5.1 Research Findings:

This chapter presents the summary of findings, conclusions drawn from the study recommendation for future research and discussion plan for dissemination.

An exploratory educational intervention study was conducted among secondary school adolescents of two government secondary schools in Ilam District. This study is intended to assess knowledge and attitude regarding HIV/AIDS. A structured teaching programmes was conducted for the students of class 9th and 10th to find out the change in the knowledge and attitude of secondary school adolescents regarding HIV/AIDS. The sample size was 170 including the students of two secondary schools of Ilam district.

The all obtained data, were thoroughly analysed and interpreted on the basis of objective and hypothesis of the study. The major study findings are discussed in this chapter. The pretest findings are related to the first objective of this study and the post test results are concerned with the second objective.

In pretest the existing knowledge of the respondents about HIV/AIDS was moderately adequate, that is 80.58%. Although misconceptions and confusion regarding non-sexual transmission or routes of HIV, Signs and symptoms and treatment noticed at a considerable level.

Out of 170 adolescents, 35 of them were exposed previously on HIV/AIDS programme. Majority of them had moderately adequate knowledge during pretest. It shows that seminar workshop and awareness rally about HIV/AIDS prevention could play an important role in the general public to increase the level of awareness towards HIV/AIDS.

Almost all adolescents had heard about HIV/AIDS. It is congruence with the result of the study done by Sharma Mahesh, Poudel Krishana and Poudel Kalpana (2000). They found that almost all boatman (98%) had heard about HIV/AIDS.

Radio- 72.32%, Television- 54.70% and poster - 37.64 seem to be powerful for mass education than others such as interaction among friends and newspapers seventy two point thirty five percent (72.35%) of the adolescents had radio and 54.70% of them had a television in their home for receiving information. Baseline study conducted by STD/HIV prevention programme (1996) found that radio and television were the main sources of information. It was also found that poster was another powerful media by means of which many students came to know about HIV/AIDS. that it was also expressed by students that they liked to watch TV and movies more than reading newspapers and magazines Twenty Three point fifty two percent (23.52%) of them had heard about HIV/AIDS from friends . Peer education seem to be more appropriate means of communication to convey specific information and which allows students to express their feelings and concerns about HIV/AIDS. That can serve as the first point of information.

In pretest only 25.3% of the adolescents knew about the full form of AIDS. In discussions with students about the distinction between AIDS and HIV, they had a lot of confusion between the term HIV and AIDS. Similarly low percentage 39.4% of the adolescents stated the data of first reported AIDS patients in world only 14.70% of them were able to state the date of first reported AIDS patient in Nepal. It shows that adolescents lacked general knowledge on HIV/AIDS. This might be the impact of mass media which concentrates more on preventive aspects rather than details of it .

In pretest very low percentage 19.4% of the adolescents mentioned that AIDS is life-threatening disease, preventable as well as contagious disease.

Majority of the students (82.35%) knew the causative organisms of AIDS. Almost all adolescents were aware that HIV/AIDS is prevalent in Nepal and majority of them (82.35%) said that AIDS patient need not to be isolated. This is also due to the effect of powerful mass media which concentrates more in explaining about its fatality, its preventive measures and also it gives the fact about the prevalence in Nepal.

Ten percent (10%) of the adolescents expressed that sex workers, drug abuser, unfaithful to their sex partners were cited as the groups at the greatest risk of contracting the virus.

During pretest overall knowledge about HIV/AIDS was good among adolescents but had considerable misconceptions were still frequent. Eighty one point seventy six percent (81.76%) of the adolescents were aware that HIV/AIDS is spread by sexual contact that is probably due to the effect of mass media which gives more importance on the spread of infection by sexual contact .

Majority of the adolescents (82.25%) were aware that HIV infected mother can transmitted the infection to unborn foetus during pregnancy Sixty four point seventy percent (64.70%) of them said that breast feeding also transmits HIV/AIDS. Even though they were not aware of the underlying Pathophysiology, they knew that the child may also get affected through the infected mother.

Eighty four point seventy percent (84.70%) of the adolescents said that HIV/AIDS can be transmitted through common use of syringe by drug abuser. This may be due to information about the prevalence of HIV among intravenous drug users (IVD US) in Nepal. Very low percentage 17.05% of the adolescents knew HIV/AIDS could be transmitted by deep kissing with HIV infected person. It may be due to mass media, which gives importance that HIV/AIDS spreads through sexual contact than other mode of transmission.

Most of them who knew about HIV, had some false beliefs about the mode of transmission that HIV could be contracted through the touch with AIDS patient 8.23%, hugging with AIDS patient-17.64%, sitting together using common toilets, swimming pool - 11.17% and bites of insects 31.76%. Incidental information that they got from their friends, magazines and mass media might miss lead sometimes. It is because mass awareness cannot convey clear and enough massage.

Nine point forty one percent 9.41% of the female adolescents had not heard about condom. Those who knew about condom (24.70%) knew that it is used for family planning purpose only and 29.41% of them knew about the protective value of condom against STD. About 9.41% of female adolescents didn't response this statements. It shows girls are more shy to answer explicit questions relating to sexual behavior and STD/HIV.

The majority of them , knew accurately that using condom during sex, being faithful to one another, avoiding multiple partners, using only sterilized equipment avoid taking drug through contaminated syringe can help to prevent the spread of AIDS. But very low percentage 41.76% of them were aware about transfusion of safe blood and only 34.70% of the adolescent were aware of homosexual activities. The fact behind this result is homosexuality is not openly acceptable in Nepal unlike in western countries.

In pretest 25.88% of them know about sign and symptoms of disease and 8.82% of adolescents were familiar about the Elisa is the confirmatory test for AIDS and 6.47% of them mentioned westron blot. Only 22.35% of them knew about window period and 40.58% of adolescents knew asymptomatic state of AIDS. Moreover, the test for HIV/AIDS, sign and symptoms are not propagated through mass media education at school is limited in certain aspects. So there is no chance of knowing this until and otherwise they have undergone any study programme on AIDS.

The majority of them did no know about the treatment available for HIV/AIDS and 60.58% of them did not know that treating a new born baby within 48hrs with AZT reduces the risk of transmission of HIV/AIDS from HIV infected mother. About 25.29% of students believed AIDS could be cured.

Around 30% of adolescents mentioned that there is medicine (AZT) available for curing HIV/AIDS. Medicine available for curing HIV/AIDS makes them to perceive AIDS is a curable disease.

Overall findings about knowledge of adolescents towards HIV/AIDS was found during pre test.

Besides the level of knowledge the attitudinal questions also revealed considerable difference. Male's attitudes towards HIV/AIDS were found more positives than female. In comparing the statements by respondents from both genders. It became clear that the male respondents expressed their opinions clearly while only some of female students did not response the statements. Mostly female adolescents were rather indecisive about agreeing or disagreeing with a statement.

5.1.1 Major Demographical Findings of the respondents.

1.1 Out of 170 respondents, 94 of them were from class 9 and 76 were from class 10th. The number of female students were 95 where as male students were 75.

1.2 Out of 17 respondents, 114 students were of between the age of 16-18 years, 46 were between the age of 13-15 years and remaining 10 were between the age of 19 to 21 years.

1.3 Majority of students were Brahmin–fourty three point thirty five percent (43.35%) followed by Chhetri– 14.70%, Rai – 10.58%, Limbu – 8.82%, newar 5.88 % and others were 17.64% which includes Magar, Tamang, Gurung, Kami and Damai.

1.4 Ninety two point thirty five percent (92.35%) of students belongs to Hindu and only seven point sixty four percent were Buddhist.

1.5. Majority of students fifty seven point sixty four percent (57.64%) were from rural area and forty two point thirty five percent (42.35%) were from urban area.

1.6 Fifty five point two percent (55.2%) students wee from joint family and 44.7% were from nuclear family.

1.7 The family income of majority (91 students) was below Rs. 4000 per month, however the family income of 41 students was Rs. 4000-7000, the income of 18 of them was Rs. 7000-10000 and only remaining 20 respondents family income was above 10,000.

1.8 Among the 170 respondents their mothers occupation varies like this agriculture 81.17% business – 7.05%, 5.88% and service– 2.35% unfortunately 3.52% of respondents did not response this question.

1.9 Father's occupation, Agriculture 69.41 % service 24.11 % and business 6.47%.

1.10 Educational status of mothers; 43.52% were illiterate, primary level 31.17%, middle school – 15.29%, High school level – 3.52% and campus 2.94% only. for 3.52% of the students did not response this questions.

1.11 Educational status of fathers; 22.94% were illiterate primary education 26.47% middle school 27.05% high school 8.82% and campus 14.7%.

1.12 The source of information on HIV/AIDS for the respondents were
72.35% –radio, 54.70% – T.V, 38.82%– magazines, 29.17%– newspapers.

5.1.2 Research Hypothesis:

The investigator stated the hypothesis that school students who were exposed to a structured teaching program will have improved knowledge and develop positive attitude towards the people with HIV/AIDS.

The study revealed that there was a big improved test scores in overall knowledge and attitude scores after structured teaching. In the post test, it was found that the misconception of school students regarding, spread, diagnosis treatment and prevention of AIDS had been clarified and the knowledge about the cause of AIDS. sign and symptoms treatment and prevention had been improved significantly. The overall attitude of students towards HIV/AIDS had been adequately changed into positive towards HIV/AIDS.

This supports hypothesis that was selected by the researchers at the time of proposal writings.

This study is also consistent with the conceptual framework based on Newman's system theory. The input proved to be effective in departing the knowledge and changing attitude of school students on HIV/AIDS.