**7. Effectiveness of school education against HIV/AIDS**

Health literacy is explained by competence in critical thinking and problem solving, responsible and productive, self-directed learning, and effective communication. School health education is to teach students the information and skills they need to be literate and maintain and improve their health, prevent disease and reduce their health-related risk behaviors, including those related to HIV/AIDS. School planned comprehensive curricula, covering health education and promotion, including HIV infection prevention, now represent a prerequisite. Students should comprehend concepts related to HIV/AIDS prevention and health protection and promotion. Schools and universities are settings that most children and many young people, respectively, attend. This provides an opportunity for knowledge and skills provision and accordingly for changing behaviors and modeling healthy practices. Therefore, schools and universities are a crucial setting for health promotion and HIV/AIDS control.

Schools and universities represent an effective and efficient means to reach a large proportion of young people and, in turn, their families and communities (Kore et al., 2004; Naidu & Aparna, 2008). Several researchers proved that students' HIV/AIDS education interventions improve knowledge (Svenson et al., 1997; UNAIDS, 2008; Ahmed et al., 2009). This in turn increases personal concern about the risk and possible disease contraction, and thus leads to disease prevention behavior. Educated students succeeded in developing skills for negotiating prevention and risk reduction, and resisting peer pressure to engage in riskrelated behaviors (Becker & Maiman, 1975; Hingson et al., 1990; Svenson & Varnhagen, 1990; Svenson et al., 1997). Nevertheless, other researchers reported that school or university education courses do not necessarily affect students' behaviors (Baldwin et al., 1990; DiClemente, 1992).

The International Union for Health Promotion and Education (IUHPE, 1999) demonstrated that schools are cost-effective sites for health promotion interventions. The effectiveness and sustainability of school health is governed by how closely health promotion interventions are linked to the primary business of schools in developing the educational skills and knowledge base of young people. Schools can create an educated population who are the better able to make use of any health education they receive in later life from sources such as newspapers, magazines, books and booklets or leaflets. Provision of education concerning sexual health and of HIV/AIDS education is best started at school. The United Nations Program on HIV/AIDS (UNAIDS, 1999) showed that responsible and safe behavior can be learned. Reaching the adolescents as early as possible is arguably the highest HIV/AIDS prevention priority. This includes protection from other sexually transmitted diseases.

## **8. Appropriate students HIV/AIDS education**

Students empowerment, including teaching of appropriate skills, combined with proper provision of HIV preventive knowledge and acquiring healthy attitudes, can motivate practicing healthy behaviors even when students are outside of the school or university setting (Svenson et al., 1997). Several health issues, such as HIV/AIDS control, can be integrated within and into the different subjects, including biology, sociology, environment,

also to assess attitudes towards prevention and treatment. It was to identify differences in knowledge and attitudes by gender and by different medical sciences faculties; medicine, pharmacy, dentistry and medical technology. The study was also designed to identify areas of misconceptions, gaps in knowledge and discussion, as well as, conclusions and

Study ethical approval was obtained from the local Scientific Committee, at the Faculty of Pharmacy, University of Zawia, Zawia, Libya, on March 2010. A WHO approved, pre-tested and previously utilized standard closed-end questionnaire was used. The questionnaire included 39 statements, divided to three parts. These are general knowledge about HIV/AIDS, knowledge on the routes of transmission and attitudes towards prevention and treatment. The questionnaire was piloted for feedback and validation. Simple random sampling method was applied to recruit 400 final year (BSc) university students, 100 from each faculty. These are faculties of medicine, pharmacy, dentistry and medical technology. The targeted participants were requested to tick their gender and to tick one of the given choices in front of each statement; 'Yes', 'No' or 'I don't know'. Then, only the response of the correct answer was considered. The answer 'I don't know' was considered as a wrong answer. The questionnaire was self administered by the participants colleagues, within their regular university classes, during May 2010. Study objectives and method were explained to each. Verbal consent was obtained accordingly. Validity and reliability of attitude measuring questions were found satisfactory. Questionnaires were answered anonymously and confidentiality was assured.

Fifteen minutes were given to each participant to complete the questionnaires.

All data were statistically described and analyzed with the statistical package for social sciences (SPSS) for windows, version 13.0. Data obtained were evaluated by frequency and percentage of responses of correct answers, and *t*-test was used to find the difference at *p*

The 100 handed over questionnaires in each faculty were completed and returned. Total returned questionnaires were 400. Males represented 16.75% of all study participants; 23% at the faculty of medicine, 12% at the faculty of pharmacy, 16% at the faculty of dentistry and 16% at the faculty of medical technology. Percentage of responses of correct answers in all faculties participants was 74.21%. Percentages of responses of correct answers were 72.1%, 69.2%, 75.8% and 74.6% in the faculties of medicine, pharmacy, dentistry and medical technology respectively. Comparison of responses to groups of statements according to faculties is given in Table 1. Percentages of responses of correct answers of students of the four faculties to all given statements are shown in Table 2. Responses comparison (in terms of Mean

+SD & range in parenthesis), among the four studied faculties, is presented in Table 3.

Several studies and surveys, in different parts around the globe, have attempted to assess knowledge and attitudes related to HIV/AIDS among university students. To the authors'

recommendations on the basis of outcomes.

**9.3 Methods** 

**9.4 Statistical analysis** 

value < 0.05.

**9.5 Results** 

**10. Discussion** 

physical education, economics, mathematics and languages or linguistics. In addition to classroom lessons and activities, practical in-school and in-community activities and programs have to be organized. Examples include the school club, the school theatre, the school fraternity, the scouts activities and the local community cultural and entertainment programs. In addition to these, schools and universities influence students, through the values they teach, including respect, gender equality and human rights. Education settings can also create an environment that is safe from abuse and fosters understanding, caring and no-discrimination. These are well applied within the concept of 'health-promoting schools'. Furthermore, the student-to-student, child-to-child and peer-led projects or programs encourage the adolescents to undertake community projects. Older and trained peers can be selected as health guides and are then involved in teaching other pupils. The involvement of adolescents themselves in developing messages and approaches is a critical element. The UNAIDS (1999) has demonstrated that these projects and programs have greater credibility and acceptance.

Internations and intercommunities differences, including cultural and religious perspectives, need to be taken in consideration when deciding on the timing for the introduction of components of reproductive health and HIV/AIDS education in schools and universities. A number of other factors will also need to be considered when defining the minimum set of interventions that can be implemented, including the reality and diversity of educational settings, capacity of education system, levels of enrollment and retention and the continuum of the system. The strategies to increase the knowledge of children and youth to prevent and control HIV/AIDS will be highlighted at the "Discussion" section of this chapter.

An important base for designing proper prevention programs is to assess people's knowledge and attitudes towards HIV/AIDS. University students, especially in medical faculties, represent a primary resource. A number of studies have been conducted in several countries to assess medical students' knowledge and attitudes about HIV/AIDS. However, to the authors' knowledge, this is the first study to include Libyan university students at the final year of the faculties of medical sciences.
