Knowledge, attitudes and behaviour of students from a medicine faculty, dentistry faculty, and medical technology Vocational Training School toward HIV/AIDS.

IJOMEH 2010;23(2) 153
O R I G I N A L P A P E R S
International Journal of Occupational Medicine and Environmental Health 2010;23(2):153 – 160
DOI 10.2478/v10001-010-0008-5
KNOWLEDGE, ATTITUDES AND BEHAVIOUR
OF STUDENTS FROM A MEDICINE FACULTY,
DENTISTRY FACULTY, AND MEDICAL TECHNOLOGY
VOCATIONAL TRAINING SCHOOL TOWARD HIV/AIDS
OZGE TURHAN1, YESIM SENOL2, TIMUCIN BAYKUL3, RABIN SABA1, and ATA NEVZAT YALÇIN1
1 Akdeniz University Faculty of Medicine, Antalya, Turkey
Department of Infectious Diseases and Clinical Microbiology
2 Akdeniz University Faculty of Medicine, Antalya, Turkey
Department of Medical Education
3 Süleyman Demirel University Faculty of Dentistry, Isparta, Turkey
Department of Oral and Maxillofacial Surgery
Abstract
Objectives: With increasing numbers of HIV/AIDS patients, physicians, dentists, and nurses taking care of these patients
should have sufficient knowledge of the disease, and their attitude and behaviour should be proper. In our study, we aimed
to examine the level of knowledge about HIV/AIDS among students from a medicine faculty, dentistry faculty, and medical
technology vocational training school, to investigate attitudes and behaviour, and differences between first- and last-year
students (if any) and to determine students’ perception of the importance of this disease for our country and our world.
Material and Methods: This descriptive study comprised first-year and last-year students of Akdeniz University Faculty
of Medicine, Akdeniz University Medical Technology Vocational Training School (MTVTS), and Süleyman Demirel Uni-
versity Faculty of Dentistry. A questionnaire was administered to a total of 357 students. Results: Lack of the relevant edu-
cation is obvious among all three occupational groups in our study Conclusions: The importance of HIV/AIDS as a public
health problem all over the world should be emphasized more, and awareness of all humanity should be augmented.
Key words:
HIV/AIDS, Knowledge, Attitudes, Behaviour, Medicine, Dentistry
This study was supported by Akdeniz University Research Foundation.
Received: January 11, 2010. Accepted: March 8, 2010.
Address reprint request to Y. Senol, Akdeniz University Faculty of Medicine, Department of Medical Education, 07070, Antalya, Turkey (e-mail: yigiter@akdeniz.edu.tr).
INTRODUCTION
Infection with human immunodeficiency virus type 1
(HIV-1) and the resultant acquired immune deficiency
syndrome (AIDS) is a major public health challenge of
modern times [1].
There are 33.4 million people living with HIV, includ-
ing 2.7 million new-infected with HIV, and AIDS deaths
were two million in 2008 all over the world [2]. Since 2000,
the rate of diagnosed new cases of HIV reported per mil-
lion population has more than doubled, from 44 per million
in 2000 to 89 per million in 2008, based on the 43 coun-
tries that have consistently reported HIV surveillance data.
In 2008, 51 600 cases of HIV were diagnosed and reported
and 7565 cases of AIDS were reported by 48 of the 53 coun-
tries of the WHO European Region and Liechtenstein [3].
According to data of Ministry of Health Department in our
country, first two cases were reported in 1985 and the num-
ber of HIV/AIDS cases is 3671 by 2009 [4].
All healthcare workers — especially physicians, dentists and
nurses — are at risk for occupationally acquired HIV in-

O R I G I N A L P A P E R S O. TURHAN ET AL.
IJOMEH 2010;23(2)154
Training School (MTVTS), and Süleyman Demirel Uni-
versity Faculty of Dentistry. A questionnaire was admin-
istered to a total of 357 students, 200 from the Faculty of
Medicine, 94 from the Medical Technology Vocational
Training School, and 63 from the Faculty of Dentistry.
In the study, 100% of first-year and 83.3% of last-year
students of the Faculty of Medicine, 80% of first-year
and 78% of last-year students at the MTVTS, and all stu-
dents of Faculty of Dentistry were accessed.
Data collection
During data collection, questionnaires about knowledge
and attitude were sent to students. The students answered
the questions under the supervision of the person respon-
sible for the questionnaire in the classroom. They filled
in the forms without interference and without giving their
names. It was found that some students neglected to an-
swer some questions on the form, so when results were
analysed, percentages were calculated according to the
number of students answering each question.
The questionnaire consisted of three parts. In the first
part, 19 questions were asked to determine the level of
knowledge about HIV/AIDS among students. This is
a 19 item questionnaire with a “true”, “false” and “do not
know the answer” format. Knowledge about HIV/AIDS
questions included the following question-sentences, “An
HIV carrier and an AIDS patient are the same”, “If prop-
er treatment is received, being an HIV carrier is the same
situation as having a chronic disease like diabetes or hy-
pertension”, “HIV may be transmitted by using the same
water closet”, “An HIV test performed immediately af-
ter suspicious sexual intercourse gives definitive results”
and “HIV contamination risk by penetration of a needle
contaminated by a well-known HIV+ patient is 0.03%”.
In the second part, three questions aimed to measure the
attitudes and behaviour of students regarding HIV/AIDS.
“Do you feel disturbed if you receive education with an
AIDS student in the same classroom?”, “Will you treat an
HIV/AIDS patient in the future?”, “What will be your at-
titude to a friend that you have recently learned if he/she
has HIV/AIDS?”. The last five questions examined their
sources of knowledge on HIV/AIDS and how they
fections from close contact with blood and other body fluids
of patients [5,6]. With the spread of HIV, increasing num-
bers of health care professionals are becoming involved in
the care and treatment of these patients. As the disease
spreads beyond current AIDS epicentres, more profession-
als are required to have a baseline working knowledge of
HIV infection. And the reluctance of many health care pro-
fessionals to offer treatment for HIV-positive individuals,
along with already existing staff shortages, limits access to
care and makes the provision of responsive educational pro-
grams even more important. Generic programs to educate
health professionals frequently lack sufficient specificity and
sensitivity to address the needs of health professionals with
varying levels of knowledge and role responsibility [7].
Physicians, dentists and nurses make up the bulk of health-
care workers. Knowledge, attitude and behaviour of the stu-
dents of these professions about infectious diseases like HIV/
AIDS is very important as they will take care of HIV/AIDS
patients in the future. In this study, we aimed to examine the
level of knowledge about HIV/AIDS among students from
a medicine faculty, dentistry faculty, and medical technol-
ogy vocational training school, to investigate attitudes and
behaviour, and differences between first- and last-year stu-
dents (if any) and to determine students’ perception of the
importance of this disease for our country and our world.
The research questions were: What are the levels of
knowledge of medicine faculty, dentistry faculty, and med-
ical technology vocational training school students about
HIV/AIDS and how will their behaviours and attitudes be
about HIV/AIDS patients?
Are there any differences in the knowledge, behaviour
and attitudes related with HIV/AIDS between the first-
and last-year students of these schools?
Do the students of these schools consider HIV/AIDS as
an important disease for Turkey and for the world?
MATERIAL AND METHOD
Study group
This descriptive study comprised first-year and last-year
students of Akdeniz University Faculty of Medicine,
Akdeniz University Medical Technology Vocational

KNOWLEDGE, ATTITUDES AND BEHAVIOUR OF MEDICINE STUDENTS TOWARDS HIV/AIDS O R I G I N A L P A P E R S
IJOMEH 2010;23(2) 155
question concerning training in HIV/AIDS, versus 97.4%
of last-year students. At the Faculty of Dentistry, 22.9% of
first-year students indicated they were trained, compared
with 85.4% of last-year students. The corresponding rates
for the MTVTS students were 29.6% and 82.5%, respec-
tively (p = 0.03) for first-/last-year comparisons, with no
statistically significant differences (p = 0.09) in interschool
comparisons.
Responding to the question about sources of knowledge,
first-year students from the Faculty of Medicine indicated
the internet and newspapers (22.9%), whereas last-year
students mentioned lectures at school (85.4%). First-year
students from the Faculty of Dentistry mentioned classes
(50%), whereas last-year students mentioned school lec-
tures (75.8%), the same as medical students. First-year
students of MTVTS mentioned lessons at high school
(63.6%) compared with lectures and classes (64.8%)
among last-year students. Of all first-year students in the
Faculty of Medicine, 8.5% thought lectures were suffi-
cient, compared with 81.8% of last-year students. The
same rates were 4% and 21.6% for Faculty of Dentistry
students, respectively, and 11.8% and 5% for MTVTS stu-
dents, respectively (p = 0.02 for first-/last-year compari-
sons and p = 0.04 for interschool comparisons, while the
difference was attributable mainly to the results of Faculty
of Medicine students).
Table 2 shows mean averages of correct answers measur-
ing students’ level of knowledge about HIV/AIDS. The
difference in levels of knowledge between the first and last
perceived the importance of the disease for our country
and our world. Participation was voluntary. The partici-
pants were informed about the aim of the study and the
questionnaire, than requested to answer the questions.
Data analysis
Data were evaluated with SPSS 11.0 software. Descrip-
tive analyses and examination of group differences were
conducted. Descriptive statistics and chi square analyses
were conducted for the first-/last-year comparison. One-
way ANOVA, with level in school as the between-group
factor, was performed for the questionnaires. A mean of
total correct answers to 19 questions measuring students’
levels of knowledge about HIV/AIDS was calculated for
each school and resultant values were compared by t test.
In descriptive analyses, the correct answer percentages of
the first and last years were calculated. Prior to conducting
ANOVA on the questionnaire, assumptions of indepen-
dence, normality and homogeneity of variance were tested.
Skewness values indicated that the distributions did not
differ significantly from normal, symmetric distributions.
Levene’s test for homogeneity of variances suggested that
the variances were equal for the three groups.
RESULTS
Distribution of schools according to gender and years is
presented in Table 1. Only 17.7% of first-year students
at the Faculty of Medicine responded positively to the
Table 1. Distribution of schools according to gender and year of studies
Medicine Dentistry MTVTS
n % n % n %
Gender
male 101 50.5 30 47.6 – –
female 99 49.5 33 52.4 94 100.0
Year
first year 120 61.7 26 41.3 54 57.4
last year 80 38.3 37 58.7 40 42.6
Medicine — Akdeniz University Faculty of Medicine.
Dentistry — Süleyman Demirel University Faculty of Dentistry.
MTVTS — Akdeniz University Medical Technology Vocational Training School.

O R I G I N A L P A P E R S O. TURHAN ET AL.
IJOMEH 2010;23(2)156
an AIDS patient are the same”, “If proper treatment is re-
ceived, being an HIV carrier is the same situation as hav-
ing a chronic disease like diabetes or hypertension”, “HIV
may be transmitted by using the same water closet”, “An
HIV test performed immediately after suspicious sexual
intercourse gives definitive results” and “HIV contami-
nation risk by penetration of a needle contaminated by
a well-known HIV+ patient is 0.03%.”. The number of
correct answers among the last-year students was consider-
ably higher (medicine faculty, dentistry faculty, and medi-
cal technology vocational training school 69.8%, 67.3%,
and 59.6%, respectively).
Distribution of attitudes toward patients with HIV/AIDS
is given in Table 3. Most of the students did not want to
receive education in the same class-room with HIV/AIDS
year was statistically significant (p = 0.01), but there was
no statistically significant difference among schools. Fewer
than 20% of first-year students provided correct answers
to the following question-statements: “An HIV carrier and
Table 2. Mean counts of correct answers to questions about
HIV/AIDS according to schools
School
Mean±SD
P*
first year last year
Medicine 7.9±2.2 9.3±1.8 0.00
Dentistry 7.6±2.3 9.7±2.1 0.00
MTVTS 7.8±1.9 9.9±1.7 0.00
P** > 0.05 > 0.05 > 0.05
Abbreviations as in Table 1.
* p value for years.
**p value for schools.
Table 3. Distribution of attitude towards patient with HIV/AIDS
Answers to questions
Schools
[%]
P**
Medicine Dentistry MTVTS
first year last year first year last year first year last year
I shall agree to be educated in the same
classroom with HIV/AIDS patient
14.6 11.7 38.5 8.1 25.9 15.0 > 0.05
I shall treat a patient who’s aware he/she
has HIV/AIDS
79.0 88.3 76.9 78.4 81.5 92.5 > 0.05
P* > 0.05 < 0.05 > 0.05
Abbreviations as in Table 1.
* p value for year.
**p value for schools.
Table 4. Attitude towards a friend with known HIV/AIDS
Answers to questions
Schools
[%]
P**
Medicine Dentistry MTVTS
first year last year first year last year first year last year
There’ll be no change in my attitude 22.6 35.1 23.1 21.6 16.7 47.5 > 0.05
I get away from him/her as soon as possible 3.2 0 3.8 5.4 7.4 0.0 > 0.05
I feel pity towards him/her 14.5 14.3 30.8 10.8 11.2 12.5 > 0.05
I try to help 54.8 45.5 38.5 51.4 61.2 42.51 < 0.01
Other 4.8 2.6 3.8 10.8 7.4 5.0 > 0.05
P* > 0.05 > 0.05 < 0.05
Abbreviations as in Table 1.
* p value for years.
**p value for schools.
1 The row causing the significance.

KNOWLEDGE, ATTITUDES AND BEHAVIOUR OF MEDICINE STUDENTS TOWARDS HIV/AIDS O R I G I N A L P A P E R S
IJOMEH 2010;23(2) 157
The distribution of students according to school who
thought that HIV/AIDS was very important for the health
of the world population was as follows: 49.3% of first-year
students and 56.7% of last-year students of the Faculty of
Medicine; 53.9% and 74.9% for Faculty of Dentistry, re-
spectively; and 66.5% and 36.9% for MTVTS, respectively
(Figure 1) (p = 0.03 for MTVTS, p = 0.02 for Faculty of
Dentistry, p = 0.01 for interschool comparisons, while the
difference was attributable mainly to the results of Faculty
of Medicine students).
The distribution of students according to school who
thought that HIV/AIDS was very important for Turkey
was as follows: 30% of first-year students and 27.2% of
last-year students from the Faculty of Medicine; 34.5%
and 46.9% for Faculty of Dentistry, respectively; and 65%
and 30.03% for MTVTS, respectively (Figure 2) (p = 0.03
for MTVTS).
DISCUSSION
HIV/AIDS has become one of the most serious health
problems in the world. HIV-1 infection may be transmitted
by occupational exposure in the hospital setting as a result
of needlestick injury, by transmission during surgery, in
outpatient dental circumstances, or in other instances in
which transmission-enabling contact may occur [8]. With
increasing numbers of HIV/AIDS patients, physicians,
dentists, and nurses taking care of these patients should
have sufficient knowledge of the disease, and their atti-
tude and behaviour should be proper. Health care pro-
fessionals get their knowledge and behaviour from their
education system. The Centres for Disease Control and
Prevention (CDC) estimated that, in the United States, up
to 5000 HIV exposures may occur annually among health
care workers [5]. The sample in this study does not repre-
sent all young people of the same age and occupational
group, but we believe that, like recent studies [9–13], our
study will help to generate an overall idea of knowledge
and attitudes of young people about HIV/AIDS. The study
group was composed only of the students of University,
and the results are not representative for the whole coun-
try. However, we compared our results with the results of
friends but stated that they would treat patients with HIV/
AIDS in the future. However, there was no statistically sig-
nificant difference in attitude between first-year and last
year students. Distribution of attitudes of students toward
a friend known as an AIDS patient is presented in Table 4.
Fewer last-year, compared to first-year students from the
Faculty of Medicine and MTVTS declared that they would
“try to help”. But this difference was not statistically signif-
icant. A higher proportion of last-year students of Faculty
of Dentistry stated that they would try to help compared
with the first year students (p = 0.01). There was a statisti-
cally significant difference among the first and last year
students of MTVTS for the ‘Attitude towards a friend with
known HIV/AIDS’ question. The difference was due to
the “There’ll be no change in my attitude” choice. A high-
er proportion of last-year students stated that there would
be no change in their attitudes.
Medicine — Akdeniz University Faculty of Medicine.
Dentistry — Süleyman Demirel University Faculty of Dentistry.
MTVTS — Akdeniz University Medical Technology Vocational
Training School.
Fig. 1. Distribution of students, according to schools, who think
that HIV/AIDS is very important for the world.
Abbreviations as in Figure 1.
Fig. 2. Distribution of students, according to schools, who think
that HIV/AIDS is very important for Turkey.