People living with HIV/AIDS (PLHAs) Knowledge regarding progression of HIV infection

A cross-sectional study

Sir,

HIV progression means the advancement of HIV from an early infection to a disease state.[¹] The progression of clinical syndrome in HIV/AIDS may depend on various factors. Several knowledge, attitude, and practice studies have been carried out worldwide in relation to HIV/AIDS transmission and infection, while scanty literature addressed the knowledge of people living with HIV/AIDS (PLHAs) toward the progression of HIV. Thus, there is a need to study the awareness level among the PLHAs with respect to progression and to take necessary steps so that all PLHAs would take necessary measures to prevent the progression of the disease which becomes utmost important in this era of antiretroviral treatment. In view of the above, we carried out a cross-sectional, hospital-based study with the objective to assess the awareness level regarding the progression of the disease among 102 PLHAs who were not on treatment. The mean age of the participant was 35.55 years (standard deviation, 7.44 years). 60.8%, were educated up to class X, 92.2% were married, and 71.6% of individuals were from rural backgrounds. Forty-nine percent of participants belonged to high prevalence states. 43 (42.2%) were diagnosed HIV positive less than a year ago.

A majority of 73 (71.6%) participants knew the difference between HIV and AIDS. 30.4% had correctly answered the time taken from HIV to develop AIDS and a majority 88.2% knew that HIV infection progresses by the destruction of the immune system. 85.3% felt that they are likely to suffer from tuberculosis and pneumonia (59.8%). However, very few of them were aware that they are likely to suffer from various other diseases/infections. 63.7% were aware of the relation between CD4 count with the progression of the disease while 33.3% felt that HIV is a potentially fatal disease. 59.8% felt that HIV cannot be cured but can be made into chronic treatable disease such as diabetes/hypertension. On the contrary, 3.9% felt that it can be completely cured by costly allopathic medicine or traditional medicines. It was seen that 79.4% of respondents were found to have satisfactory and 20.6% unsatisfactory knowledge as per the predecided knowledge score. A statistically significant relationship was seen between education (P = 0.03) [Figure 1] and duration of HIV positivity of the study participants (P = 0.03) [Figure 2] to that of the level of knowledge regarding HIV progression. This is in line with a study carried on HIV-positive persons attending HIV/AIDS counseling center by Sangole et al.[²] As per the National Family Health Survey-3 (2005-2006), education and regular media exposure have shown strong positive associations with all the indicators of HIV/AIDS knowledge.[³] Higher levels of HIV knowledge scores were also significantly associated with the male gender, and higher education in a cross-sectional study carried out in Dakshina Kannada district of Karnataka in 2008, while a study on recruits carried out by Ambati BK et al. in 1999 showed that education had little bearing on knowledge, attitudes, and behavior.[^4,5] However, the knowledge tested in these studies was mainly on modes of transmission and prevention aspects and had few questions on progression of the disease and their education categories were different. The finding of this study is similar to a study carried out by Mahalakshmy T et al. among HIV-infected people in 2011, wherein participants who had received counseling, studied above class 10, and those with the duration of more than 1 year since diagnosis had better HIV knowledge score (>90%).[⁶]

Figure 1: Percentage distribution of educational status and knowledge level about HIV progression

Figure 2: Percentage distribution of duration of HIV positivity and knowledge level about HIV progression

The study also shows the association of duration of illness with the knowledge regarding HIV progression. This may be due to their more contact with health care (due to illness, investigations, and follow-up) and therefore more chance of acquiring knowledge about HIV progression.

From the findings of the present study, it is concluded that there exists a considerable gap in knowledge. Hence, there is a need to raise awareness regarding the same and putting the same into practice. Care should be taken to clear misconceptions while carrying out awareness programs as these varied in the range of 3%–60% in certain issues such as "time taken from HIV to develop AIDS," "relation between HIV progression and CD4 count," availability of treatment for HIV (Anti-Retroviral Treatment) and its role.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.