INTRODUCTION:

Adolescence is a transitional stage of physical and mental development among human beings which generally occurs between puberty and legal adulthood but largely characterized as beginning and ending with the teenage stage (age of thirteen to nineteen). Most young people become sexually active during adolescence. In the absence of right guidance and information at this stage; they are more likely to have multi-partner unprotected sex with high risk behavior groups. Particularly vulnerable are impoverished, unemployed, under-employed, mobile/migrant youth, adolescents in sex work, young injecting drug users and street children as they are faced with high risk behavior in their everyday life.

AIDS is a serious illness and public health crisis that merits the concern of everyone. AIDS, which is one of the most dreaded diseases of humanity, has spread to every part of the world, threatening people from all spheres of life. India too is facing this menace, being on third number in the world (first and second being South Africa and Nigeria respectively) and largest in Asia.¹

In India, people in the age group of 15-29 years comprise almost 25 percent of the country’s population; however, they account for 31 percent of AIDS burden. This clearly indicates that young people are at high risk of contracting HIV infection. This is because physiologically, young people are more vulnerable to sexually transmitted infections than adults; girls more than boys. No doubt, awareness about sex is more these days and information is freely available as television, movies and most prominently the Internet is loaded with extremely easily accessible information. But it is also true that all information from friends and elsewhere needs to be confirmed as it may not always be correct. Hence, lack of access to correct information, tendency to experiment and an environment which makes discussing issues around sexuality taboo adds to their vulnerability.

According to the latest statistics of the global HIV and AIDS epidemic published by UNAIDS (Joint United Nations Programme on HIV/AIDS) in November 2010 around 33.3 million people are living with HIV. Out of this, 30.8 million are adults and 15.9 million are women. World has an estimated HIV prevalence of 0.8%. Each year around 2.6 million more people become infected with HIV and 1.8 million die of AIDS.² India which is having a total population of 1.2 billion recorded 2.47 million cases of HIV infection and an estimated adult HIV prevalence of 0.31% (Males: 0.36%; Females: 0.25%). Among the Indian States, Manipur has shown the highest estimated adult HIV prevalence of 1.40%, followed by Andhra Pradesh (0.90%), Mizoram (0.81%), Nagaland (0.78%), Karnataka (0.63%) and Maharashtra (0.55%).³ Punjab has an estimated 60,836 cases of HIV infection with estimated adult HIV prevalence of 0.32% (Males: 0.37%; Females: 0.26%) which is greater than national prevalence.⁴

Also, there is a significant population living with HIV and AIDS among intravenous drug users (IDUs) in four of India’s biggest cities – Chennai, Delhi, Mumbai and Chandigarh. The Problem of Drug Abuse is a burning issue of today and it is spoiling the society, specially the youths. Incidence of drug abuse is on the rise in Punjab, more in border areas adjoining Pakistan. Some districts of Punjab like as Sri Muktsar Sahib, Bathinda and Ferozepur are more effected by drugs due to adjoining border with Rajasthan. Further, Sri Muktsar Sahib falls in a rural area and has an average literacy rate of 58.25 % (65.94 % for males and 50.57 % for females) which shows the lack of awareness and gender disparity.⁵

Last, but not the least, young generation is moving out for studies and jobs to bigger towns. They live independently without parent’s supervision. They feel that they are free to do whatever they want as there are no restrictions on them. From the personal experience of the investigator, HIV/AIDS is a topic about which parents do not talk with their children at home. Talking openly about sex is still a taboo in India.

Keeping in mind the increased prevalence of HIV/AIDS, increased number of intravenous drug abusers, presence of misconceptions about HIV/AIDS and skipping of topics regarding reproductive and sexual health by the school teachers and personal knowledge; investigator felt that a research study should be conducted to impart the knowledge regarding prevention and control of HIV/AIDS among adolescent school girls of Sri Muktsar Sahib.

MATERIALS AND METHODS:

Objectives:

a) To evaluate the effectiveness of the Structured Teaching Programme regarding the knowledge of HIV/AIDS among the adolescent girl students.

b) To find out the association between the selected demographic variables and knowledge about HIV/AIDS among the adolescent girl students.

HYPOTHESIS:

H₁: There will be significant difference in the posttest knowledge scores as compared to pretest knowledge scores among adolescent girl students related to prevention and control of HIV/AIDS.

H₀: There will be no statistically significant association between the levels of posttest knowledge scores of adolescent girl students in relation to the selected demographic variables.

METHODOLOGY:

A Quasi-experimental approach was employed to conduct the present study to assess the effectiveness of structured teaching programme on the prevention and control of HIV/AIDS. A Single group, pretest-posttest design was employed to carry out the study. The study was conducted in the Guru Nanak Girls School, Tibbi Sahib Road, Sri Muktsar Sahib, Punjab, India. Target population of the study was all the adolescent girl students studying in schools located at Sri Muktsar Sahib, Punjab available in the month of January, 2010. A total of 50 adolescent girl students from 11th and 12th standard were taken. Random sampling technique was adopted to select the study subjects.

For the purpose of conducting this study, a teaching tool i.e. a Structured Teaching Programme on the prevention and control of HIV/AIDS for the adolescent girl students was developed as well as a knowledge assessment tool/questionnaire was developed based on Structured Teaching to evaluate the pretest and posttest knowledge scores.

Prior to the development of the tool the investigator consulted the experts in the field of nursing, medicine, oncology and pathology. Questionnaire consists of two parts: Part A: It consisted seven items of demographic data (1-7). Part B: It included 30 (thirty) multiple choice questions, each having 4 (four) alternatives, with 3 (three) distracters and 1 (one) correct answer. Each item of the questionnaire was scored for the correct as well as for the incorrect response. Score 1 (one) was assigned to the correct response and 0 (zero) to the incorrect response. The total score of the questionnaire ranged from 0-30. According to the scores obtained by the study subjects, they were categorized into very good (25-30), good (19-24), average (13-18), poor (7-12) and very poor (0-6) level of knowledge. Before conducting the final study, a pilot study was conducted during the month of December 2010, to find out the practicability and feasibility of the tool.

The reliability of the questionnaire was calculated by using Split-half Technique. Karl Pearson’s coefficient of correlation was used to determine the correlation between the test and retest and it was found to be “r=0.97” which was highly significant. The data was collected in January, 2011 at Guru Nanak Girls School, Tibbi Sahib Road, Sri Muktsar Sahib, Punjab.

RESULTS:

As depicted in table-1, from the sample of 50 subjects, majority 22 (44%) each of the subjects, were in the age group of 15-16 and 16-17 followed by 4 (8%) in the age group of 17-18 years and the remaining 2 (4%) in the age group of 14-15 years. 26 (52%) subjects belonged to first birth order followed by 19 (38%) in second birth order, 4 (8%) in third birth order and only 1 (2%) belonged to fourth in the birth order. Maximum 33 (66%) of subjects were studying in 11^th standard and rest 17 (34%) belonged to 12^th standard. Majority 39 (78%) of subjects were living in rural area followed by 10 (20%) in urban area and only 1 (2%) belonged to the sub-urban area. Majority 29 (58%) were living in a joint family while other 21 (42%) were living in nuclear families. No subject was living in an extended family. The monthly family income of majority 21 (42%) subjects was Rs.5001-10000 followed by 13 (26%) whose monthly family income was Rs.10001-15000 and 8 (16%) each belonged to the monthly family income group of Rs.<5000 and Rs. >15000 respectively. Majority 41 (82%) of students gained knowledge on HIV/AIDS from Books/ Magazines/ Newspapers while 8 (16%) got same from films/ T.V. and the remaining 1 (2%) from peer group. None of the subjects had ever attended any role play or educational programme on HIV/AIDS.

TABLE-1: Percentage distribution of demographic characteristics of the subjects. N = 50

CHARACTERISTICS OF THE SUBJECTS	FREQUENCY (n)	PERCENTAGE (%)
1. Age (in years)
a) 14-15	2	4
b) 15-16	22	44
c) 16-17	22	44
d) 17-18	4	8
2. Birth order in family
a) 1^st	26	52
b) 2^nd	19	38
c) 3^rd	4	8
d) 4^th	1	2
3. Educational status
a) 11^th standard	33	66
b) 12^th standard	17	34
4. Habitat
a) Rural	39	78
b) Urban	10	20
c) Sub-urban	1	2
5. Type of family
a) Nuclear	29	58
b) Joint	21	42
6. Monthly family income
a) <5000	8	16
b) 5001-10000	21	42
c) 10001-15000	13	26
d) >15000	8	16
7. Source of information about HIV/AIDS
a) Books/Magazines/ Newspaper	41	82
b) Films/T.V.	8	16
c) Peer group	1	2

Table-2 depicts that the value of mean posttest knowledge scores (22.94) of subjects regarding prevention and control of HIV/AIDS after administration of Structured Teaching Programme was significantly higher than their mean pretest knowledge score (12.64) with a mean gained knowledge score of 10.30 which was highly significant (p<0.01).

Table-2: Comparison of means of pretest and posttest knowledge scores of the subjects regarding prevention and control of HIV/AIDS. N = 50

N	MEAN KNOWLEDGE SCORES				t-value	p-value
	Pre-test		Post-test
	Mean	S.D.	Mean	S.D.
50	12.64	2.648	22.94	2.903	20.176**	0.01

**Highly Significant at 1% level

As indicated in table-3, in pretest, majority 29(58%) of subjects secured average knowledge scores followed by 20 (40%) who were having poor knowledge scores. Only 1(2%) subject had very poor knowledge score. None of the subject had secured good or very good level of knowledge scores in pretest. After administration of Structured Teaching Programme, the level of knowledge scores of study subjects increased as the result of posttest almost shows half of the subjects 26 (52%) achieved good level of knowledge score followed by 18 (36%) who attained very good level of knowledge. Only 6 (12%) were having average level of knowledge score. None of the subjects were found to be having poor or very poor level of knowledge scores.

Table-4: Association between the levels of posttest knowledge scores of the subjects and their selected demographic variables.

Selected demographic Variables	Levels of posttest knowledge scores					Chi-square Value	p-value
Selected demographic Variables	VG	G	A	P	VP	Chi-square Value	p-value
Age (in years)
14-15	01	01	00	00	00	4.414^NS	p>0.05
15-16	05	14	03	00	00
16-17	10	09	03	00	00
17-18	01	03	00	00	00
Educational status
11^th Standard	09	19	00	00	00	3.437^NS	p>0.05
12^th Standard	09	07	01	00	00	3.437^NS	p>0.05
Type of family
Nuclear	08	18	03	00	00	2.861^NS	p>0.05
Joint	10	08	03	00	00	2.861^NS	p>0.05
Monthly family income (in Rupees)
< 5000	04	04	00	00	00	8.449^NS	p>0.05
5001-10000	07	13	01	00	00
10001-15000	04	07	02	00	00
> 15000	03	05	03	00	00

VG: Very Good (25-30); G: Good (19-24); A: Average (13-18); P: Poor (7-12); VP: Very Poor (0-6);

NS: Not Significant at 5% level

DISCUSION:

Table 2 depicts the interpretation of H₁hypothesis indicating that H₁ hypothesis stands accepted as there was highly significant (p<0.01) difference in the posttest knowledge scores among the adolescent girl students compared to their pretest knowledge scores.

Table 4 illustrates that H₀hypothesis was retained as the association between the adolescent girl students’ knowledge scores and their age (in years), educational status, type of family and monthly family income (in Rupees) was found to be statistically insignificant (p>0.05).

The above findings are supported by study conducted by Udumala.⁶ In her study after implementing AIDS Education Programme (AEP) on adolescent girls in Guntur district of Andhra Pradesh, India, she found it very effective in increasing knowledge as the knowledge scores increased to 94.35% with a gain of 31.41%. There was a significant difference between mean posttest knowledge scores (141.52) and mean pretest knowledge scores (97.63). A similar study was undertaken by Kokilawani⁷ on high school students at Acharapakkam, Tamil Nadu who found that structured teaching programme which she administered brought excellent changes in their level of knowledge. The result shows that in pretest, 78% had moderate knowledge, 14% had adequate knowledge and 8% had inadequate knowledge. In the posttest, 92% had adequate knowledge and 8% had moderate knowledge regarding AIDS.

CONCLUSION:

From the findings of the present study, it can be concluded that administration of the Structured Teaching Programme on the adolescent girl students regarding the prevention and control of HIV/AIDS was effective.

REFERENCES:

1. List of countries by HIV/AIDS adult prevalence rate. From Wikipedia, the free encyclopedia. [Internet]. 2011 [updated 2011 Mar 13; cited 2011 May1]. Available from:http://en.wikipedia.org/wiki/List_of_countries_by_HIV/AIDS_adult_prevalence_rate

2. Worldwide HIV & AIDS Statistics. [Internet]. 2011 [cited 2011 May1]. Available from:

3. http://www.avert.org/worldstats.htmGovernment of India Ministry of Health & Family Welfare. NACO Press release HIV estimates in India. [Internet]. 2010 Dec.1 [cited 2011 May1]. Available from: http://www.nacoonline.org/upload/HomePage/NACO%20Press%20Release%20on%20HIV%20Estimates.pdf

4. Overview of HIV in Punjab. (Till Feburary 2011). [Internet]. 2011 Feb [updated 2011 Mar; 20 cited 2011 May1]. Available from:http://www.punjabsacs.org/OverViewHIV.aspx

5. Muktsar. From Wikipedia, the free encyclopedia. [Internet]. 2011 Mar [updated 2011 Mar 20; cited 2011 May1]. Available from: http://en.wikipedia.org/wiki/Muktsar

6. Udumala Vijya M. The effectiveness of an AIDS Education Programme to Adolescent Girls in Guntur District of Andhra Pradesh, India. Nightingale Nursing Times. 2008; 3(12): 12-6.

7. Kokilawani N. Effectiveness of structured teaching programme on awareness of AIDS among the higher secondary school students. Journal of Nursing Research Society of India. 2008; 1(3):4-7

Received on 31.10.2017 Modified on 16.11.2017

Int. J. Nur. Edu. and Research. 2018; 6(1): 93-97.

DOI: 10.5958/2454-2660.2018.00023.6

LEVEL OF KNOWLEDGE SCORES	PRETEST		POSTTEST
LEVEL OF KNOWLEDGE SCORES	Frequency (n)	Percentage(%)	Frequency(n)	Percentage(%)
Very Good (25-30)	0	0	18	36
Good (19-24)	0	0	26	52
Average (13-18)	29	58	6	12
Poor (7-12)	20	40	0	0
Very Poor (0-6)	1	2	0	0