Short Communication Awareness of HIV/STD among children aged 13 to 17 years of an urban high school in Mangalore

Adolescence is a special period of growth where the individual is learning to outgrow childhood and has to cope with various behavioral and physiological changes. This complicated by urge for experimentation makes them vulnerable for acquisition of sexually transmitted diseases1. Educational interventions may have some impact in reducing the risky behavior common to this population, in preventing the spread of infection. Women and children are at a higher risk for STD/HIV transmission in India and in this background educating and raising the awareness among the vulnerable adolescent girls should be of utmost importance in preventing this epidemic disease. This study attempts to assess the knowledge of HIV and STD among the school going student aged between 13 years to 17 years in Mangalore, a coastal town in south India.


Short Communication
Adolescence is a special period of growth where the individual is learning to outgrow childhood and has to cope with various behavioral and physiological changes. This complicated by urge for experimentation makes them vulnerable for acquisition of sexually transmitted diseases 1 . Educational interventions may have some impact in reducing the risky behavior common to this population, in preventing the spread of infection. Women and children are at a higher risk for STD/HIV transmission in India and in this background educating and raising the awareness among the vulnerable adolescent girls should be of utmost importance in preventing this epidemic disease. This study attempts to assess the knowledge of HIV and STD among the school going student aged between 13 years to 17 years in Mangalore, a coastal town in south India.
This was an observational study which included student attending high school of an urban area school where the subjects were from a mixed socioeconomic status. Ethical clearance was taken from the institutional ethical committee. After informed consent from the school head and the student, a questionnaire was given to be answered individually by the subject. Any doubts regarding the questions were cleared by the investigator at the site followed by an educational talk lasting 15 minutes post test.
The Total numbers of respondents were 768, among them 702 were male and 66 were female subjects. Among them 253 (32.9%) either believed that HIV was not prevalent in Mangalore or did not know the existence of such a disease, 409 (53.3%) believed promiscuous behavior and 203 (26.4 %) be lived a drug abuse as high risks for HIV/STD transmission, 185 (24 %) believed kissing transmitted HIV/STD, 76 (9.9 %) due to mosquito bite, 111 (14.5%) due to use of common toilets, 93(12.1%) due to sharing a room, 38 (5%) due to shaking hands. Among the respondents 178 (23%) did not know the use of condom in preventing STDs/HIV transmission. More girls were aware about condom and its use than boys (57.6% Vs 20%). Among the girls, 38 (57.6%), believed that condom can help to prevent unwanted pregnancies and only 11 (16.6%) believed it prevented STDs. In the study group (44.3%) were not aware of proper use of the condom and most of the boys 66.6 % (468) believed condom is used only by men. 53.5% believed that protected sex with condom use reduced the risk of HIV/STD transmission but 81% did not know that using a second hand needle could transmit HIV/STDs. Nearly a third (29.4%), mostly girls, advocated abstinence to avoid HIV/STD transmission and 51% believed that there was treatment available for HIV.
The first case of HIV was reported in India in 1986. An estimated 1,40,000 student in India are infected with HIV, with 14,500 newly infected added every year caused mostly by parent to child transmission with a small proportion infected by unsafe injections and blood transfusions. student less than 15 years age account for 7% and women 39% of all infections according to a recent finding by the National AIDS Control Organization (NACO) 2 . The already burdened health care system in India is handicapped by the costs of the diagnostic tests and medications required to cater to such a huge population. To achieve the global targets of 'Zero New Infections, Zero AIDS related deaths & Zero discrimination', prevention and awareness campaigns appears to be more cost effective. Many adolescents around the world are sexually active and many such contacts unprotected, which makes them at risk of contracting sexually transmitted diseases (STDs). Another reason for their vulnerability is the lack of sex education, including education on STD prevention 1 . In a conservative society like India, most parents hesitate to discuss topics related to sexual issues and teens turn to peers or cheap media and get inaccurate information. In a large community based study from western India, where the majority of responders were young people aged between 15-20 years, investigators that found awareness about HIV/STDs in 67.5% of women and most of them quoted television as the source of information. They also found 30% of the population studied would not approach government health services center for information 3 . Thus media needs to be utilized optimally for accurate sex education and awareness about STDs among the impressionable minds instead of waiting for them to approach the health service providers.
The power of education was well documented by researchers from northern India, where they found that the rural high school girls were aware of HIV but not of other STDs and when provided with educational material the awareness was found to be increased on follow up 4 . This trend has been documented in other parts of the world 5 . Better educated girls tended to delay sexual activity and were more likely to insist that their partner use a condom 6 . The present study was conducted in a district with an average literacy rate of 88.6% with a female literacy rate of 84%. We need to understand that education and awareness alone might not change the attitude or understanding regarding HIV/STDs transmission, but an accurate and sustained sex education especially of the young population is needed to weed out this illness from reaching epidemic proportions. Primary prevention among young people is the greatest hope to change the course of HIV epidemic in India. Though national and world bodies like UNICEF, NACO, UNESCO and UNFPA have initiated targeted interventions (TIs) and educational programs like Red Ribbon Clubs, it needs to be implemented in its true spirit to pass on life skills and preventive messages. According to the National Family Health Survey 2006, misconceptions about HIV transmission are more common among women, more men than women are aware of preventive strategies and of opinion that the younger generation should be sex educated at school.
Though the NACO reports are promising showing a decreasing trend of HIV transmission in India, we need to fortify our preventive strategies with providing accurate information to the vulnerable adolescents involving the schools and the media to eradicate this epidemic.