Okojie OH. Knowledge of HIV/AIDS and sexual
the students became aware that HIV/AIDS is transmitted practices among adolescents in Benin city, Nigeria. Afr J Reprod
sexually.[23] In consistency with the present study, there Health 2006;10:76‑83.
was a significant difference between pre‑test and post‑test 12. Gunndling F, Teich N, Schepp W, Strebel HM. HIV education
for youth. Health Action 2007;102:37‑9.
knowledge score (P < 0.05).
13. Saleh MA, Al-Ghamdi YS & Al- Yahia OA. Impact of health education
program on knowledge about AIDS and HIV transmission in
The present study is also supported by a study conducted students of secondary schools in Buraidah city, Saudi Arabia. East
on the impact of education in promoting the knowledge Mediterr Health J. 1999; 14: 357-370.
and attitude toward HIV/AIDS prevention among 14. Minaya J, Owen‑Smith A, Herold J. The impact of sex
Iranian students. A self‑assessment technique among education on HIV knowledge and condom use among adolescent
University students, before and after the educational females in the Dominican Republic. Int J Adolesc Med Health
2008;20:275‑82.
training program, revealed that the knowledge of students
15. Kyrychenko P, Kohler C, Sathiakumar N. Evaluation of a
increased significantly (P < 0.05) and there was also a school‑based HIV/AIDS educational intervention in Ukraine.
significant improvement in their attitude. [28] Hence, the J Adolesc Health 2006;39:900‑7.
study concluded that continuous educational programs 16. Visser MJ. HIV/AIDS prevention through peer education
should be delivered to the younger generation. and support in secondary schools in South Africa. SAHARA J
2007;4:678‑94.

CONCLUSION AND RECOMMENDATION 17. Wong LP, Chin CK, Low WY, Jaafar N. HIV/AIDS‑related
knowledge among Malaysian youth adults: Findings from a
Our findings suggest that the structured teaching Nationwide survey. Medscape J Med 2013;10:148.
programme enhanced the knowledge of the adolescent 18. Agarwal HK, Rao RS, Chandrashekar S, Coulter JB. Knowledge
and attitude towards HIV/AIDS of seniors secondary school pupils
girls on transmission and prevention of HIV/AIDS. Hence,
and trainee teachers. J Indian Pediatr 2015;45:38‑42.
we recommend that structured teaching programmes
19. Raizada N, Somasundaram C, Mehta JP, Pandya VP. Effectiveness
on transmission and prevention of HIV/AIDS should be of various IEC in improving awareness and reducing stigma related
encouraged among adolescents and youths to reduce the to HIV/AIDS among school going teenagers. Indian J Comm Med,
spread of HIV infection. 2004; 29: 29–34.
20. Li S, Huang H, Xu G, Cai Y, Shi R, Shen X, et al. HIV/
AIDS‑related knowledge, sources and perceived need among senior
Financial support and sponsorship high school students: A cross‑sectional study in China. Int J STD
Financial support was not received for this study. AIDS 2009;20:561‑5.
21. Mahat G, Scoloveno MA. A cross sectional correlation study in a
Conflicts of interest private school in Kathmandu. J Adolesc Health 2013;16:175‑9.
There are no conflicts of interest. 22. P´erez V R, Barrales C I, Jara P J, Palma R V, Ceballos M A.
Knowledge of HIV/AIDS among adolescents in chill´an, chile.
Midwifery. 2008; 24:503–8.
REFERENCES 23. Sankaranarayan S, Naik E, Reddy PS, Gurunani G, Ganesh K,
1. Arnett JJ. Emerging adulthood: What is it and what is it good for? Gandewar K, et al. Impact of school‑based HIV and AIDS education
Child Dev Perspect 2010;1:68‑73. for adolescents in Bombay, India. Southeast Asian J Trop Med Public

Indian Journal of Sexually Transmitted Diseases and AIDS Volume 41, Issue 1, January-June 2020 81
 Stephen, et al.: Effectiveness of structured teaching program on transmission and prevention of human immunodeficiency virus/acquired immune deficiency syndrome

Health 1996;27:692‑5. knowledge among middle class high school students in New Delhi.
24. Farid-Ul-Hasnian, S Johansson E, Krantz G. Prevention of HIV Adolesc Health 2013;47:202‑8.
infection among adolescents in Karachi, Pakistan. J BMC Infect Dis 27. A k p a b i o I I , A s u z u M C , Fa j e m i l e h i n B R , O f i A B .
2014;26:38. A quasi‑experimental study to examine the effects of HIV/AIDS
25. Barss P, Grivna M, Ganczak M, Bernsen R, Al‑Maskari F, El Agab H, preventive health education with parental involvement in AkwaIbom
et al. Effects of a rapid peer‑based HIV/AIDS educational State, Nigeria. J Adolesc Health 2014;44:118‑23.
intervention on knowledge and attitudes of high school students 28. Jodati AR, Nourabadi GR, Hassanzadeh S, Dastgiri S, Sedaghat K.
in a high‑income Arab country. J Acquir Immune Defic Syndr Impact of education in promoting the knowledge of and attitude to
Downloaded from http://journals.lww.com/ijst by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

2009;52:86‑98. HIV/AIDS prevention: A trial on 17,000 Iranian students. Int J

26. Pramanik S, Chartier M, Koopman C. HIV/AIDS stigma and STD AIDS 2007;18:407‑9.
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 07/03/2024

82 Indian Journal of Sexually Transmitted Diseases and AIDS Volume 41, Issue 1, January-June 2020