**10. Discussion**

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'

**Faculty of Pharmacy** 

66.1 +32.1 (12-100)

77.9 +23.0 (25-100)

52.3 +23.1 (31-92)

**All** 

0

**Faculty of** 

100. 0

**Medicine** 

**Faculty of** 

100. 0

30.0 11.0 12.0 22.0 75.0

37.8 38.0 29.0 39.0 31.0

41.3 37.0 23.0 37.0 36.0

85.8 88.0 87.0 89.0 79.0

89.8 94.0 88.0 86.0 91.0

82.3 84.0 77.0 84.0 84.0

74.8 68.0 76.0 80.0 75.0

95.5 99.0 96.0 94.0 93.0

36.3 41.0 39.0 35.0 30.0

**Pharmacy** 

**Faculty of** 

100. 0

**Dentistry** 

**Faculty of** 

100.0

**Medical** 

**Technology**

**Faculty of Dentistry** 

69.2 +29.5 (15-100)

81.5 +21.5 (32-100)

53.1 +20.4 (37-89)

**Faculty of Medical Technology** 

70.7 +28.4 (8-100)

83.1 +20.2 (29-100)

57.0 +20.3 (35-86)

**Medicine** 

(11-100)

(40-100)

(40-88)

Table 1. Comparison of responses to groups of statements according to faculties.

I have enough knowledge about AIDS 58.8 52.0 55.0 60.0 68.0 I know the name of the causative agent for AIDS 94.3 97.0 93.0 91.0 96.0

An HIV infected person can have no symptoms 86.0 86.0 81.0 92.0 85.0

I am aware how HIV is transmitted 98.0 99.0 98.0 99.0 96.0 I know the vulnerable groups of people to HIV 88.0 92.0 90.0 85.0 85.0

**Group of statements Faculty of** 

1. General knowledge 68.8 +31.5

2. Routes of transmission 83.2 +16.9

3. Prevention and treatment 63.6 +22.4

Data presented as Mean +SD, range in parenthesis. No statistical difference was found between groups.

*1. General knowledge*

after infection with HIV

the virus infection itself

disease complications

may infect others

disease itself

pregnant

infection

**Statements** 

Primary symptoms of AIDS occur immediately

HIV infected persons are expected to die because of

AIDS patients are expected to die because of the

AIDS patients are expected to die because of the

Someone who looks healthy but is HIV infected

It is possible that any ordinary person can get HIV

It is possible that any ordinary person can get HIV

HIV infected person becomes a source of infection

infection from someone who is infected

immediately after getting the infection

The HIV infected woman is able to become

I am aware about AIDS 100.

knowledge, this study was the first one in Libya to assess those of final year medical sciences students. Self administration of the questionnaire led to 100% response rate. Gender participation was representative of the faculties composition. The study revealed several interesting findings. All study participants (100%), in the four studied faculties, had heard of AIDS. Most (94%) believed that they are aware about the causative agent of AIDS and almost all (98%) indicated that they are aware how HIV is transmitted. However, they demonstrated lower level of deeper knowledge on routes of virus transmission. Moreover, only 58.8% of the participants indicated that they have enough knowledge about AIDS. Percentages of responses of correct answers of students of the different faculties have varied greatly, from 8% to 99%. Mean percentage of responses of correct answers in all faculties participants is 74%. For instance, within responses to statements related to general knowledge, only 13% of the study participants indicated that HIV infected person becomes a source of infection after some period of time from getting the infection. Moreover, only about a third believed that primary symptoms of AIDS do not necessarily occur immediately after infection with HIV. On the other hand, 96% knew that it is possible that any ordinary person can get HIV infection from someone who is infected, while more than 17% did not think that someone who looks healthy but is HIV infected may infect others.

Similar university students assessment studies that were conducted in several countries around the world showed similar results. These studies demonstrated lack of good knowledge on various aspects of HIV/AIDS and revealed the presence of apparent unease or lack of positive attitudes (Al-Owaish et al., 1999; Ahmed et al., 2009; Albrektsson et al., 2009). Kore and others (2004) found that knowledge and awareness about HIV/AIDS among university students is grossly inadequate. On the other hand, some studies found that most students have a relatively good knowledge, with positive attitudes, but with some misconceptions and risky behaviors (Svenson et al., 1997; Tan et al., 2007). Another study showed satisfactory findings, despite some disappointing facts on basic knowledge (Al-Jabri & Al-Jabri, 2003). Only 6% of the students, of Al-Jabri study, either thought that AIDS is not caused by HIV or they did not know. Most of the respondents to that study showed a moderate knowledge regarding the routes of HIV transmission. The earlier United Nations General Assembly Special Session (UNGASS) Libya Progress Report 2010 (UNAIDS, 2010) showed that 87% of Libyan students, aged 15-25 years, stated that they knew what HIV and AIDS are. Furthermore, Greenlee and Ridley (1993) found that only 61% of university students knew that HIV infected individuals do not necessarily lock sick.

In this current study, there was an uneven knowledge in the subcategories of routes of transmission of the virus. As high as 69% of the targeted students believed that mosquitoes are vectors of HIV and more than half of the students thought that it is risky to share swimming pools or toilets with infected people respectively. This might be due to the controversy of some of these modes of transmission and the lack of solid scientific evidence around some of them. Furthermore, almost all study participants pointed out that HIV is sexually transmitted, while only 92% agreed that homosexuality can lead to virus transmission. Almost all (98%) assumed that sharing drugs needles with an infected person represents a source of infection. On the other hand, 96% and about 90% knew that the virus can be transmitted by sharing razor blades or toothbrushes with an infected person respectively. Receiving blood from an infected person was seen by 97% as a possible source of infection. However, some of the studied students lacked knowledge regarding the relationship between sharing clothes, plates or cups with infected people and increased HIV transmission, at which about a quarter of them thought that the virus can be transmitted through these ways of sharing.

114 Social and Psychological Aspects of HIV/AIDS and Their Ramifications

knowledge, this study was the first one in Libya to assess those of final year medical sciences students. Self administration of the questionnaire led to 100% response rate. Gender participation was representative of the faculties composition. The study revealed several interesting findings. All study participants (100%), in the four studied faculties, had heard of AIDS. Most (94%) believed that they are aware about the causative agent of AIDS and almost all (98%) indicated that they are aware how HIV is transmitted. However, they demonstrated lower level of deeper knowledge on routes of virus transmission. Moreover, only 58.8% of the participants indicated that they have enough knowledge about AIDS. Percentages of responses of correct answers of students of the different faculties have varied greatly, from 8% to 99%. Mean percentage of responses of correct answers in all faculties participants is 74%. For instance, within responses to statements related to general knowledge, only 13% of the study participants indicated that HIV infected person becomes a source of infection after some period of time from getting the infection. Moreover, only about a third believed that primary symptoms of AIDS do not necessarily occur immediately after infection with HIV. On the other hand, 96% knew that it is possible that any ordinary person can get HIV infection from someone who is infected, while more than 17% did not think that someone who looks healthy but is HIV infected may infect others. Similar university students assessment studies that were conducted in several countries around the world showed similar results. These studies demonstrated lack of good knowledge on various aspects of HIV/AIDS and revealed the presence of apparent unease or lack of positive attitudes (Al-Owaish et al., 1999; Ahmed et al., 2009; Albrektsson et al., 2009). Kore and others (2004) found that knowledge and awareness about HIV/AIDS among university students is grossly inadequate. On the other hand, some studies found that most students have a relatively good knowledge, with positive attitudes, but with some misconceptions and risky behaviors (Svenson et al., 1997; Tan et al., 2007). Another study showed satisfactory findings, despite some disappointing facts on basic knowledge (Al-Jabri & Al-Jabri, 2003). Only 6% of the students, of Al-Jabri study, either thought that AIDS is not caused by HIV or they did not know. Most of the respondents to that study showed a moderate knowledge regarding the routes of HIV transmission. The earlier United Nations General Assembly Special Session (UNGASS) Libya Progress Report 2010 (UNAIDS, 2010) showed that 87% of Libyan students, aged 15-25 years, stated that they knew what HIV and AIDS are. Furthermore, Greenlee and Ridley (1993) found that only 61% of university

students knew that HIV infected individuals do not necessarily lock sick.

that the virus can be transmitted through these ways of sharing.

In this current study, there was an uneven knowledge in the subcategories of routes of transmission of the virus. As high as 69% of the targeted students believed that mosquitoes are vectors of HIV and more than half of the students thought that it is risky to share swimming pools or toilets with infected people respectively. This might be due to the controversy of some of these modes of transmission and the lack of solid scientific evidence around some of them. Furthermore, almost all study participants pointed out that HIV is sexually transmitted, while only 92% agreed that homosexuality can lead to virus transmission. Almost all (98%) assumed that sharing drugs needles with an infected person represents a source of infection. On the other hand, 96% and about 90% knew that the virus can be transmitted by sharing razor blades or toothbrushes with an infected person respectively. Receiving blood from an infected person was seen by 97% as a possible source of infection. However, some of the studied students lacked knowledge regarding the relationship between sharing clothes, plates or cups with infected people and increased HIV transmission, at which about a quarter of them thought


Data presented as Mean +SD, range in parenthesis.

No statistical difference was found between groups.

Table 1. Comparison of responses to groups of statements according to faculties.


(13-100) n= 23

(8-100) n= 12

(0-100) n= 16

(0-100) n= 16

(48-100) n= 23

(50-100) n= 12

(43-100) n= 23

(19-100) n= 16

(61-83) n= 23

(33-75) n= 12

(35-83) n= 23

(31-88) n= 16

Table 3. Gender distribution and comparison of responses to groups of statements.

68.2 +31.9 (10-100) n= 77

66.2 +32.7 (13-100) n= 88

67.6 +28.6 (13-100) n= 77

71.9 +27.1 (10-100) n= 84

82.7 +18.1 (34-100) n= 77

77.4 +23.9 (22-100) n= 88

81.5 +27.4 (16-100) n= 77

84.3 +19.1\* (31-100) n= 84

61.7 +27.7 (31-94) n= 77

51.8 +24.6 (27-94) n= 88

52.6 +21.7 (135-91) n= 77

57.8 +20.9 (36-86) n= 84

**Faculties Males Females** 

**Medicine** 70.6 +31.3

**Pharmacy** 67.1 +31.5

**Dentistry** 66.4 +36.4

**Medical Technology** 64.9 +36.4

**Medicine** 85.2 +15.4

**Pharmacy** 82.8 +18.7

**Dentistry** 82.8 +17.9

**Medical Technology** 73.6 +28.3

**Medicine** 71.2 +9.6

**Pharmacy** 55.5 +15.6

**Dentistry** 55.1 +17.2

**Medical Technology** 52.1 +19.7

Data presented as Mean +SD, range in parenthesis.

\*P < 0.05, t =2.5.

*1. General knowledge*

*2. Routes of transmission*

*3. Prevention and treatment*


Table 2. Percentages of responses of correct answers of students of the four faculties to the given statements.

Touching an HIV infected person 82.0 88.0 69.0 82.0 89.0 Sharing plates or cups with an infected person 73.5 74.0 64.0 86.0 70.0 Sharing clothes with an infected person 74.3 76.0 71.0 69.0 81.0 Sharing swimming pools with an infected person 53.8 68.0 49.0 45.0 53.0 Sharing toilets with an infected person 51.3 59.0 41.0 40.0 65.0 Receiving blood from an infected person 96.5 98.0 92.0 98.0 98.0

Sharing drugs needles with an infected person 98.0 99.0 96.0 100.

Making sex with an infected person 99.5 98.0 100.

Sharing razor blades with an infected person 95.8 95.0 97.0 93.0 98.0 Sharing toothbrushes with an infected person 90.3 87.0 90.0 93.0 91.0 Sharing cupping tools with an infected person 95.8 93.0 95.0 97.0 98.0 Sharing circumcision tools with an infected person 94.3 90.0 99.0 96.0 92.0 Being bitten by a mosquito 31.5 40.0 25.0 32.0 29.0 Mother to fetus 93.8 91.0 94.0 95.0 95.0 Mother to breastfed infant 64.8 65.0 61.0 69.0 64.0

Table 2. Percentages of responses of correct answers of students of the four faculties to the

**All** 

**Faculty of** 

98.5 100. 0

**Medicine** 

**Faculty of** 

13.0 15.0 14.0 15.0 8.0

**Pharmacy** 

95.0 100. 0

0

91.5 94.0 87.0 91.0 94.0

34.3 46.0 33.0 37.0 35.0

33.3 45.0 42.0 38.0 40.0

88.8 88.0 92.0 89.0 86.0

39.0 40.0 31.0 40.0 45.0

62.5 87.0 51.0 50.0 62.0

70.0 76.0 65.0 65.0 74.0

0

100. 0

**Faculty of** 

**Dentistry** 

**Faculty of** 

99.0

97.0

100.0

**Medical** 

**Technology**

**Statements** 

HIV infected person becomes a source of infection after some period of time from getting the infection

Sharing medications needles with an infected

Male making sex with an infected male

HIV infected persons should be isolated to avoid

AIDS patients should be isolated to avoid virus

Ordinary people can avoid the risk of HIV infection

Ordinary people can avoid the risk of HIV infection

Ordinary people can avoid the risk of HIV infection by

It is possible that HIV infected persons can be cured

by using condoms during sexual intercourse

*2. Routes of transmission*

person

(homosexuality)

*3. Prevention and treatment*

virus transmission to others

transmission to others

by behavior change

using the HIV vaccine

using relevant treatment

given statements.

The HIV virus can be transmitted by:


Data presented as Mean +SD, range in parenthesis. \*P < 0.05, t =2.5.

Table 3. Gender distribution and comparison of responses to groups of statements.

In this study, in general, there were no statistically significant differences, neither by faculty nor by gender, regarding the groups of statements of HIV/AIDS general knowledge, routes of transmission, or prevention and treatment. A small significant difference was found between males and females of the faculty of medical technology in respect to the group of statements related to the routes of transmission. Ahmed and colleagues' similar university students study (2009) revealed similar findings. However, other studies demonstrated some significant gender differences; some favored males and others favored females. For example, one study showed that only 36% of males have comprehensive knowledge about HIV/AIDS, whereas only 20% of females do so (IIPS & ORC Macro, 2008). On the other hand, Kore and others' study (2004) pointed out that 53% males and 62.0% females knew that AIDS is an infective communicable disease. The aetiology of AIDS, being the HIV virus was known by 55% male and 69% female students. Moreover, 18% and 13% male and female university students respectively thought that HIV is a bacteria (Kore et al., 2004). Albrektsson and colleagues (2009) have also found that female students had better

Being medical sciences university final year students, responses of this study participants are assessed by the study authors as unsatisfactory. Many of them do not have a good level of understanding and attitudes towards HIV/AIDS. Similarly, much research from around the world has demonstrated gaps in health care students knowledge about HIV transmission and patients' treatment. Moreover, some medical sciences university students hold negative attitudes and risk perceptions that could become barriers in their eventual professional care of HIV/AIDS patients (Ahmed et al., 2009). It can be argued that medical schools disease orient their students, and at the best, they risk-factor orient their students. They concentrate on clinical sciences and conduct their training programs on the various branches of curative medical services, at university hospitals. Many of the medical schools around the globe prepare doctors not to care for the health of the people or to promote the individual's or the community's health. They engage them in a medical practice that is blind to any thing but disease and the technology for dealing with it. Therefore, students get less orientation towards health promotion, health protection and

On the other hand, other researchers (Al-Jabri & Al-Jabri, 2003; Tan et al., 2007; Gopal et al., 2010) revealed that medical faculties' students acquired more accurate and complete information regarding HIV/AIDS, compared with students from other faculties including science. In fact, health professionals, in general, are at high occupational risk for contracting HIV, since they have a high exposure to HIV and AIDS patients. Therefore, health care students need to stay knowledgeable and aware of all relevant issues around HIV and AIDS and must receive an improved HIV/AIDS training. However, education against HIV/AIDS is not only required for medical and paramedical students, but also to a large extent, for all university level students, in addition to the basic education to those in the primary and

Findings of this study highlight the need for immediate general public education actions, within a wide comprehensive strategy. At which, if HIV/AIDS awareness is left unaddressed can permit the virus to spread considerably in the coming years. The most effective and efficient way to combat HIV/AIDS is through interventions for information, education and communication that target most at-risk populations and groups. Emphasis is

knowledge than male students.

disease protection.

secondary levels.

The present data are consistent with those of other studies (Al-Jabri & Al-Jabri, 2003; Tan et al., 2007; UNAIDS, 2010). UNGASS Libya Progress Report (UNAIDS, 2010) showed that there is a high degree of misconception amongst secondary school Libyan students with regards to modes of transmission and prevention. Only 42% of those previously surveyed students, aged 15-25 years, agreed that HIV can be transmitted through use of public toilets, while 31% stated that HIV infection can be transmitted by getting near to an HIV-infected individual while sneezing or coughing and 30% stated that HIV can be transmitted by looking after an HIV-infected individual (UNAIDS, 2010). Tan and colleagues (2007) demonstrated that most university students were also aware that HIV can be transmitted by unsafe sex (99%), by sharing needles with infected drug users (98%), or by receiving blood from an infected person (97%). However, only 90% agreed that swimming pools do not transmit the virus, and only 40% understood that mosquito does not carry risk. University students that were studied by Al-Jabri and Al-Jabri (2003) showed that they very strongly agreed that sex (98%) and drug needles (99%) are modes of virus transmission. However, 19% thought a person may get HIV by a mosquito bite and 46% believed that blood donation leads to a risk of infection.

In this present study, although about 90% thought that ordinary people can avoid the risk of HIV infection by behavior modification, a large proportion of the students had poor attitudes. Only 39% of them believed that condom use during sexual intercourse is essential for the prevention of HIV transmission. Furthermore, results revealed that there is a high level of stigma among the students towards HIV infected individuals. About two thirds agreed that isolation of HIV positive or AIDS patients is necessary to achieve protection. Negative attitudes regarding prevention misconceptions of HIV/AIDS reflect a false perception of the disease among these university students. On the other hand, the authors of this study see it is disappointing that about a third of the studied medical sciences university students thought that there is a vaccine to protect from the risk of HIV infection (37.5%) or that it is possible to cure an HIV infected person (30%).

These findings on university students attitudes towards HIV/AIDS are in line with those found by other researchers (Al-Jabri & Al-Jabri, 2003; Kore et al., 2004; Tan et., 2007; Ahmed et al., 2009; Albrektsson et al., 2009; UNAIDS, 2010). For instance, an earlier study revealed that 61% of the Libyan students strongly agreed or agreed that HIV infected individuals are dangerous and believed that they should be banned from entering into the country (UNAIDS, 2010). Moreover, about one third of Omani students believed that HIV infected individuals should be separated from others, and nearly a quarter of them thought that AIDS patients should always kept at hospitals, not at home (Al-Jabri & Al-Jabri, 2003).

This is probably because the conservative school education was not able to cover certain sensitive issues around HIV/AIDS. Moreover, mass media education could not be thorough enough and was not able to cover such issues. In addition, the coverage of such content in public remains low. The UNAIDS Report (2010) demonstrated that there is a lot of cultural sensitivity associated with the issue. There is a probable difficulty, even in permissive Western societies, to discuss sensitive issues related to HIV prevention, such as the importance of use of condoms, with the adolescents in schools. Hence, some specialists in the field call for a more liberal ideology can be promoted. Teachers and social workers require greater skills in tackling such sensitive issue areas, and as such students are may not be receiving the information that they need.

The present data are consistent with those of other studies (Al-Jabri & Al-Jabri, 2003; Tan et al., 2007; UNAIDS, 2010). UNGASS Libya Progress Report (UNAIDS, 2010) showed that there is a high degree of misconception amongst secondary school Libyan students with regards to modes of transmission and prevention. Only 42% of those previously surveyed students, aged 15-25 years, agreed that HIV can be transmitted through use of public toilets, while 31% stated that HIV infection can be transmitted by getting near to an HIV-infected individual while sneezing or coughing and 30% stated that HIV can be transmitted by looking after an HIV-infected individual (UNAIDS, 2010). Tan and colleagues (2007) demonstrated that most university students were also aware that HIV can be transmitted by unsafe sex (99%), by sharing needles with infected drug users (98%), or by receiving blood from an infected person (97%). However, only 90% agreed that swimming pools do not transmit the virus, and only 40% understood that mosquito does not carry risk. University students that were studied by Al-Jabri and Al-Jabri (2003) showed that they very strongly agreed that sex (98%) and drug needles (99%) are modes of virus transmission. However, 19% thought a person may get HIV by a mosquito bite and 46% believed that blood

In this present study, although about 90% thought that ordinary people can avoid the risk of HIV infection by behavior modification, a large proportion of the students had poor attitudes. Only 39% of them believed that condom use during sexual intercourse is essential for the prevention of HIV transmission. Furthermore, results revealed that there is a high level of stigma among the students towards HIV infected individuals. About two thirds agreed that isolation of HIV positive or AIDS patients is necessary to achieve protection. Negative attitudes regarding prevention misconceptions of HIV/AIDS reflect a false perception of the disease among these university students. On the other hand, the authors of this study see it is disappointing that about a third of the studied medical sciences university students thought that there is a vaccine to protect from the risk of HIV infection

These findings on university students attitudes towards HIV/AIDS are in line with those found by other researchers (Al-Jabri & Al-Jabri, 2003; Kore et al., 2004; Tan et., 2007; Ahmed et al., 2009; Albrektsson et al., 2009; UNAIDS, 2010). For instance, an earlier study revealed that 61% of the Libyan students strongly agreed or agreed that HIV infected individuals are dangerous and believed that they should be banned from entering into the country (UNAIDS, 2010). Moreover, about one third of Omani students believed that HIV infected individuals should be separated from others, and nearly a quarter of them thought that AIDS patients should always kept at hospitals, not at home (Al-Jabri & Al-Jabri, 2003). This is probably because the conservative school education was not able to cover certain sensitive issues around HIV/AIDS. Moreover, mass media education could not be thorough enough and was not able to cover such issues. In addition, the coverage of such content in public remains low. The UNAIDS Report (2010) demonstrated that there is a lot of cultural sensitivity associated with the issue. There is a probable difficulty, even in permissive Western societies, to discuss sensitive issues related to HIV prevention, such as the importance of use of condoms, with the adolescents in schools. Hence, some specialists in the field call for a more liberal ideology can be promoted. Teachers and social workers require greater skills in tackling such sensitive issue areas, and as such students are may not

(37.5%) or that it is possible to cure an HIV infected person (30%).

donation leads to a risk of infection.

be receiving the information that they need.

In this study, in general, there were no statistically significant differences, neither by faculty nor by gender, regarding the groups of statements of HIV/AIDS general knowledge, routes of transmission, or prevention and treatment. A small significant difference was found between males and females of the faculty of medical technology in respect to the group of statements related to the routes of transmission. Ahmed and colleagues' similar university students study (2009) revealed similar findings. However, other studies demonstrated some significant gender differences; some favored males and others favored females. For example, one study showed that only 36% of males have comprehensive knowledge about HIV/AIDS, whereas only 20% of females do so (IIPS & ORC Macro, 2008). On the other hand, Kore and others' study (2004) pointed out that 53% males and 62.0% females knew that AIDS is an infective communicable disease. The aetiology of AIDS, being the HIV virus was known by 55% male and 69% female students. Moreover, 18% and 13% male and female university students respectively thought that HIV is a bacteria (Kore et al., 2004). Albrektsson and colleagues (2009) have also found that female students had better knowledge than male students.

Being medical sciences university final year students, responses of this study participants are assessed by the study authors as unsatisfactory. Many of them do not have a good level of understanding and attitudes towards HIV/AIDS. Similarly, much research from around the world has demonstrated gaps in health care students knowledge about HIV transmission and patients' treatment. Moreover, some medical sciences university students hold negative attitudes and risk perceptions that could become barriers in their eventual professional care of HIV/AIDS patients (Ahmed et al., 2009). It can be argued that medical schools disease orient their students, and at the best, they risk-factor orient their students. They concentrate on clinical sciences and conduct their training programs on the various branches of curative medical services, at university hospitals. Many of the medical schools around the globe prepare doctors not to care for the health of the people or to promote the individual's or the community's health. They engage them in a medical practice that is blind to any thing but disease and the technology for dealing with it. Therefore, students get less orientation towards health promotion, health protection and disease protection.

On the other hand, other researchers (Al-Jabri & Al-Jabri, 2003; Tan et al., 2007; Gopal et al., 2010) revealed that medical faculties' students acquired more accurate and complete information regarding HIV/AIDS, compared with students from other faculties including science. In fact, health professionals, in general, are at high occupational risk for contracting HIV, since they have a high exposure to HIV and AIDS patients. Therefore, health care students need to stay knowledgeable and aware of all relevant issues around HIV and AIDS and must receive an improved HIV/AIDS training. However, education against HIV/AIDS is not only required for medical and paramedical students, but also to a large extent, for all university level students, in addition to the basic education to those in the primary and secondary levels.

Findings of this study highlight the need for immediate general public education actions, within a wide comprehensive strategy. At which, if HIV/AIDS awareness is left unaddressed can permit the virus to spread considerably in the coming years. The most effective and efficient way to combat HIV/AIDS is through interventions for information, education and communication that target most at-risk populations and groups. Emphasis is

mosquitoes are vectors of HIV and more than half of the students thought that it is risky to share swimming pools or toilets with infected people. Furthermore, some of the studied students lacked knowledge about the relationship between sharing clothes, plates or cups with infected people and increased HIV transmission, at which about a quarter of them

Although 89% thought that ordinary people can avoid the risk of HIV infection by behavior modification, a large proportion of the students had negative attitudes. Only 39% of them believed that condom use during sexual intercourse is essential for the prevention of HIV transmission. Furthermore, about two thirds agreed that isolation of HIV positive or AIDS patients is necessary to achieve protection. Negative attitudes regarding prevention misconceptions of HIV/AIDS reflect misconceptions about the virus and disease among

This study showed that participants' awareness and attitudes on HIV/AIDS are not satisfactory, especially for final year medical sciences university students. General public education, with a focus on the adolescents, should represent a fundamental role of the national, regional and international HIV/AIDS control programs. Schools and universities are strongly recommended to be the priority setting. Peer education programs are suggested to be utilized, as they demonstrated success worldwide. Moreover, it is important to build learning experiences into students' active participation programs at all levels. In this way, students will be able to understand more about the different factors that influence their health and how to be safe from all sexually transmitted diseases, including HIV/AIDS. Furthermore, university students have a vital role in the community prevention and control of HIV/AIDS, at which, social changes are commanded and transmitted from schools. Educational interventions, in addition to providing HIV/AIDS prevention knowledge, have to emphasize on students' empowerment and motivation. It is important to use students-centerd approaches that develop a critical awareness of the situation and empower the students to work together for their personal, family and community improved awareness and behavior change. Development of appropriate skills for behavior modification should be included. Ensuring the greatest success involves a

At the education settings, group techniques offer an intermediate approach between the one-to-one interaction and the wider community or mass media communications. As the required HIV prevention behavioral modification is complex, experiential group learning can be performed. The didactic approach can then be utilized. It includes content knowledge, lecturing skills and the ability to answer questions clearly. The didactic approach generally is individualistic and can be directed at groups to bring about such

Finally, individuals' knowledge, attitudes and behaviors change over time. Therefore, repeated surveys and evaluation studies of the effectiveness of educational interventions by monitoring changes in health knowledge, attitudes and behaviors are necessary. Then, health education, disease prevention and health promotion should be planned, implemented and

Agrawal, G., Ahmad A. & Zubair M. (2010) Knowledge, attitude and beliefs towards

HIV/AIDS among youth students in India. World Family Medicine Journal. Vol.

continuously evaluated and updated to meet the changes and developments.

thought that the virus can be transmitted through these ways of sharing.

these university students.

multifaceted and coordinated effort.

individual and community behavior change.

**12. References** 

8(3): 10-15.

to be made on children and youth. Schools and universities represent the most critical setting.

Several studies stressed that there is an immense need to conduct awareness programs about HIV/AIDS at schools and universities (Svenson et al., 1997; IUHPE, 1999; Al-Jabri & Al-Jabri, 2003; Kore et al., 2004; Elfituri et al., 2006). These have to be extended beyond formal education to reach teachers and parents. A previous Libyan study demonstrated that the general public ranked education against HIV/AIDS as one of top three priority issues of the national health education programs (Elfituri et al., 2006). The general public and the health officials agreed that children and youth represent the vital groups to be targeted and that schools and universities are the appropriate settings. Moreover, many HIV/AIDS educational interventions in different parts of the world have shown promising outcomes (Becker & Maiman, 1975; Hingson et al., 1990; Svenson & Varnhagen, 1990; Svenson et al., 1997; UNAIDS, 2008; Ahmed et al., 2009).

Prevention efforts, around most nations, including Libya, have been geared to providing accurate knowledge on HIV/AIDS through the school based health education system. However, similar to several other populations, only about half of the Libyans considered school health education as an effective medium of health education to raise the public health knowledge and to influence healthy behaviors (Elfituri et al., 1999). Furthermore, only one third of Chinese university students have received their first information on HIV/AIDS from schools (Tan et al., 2007), while more than 75% of them received information at university (Albrektsson et al., 2009). Moreover, the school and university settings were not the main sources of information for the Indian students (Kore et al., 2004).

#### **11. Summary, conclusions and recommendations**

Several studies to assess knowledge and attitudes of university students towards HIV/AIDS were conducted in different countries around the world. This current study was the first one to assess knowledge and awareness of final year medical sciences students. Participants were final year students from the faculties of medicine, pharmacy, dentistry and medical technology.

The study revealed several interesting findings. Although every student participated in the study believed that he/she is aware about what HIV/AIDS mean, only 94% of the students thought that they know what agent that causes AIDS. Study results indicated that the majority of the students had a moderate level of HIV/AIDS knowledge and of its routes of transmission. 98% believed that they know how HIV is transmitted. Only 59% of the participants indicated that they have enough knowledge about AIDS. Percentages of responses of correct answers of students of the different faculties have varied greatly. Only 13% of the study participants indicated that HIV infected person becomes a source of infection after some period of time from getting the infection. Moreover, only about a third believed that primary symptoms of AIDS do not necessarily occur immediately after infection with HIV. On the other hand, 96% knew that it is possible that any ordinary person can get HIV infection from someone who is infected, while more than 17% did not think that someone who looks healthy but is HIV infected may infect others.

This study demonstrated that there was an uneven knowledge in the subcategories of routes of transmission of the virus. As high as 69% of the targeted students believed that

to be made on children and youth. Schools and universities represent the most critical

Several studies stressed that there is an immense need to conduct awareness programs about HIV/AIDS at schools and universities (Svenson et al., 1997; IUHPE, 1999; Al-Jabri & Al-Jabri, 2003; Kore et al., 2004; Elfituri et al., 2006). These have to be extended beyond formal education to reach teachers and parents. A previous Libyan study demonstrated that the general public ranked education against HIV/AIDS as one of top three priority issues of the national health education programs (Elfituri et al., 2006). The general public and the health officials agreed that children and youth represent the vital groups to be targeted and that schools and universities are the appropriate settings. Moreover, many HIV/AIDS educational interventions in different parts of the world have shown promising outcomes (Becker & Maiman, 1975; Hingson et al., 1990; Svenson & Varnhagen, 1990; Svenson et al.,

Prevention efforts, around most nations, including Libya, have been geared to providing accurate knowledge on HIV/AIDS through the school based health education system. However, similar to several other populations, only about half of the Libyans considered school health education as an effective medium of health education to raise the public health knowledge and to influence healthy behaviors (Elfituri et al., 1999). Furthermore, only one third of Chinese university students have received their first information on HIV/AIDS from schools (Tan et al., 2007), while more than 75% of them received information at university (Albrektsson et al., 2009). Moreover, the school and university settings were not

Several studies to assess knowledge and attitudes of university students towards HIV/AIDS were conducted in different countries around the world. This current study was the first one to assess knowledge and awareness of final year medical sciences students. Participants were final year students from the faculties of medicine, pharmacy, dentistry and medical

The study revealed several interesting findings. Although every student participated in the study believed that he/she is aware about what HIV/AIDS mean, only 94% of the students thought that they know what agent that causes AIDS. Study results indicated that the majority of the students had a moderate level of HIV/AIDS knowledge and of its routes of transmission. 98% believed that they know how HIV is transmitted. Only 59% of the participants indicated that they have enough knowledge about AIDS. Percentages of responses of correct answers of students of the different faculties have varied greatly. Only 13% of the study participants indicated that HIV infected person becomes a source of infection after some period of time from getting the infection. Moreover, only about a third believed that primary symptoms of AIDS do not necessarily occur immediately after infection with HIV. On the other hand, 96% knew that it is possible that any ordinary person can get HIV infection from someone who is infected, while more than 17% did not

This study demonstrated that there was an uneven knowledge in the subcategories of routes of transmission of the virus. As high as 69% of the targeted students believed that

the main sources of information for the Indian students (Kore et al., 2004).

think that someone who looks healthy but is HIV infected may infect others.

**11. Summary, conclusions and recommendations** 

setting.

technology.

1997; UNAIDS, 2008; Ahmed et al., 2009).

mosquitoes are vectors of HIV and more than half of the students thought that it is risky to share swimming pools or toilets with infected people. Furthermore, some of the studied students lacked knowledge about the relationship between sharing clothes, plates or cups with infected people and increased HIV transmission, at which about a quarter of them thought that the virus can be transmitted through these ways of sharing.

Although 89% thought that ordinary people can avoid the risk of HIV infection by behavior modification, a large proportion of the students had negative attitudes. Only 39% of them believed that condom use during sexual intercourse is essential for the prevention of HIV transmission. Furthermore, about two thirds agreed that isolation of HIV positive or AIDS patients is necessary to achieve protection. Negative attitudes regarding prevention misconceptions of HIV/AIDS reflect misconceptions about the virus and disease among these university students.

This study showed that participants' awareness and attitudes on HIV/AIDS are not satisfactory, especially for final year medical sciences university students. General public education, with a focus on the adolescents, should represent a fundamental role of the national, regional and international HIV/AIDS control programs. Schools and universities are strongly recommended to be the priority setting. Peer education programs are suggested to be utilized, as they demonstrated success worldwide. Moreover, it is important to build learning experiences into students' active participation programs at all levels. In this way, students will be able to understand more about the different factors that influence their health and how to be safe from all sexually transmitted diseases, including HIV/AIDS. Furthermore, university students have a vital role in the community prevention and control of HIV/AIDS, at which, social changes are commanded and transmitted from schools.

Educational interventions, in addition to providing HIV/AIDS prevention knowledge, have to emphasize on students' empowerment and motivation. It is important to use students-centerd approaches that develop a critical awareness of the situation and empower the students to work together for their personal, family and community improved awareness and behavior change. Development of appropriate skills for behavior modification should be included. Ensuring the greatest success involves a multifaceted and coordinated effort.

At the education settings, group techniques offer an intermediate approach between the one-to-one interaction and the wider community or mass media communications. As the required HIV prevention behavioral modification is complex, experiential group learning can be performed. The didactic approach can then be utilized. It includes content knowledge, lecturing skills and the ability to answer questions clearly. The didactic approach generally is individualistic and can be directed at groups to bring about such individual and community behavior change.

Finally, individuals' knowledge, attitudes and behaviors change over time. Therefore, repeated surveys and evaluation studies of the effectiveness of educational interventions by monitoring changes in health knowledge, attitudes and behaviors are necessary. Then, health education, disease prevention and health promotion should be planned, implemented and continuously evaluated and updated to meet the changes and developments.
