HIV/AIDS awareness in schoolgoing adolescents

Objectives: To assess the awareness of school children regarding Human immunodeficiency virus[HIV] to devise strategies or subjects for future programmes and to provide suggestions for school HIV education. Methodology: As about 11 schools were taken in study, 7 were government schools and 4 were Private schools. 7 from the urban areas and 4 from the rural areas. In a school 40 – 50 students were surveyed. Total 489 students were divided in different age group i.e. 10-13 year, 14-16 year and 17-19 year, males and females, students were also studied in division of rural and urban group. The students were administered a pre-designed proforma, which included multiple choice questions. Results: In our study 489 students scored 65.4% in knowledge about disease, 57.5% in knowledge in complication of disease, 59.9% in knowledge about prevention of disease, 66.8% in knowledge about treatment of disease, 48.5% in knowledge about etiology of disease and 39.1% in knowledge about medico legal aspect of disease. Conclusion: The study showed tremendous lacunae in awareness of all Reproductive Health (RH) matters. There is a need for evolving information, education, and communication strategies to focus on raising awareness on RH and gender related issues. A sociocultural research is needed to find the right kind of sexual health services for young girls and boys


Introduction
Adolescence is a crucial period for healthy development in both psychological and physical terms. It is a stage of development transition, i.e. a bridge between childhood and adulthood. It is the stage of development of adult mental process and about adult identity and transition from total socioeconomic dependent to relative independent.
The WHO has defined adolescence as: A. Progression from appearance of secondary sex characteristics (puberty) to sexual and reproductive maturity. B. Development of adult mental processes and adult identity. Studies have reported that young people form a significant segment of those attending sexually transmitted infection (STI) clinics and those infected by HIV [1]. Program managers and policy makers have often recommended that schools can act at the center point for disseminating information and education on HIV/ AIDS. Hence school education has been described as a. social vaccine [2] and it can serve as a powerful preventive tool. In India, there is a wide gap between the inputs in the HIV/AIDS curriculum for schools and the actual education that is imparted [3].

Methodology
The present study was conducted in department of paediatrics, S.S.M.C. REWA, MP Schools are ideal locations to conduct study on adolescents as they offer the opportunity to access young people of different social and ethnic backgrounds under similar circumstances. As around 10 -19 years of school going children belonging to IX to XII standard were included in study. All students were studying the books of Madhya-Pradesh board and

Original Research Article
Pediatric Review: International Journal of Pediatric Research Aailable online at: www.pediatricreview.in 734|P a g e medium of study was Hindi in all enrolled Schools. The study was conducted over a period of 4 months from 2 nd July 2016 to 30 th October 2016. The schools were selected from the different parts of city and rural areas keeping in mind that these schoolsrepresent sample from the different age group, religion, different geographical locations, socio economic and family back grounds.
As many as 11 schools were taken in study, 7 were government schools and 4 were Private schools. 7 from the urban areas and 4 from the rural areasafter explaining the purpose of the study to them and written consent was obtained from their respective principals. The principals were informed earlier about the date of programme and thereafter conveyed to students.
The students were administered a pre-designed profarma, which included multiple choice questions. The response rate of students was 100%. Question paper was given in presence of teachers to prevent cheating and discussion among students.
The question paper did not include the name of students, so as to make her/him free of pressure of low score. While collecting the filled Proforma it was ensured that entries were complete.
In a school 40 -50 students were surveyed. All 489 students were divided in different age group i.e. 10-13 year, 14-16 year and 17-19 year, males and females, students were also studied in division of rural and urban group.

Results
The present study was conducted in department of pediatrics, S.S.M.C. REWA. In the study 489 students were included in study from both rural and urban schools. The study was done in 4-month course from 2 nd July 2014 to 30 th October 2014 in government and private schools of Rewa. All 489 students were divided gender, age group and residence.
The students were given a set of questions which shows knowledge about disease, complication of disease, Treatment of disease, Etiology of disease, and attitude and medicolegal aspect of adolescent towards HIV infected patient.
Here, K/D = knowledge about disease, which includes question no. 2,3,4,9,10, And question no. 1 shows where from the adolescent came to know about HIV/AIDS In our study there are 95 students belonged to rural areas they scored respectively 64.7% in K/D, 49.8% IN K/C, 62% in KP, 71.9% in K/T, 42.7 in KE, and 37.1% in medico legal issues while urban their respective scores are 65.5%, 59.3%, 59.3% 65.6%, 47.3% and 39.5% in K/D, K/C, K/P, K/T, K/E and K/ML respectively so their scores are better than rural participants. Except in preventive measures where rural students are more aware. Most common source of knowledge are television, books and teacher and least common are family, friend and internet. Statistical Analysis-Data was analyzed using SPSS 20 statistical package. A descriptive analysis was done on all variables to obtain a frequency distribution. The mean + SD and ranges were calculated for quantitative variables. Continuous variables were compared by the Student t test. Proportions were analyzed with the chi-square test. A P value of 0.05 or less was considered statistically significant.

Discussion
Adolescence is a period of significant growth spurt and maturation. WHO defines adolescence from age 10 th to 19 th year. In India, different policies and programs define adolescents differently. The Integrated Child Development Services (ICDS) program considers adolescents between 11 to 18 years. Adolescent should be recognized as a special target group for providing health care. They bear the right to have a complete and detailed knowledge and information relating to their development, health and sensitive sexual issues The study aimed to improve the health awareness, to suggest the sex education and remove the myths and mis-conception about HIV/AIDS. In our study we enrolled 489 adolescent belonging to rural as well as urban areas. The schools were selected from the different parts of city and rural areas keeping in mind that these schools will represent sample from the different age group, religion, different geographical locations, socio economic and family back grounds.
The students were administered a pre-designed proforma, which included multiple choice questions. The response rate of students was 100.While collecting the filled proforma it was ensured that entries were complete. In a school 40 -50 students were surveyed. Most common source of knowledge are television, books and teacher and least common are family, friend and internet. For syphilis, gonorrhoea and herpes only awareness was assessed Despite knowing that use of condoms helps protect against contracting an STD, some adolescents still regard condoms primarily as an interim method of contraception before using the pill. Authors concluded that Sexually transmitted diseases (STDs) are a major health problem affecting mostly young people, not only in developing, but also in developed countries [1]. Only 19.8% of adolescents were aware of at least one method of contraception. Only two-fifth (39.5%) were aware of AIDS. And less than onefifth (18%) were aware of STDs and most of them thought it is same as AIDS [2].
Esere MO studied theeffect of sex education programme on at-risk sexual behaviour of schoolgoing adolescents in Ilorin, Nigeria.Compared with the control group, this specially designed intervention sex education programme reduced atrisk sexual behaviour in adolescents. Based on this finding, it was recommended that sex education be introduced in Nigerian schools [3].
James S, Reddy SP et al did a cross-sectional study among 1113 grade 11 students in 19 randomly allocated secondary schools. Data were collected through structured questionnaires and analyzed using the SPSS software package.The results confirm that knowledge levels were high for causes and spread of STIs and the participants were well informed about issues relating to protection against STIs and seeking treatment. However, there was significant deviation in reported behaviours.
This discrepancy between awareness and behavior calls for a reorientation of sexuality education to include those elements critical for behavioural change, such as addressing gender discrepancies and promoting skills for communication through planned intervention programmes [4].
In South Africa's HIV/AIDS epidemic, young people, especially women, are at high risk due to an apparent gap between awareness and practice. In repeated peergroup discussions with girls aged 14-15 and boys aged 16-19,Harrison A, Xaba N et al explored influences on safe sex behaviour. Separate male and female safe sex paradigms emerged, with boys less likely to perceive themselves as 'at risk' and more likely to use condoms. Girls had not used condoms, would have preferred to delay sexual relationships and feared pregnancy as well as HIV/AIDS. Overall, these findings point to the need for programmes to address gender inequalities and emphasizebehavioral skills in the years before sexual activity begins [5]. A sociocultural research is needed to find the right kind of sexual health services for young girls and boys. Though controversial, there is an immense need to implement gender-based sex education regarding STIs, safe sex options and contraceptives in schools in India [10].

Conclusion
The most common source of information was television i.e. most accessible. But those who came to know about HIV/AIDS from books have more comprehensive knowledge. The knowledge level are lesser in females of both rural as well as urban areas.
Overall rural students have lesser knowledge than urban. The students from the higher standard as well as higher age group have more knowledge and awareness than their following standard and age groups. Awareness is increased in rural areas also shown by comparing from the past studies.
The study showed tremendous lacunae in awareness of all Reproductive Health (RH) matters. There is a need for evolving information, education, and communication strategies to focus on raising awareness on RH and gender related issues. A sociocultural research is needed to find the right kind of sexual health services for young girls and boys. Though controversial, there is an immense need to implement gender-based sex education regarding STIs, safe sex options and contraceptives in schools in India.
Funding: Nil, Conflict of interest: None initiated, Perission from IRB: Yes