Assessment of awareness of current HIV infection issues among medical and other university students

Full Text

Introduction. HIV infection remains one of the most urgent problems in many areas, especially in social and medical, which requires an up-to-date, professional and active approach to informing the population. Despite the progress in the field of medicine in the effective diagnosis and treatment of this disease and ways to obtain information, the level of knowledge of citizens on many issues, such as transmission of the virus, treatment, remains low. This factor can lead to "labels" on people living with HIV, which prevents their integration into society, as shown by the history of countries around the world (Russia, USA, European countries and many others).

There are many ways that are used to raise awareness and verify knowledge about HIV infection, such as: questionnaires; focus groups that identify the level of awareness, as well as possible misconceptions or misunderstandings; educational programs and many others. In this study, questionnaires were used as the most common method for obtaining information during social surveys of the population [1].

The purpose of this study is to assess the awareness of current HIV infection issues among medical and other university students. The tasks include:

• Mastering the use of Yandex Forms as an online survey tool;
• Conducting and distributing online testing between students on social media;
• The use of Msexcell tables in the processing of questionnaires, with the formation of final results and their visualization (diagramming) to create a presentation;
• Analyzing the information collected and evaluating the results obtained.

Materials and methods. This research project was conducted using the questionnaire method. Yandex Forms was chosen from the available platforms, which made it easier to distribute the questionnaire among students on the social network, as well as to collect and process the information received [10, 11]. Two questionnaires were developed for students of medical schools and other universities. The questionnaires included the following questions: according to socio-demographic indicators; sources of information about HIV infection; the level of awareness about HIV infection; personal attitudes or opinions reflecting tolerance towards HIV-infected people. The questionnaires were distributed through groups in the social networks of the medical university and for other universities – initially through personal acquaintances of students, with further coverage of their classmates.

Links to two questionnaires: https://forms .yandex.ru/u/6702827be010db585e019a8d / (for medical university students); https://forms .yandex.ru/u/67028aebe010db59be019aa0 / (for university students).

The questionnaires were processed using Ms. In Excel, extensive indicators (%) were calculated. The calculation of the awareness index was carried out using the formula: the sum of correct answers for all questionnaires / the total number of questionnaires X the maximum number of correct answers, expressed in %.

The target audience of the project is gender – both online questionnaires are mostly female. The course is from 1st to 6th in the surveys of medical university students. The course is from the 1st to the 1st year of the master's degree in a survey of other universities. Universities are Voronezh State Medical University named after N. N. Burdenko (VSMU, or hereinafter referred to as the first group), non–medical universities (hereinafter referred to as the second group). Age – 17-37 years. The survey covered 241 students from several faculties and universities. The average age of medical students is 19.66, and that of students from other universities is 19.09, due to the predominant inclusion of first–year students from almost all faculties.

Information on the incidence and prevalence of HIV infection in the Voronezh Region was obtained from the newsletters of the Voronezh Regional Clinical Center for the Prevention and Control of AIDS. Information on the dynamics of HIV infection detection is selected, with an emphasis on the age groups of young people.

Results and discussion. The epidemic situation of HIV infection in the Voronezh region is regarded as relatively safe, the incidence and incidence are lower than the average Russian and average values for the Central Federal District. The trend of decreasing the incidence of HIV infection in the Voronezh Region continues - in 2023, the decrease was 14% compared to the level of 2019. The age structure of primary cases in the Voronezh Region continues to show positive trends in reducing morbidity in the 18-30 age group. In 2015-2016 This cohort accounted for 37.9%-32.6% of newly diagnosed HIV patients, with a subsequent dynamic decrease to 11.4% in 2023. The number of new cases among 18-20 year olds has decreased in recent years from 15 cases in 2017 to 5 cases in 2023.

An analysis of the questionnaires received by sources of information (multiple choice) showed that students most often turn to the Internet in search of answers to questions (82.5% of the first group and 89.4% of the second). Teachers and lecturers occupy the second place, but their share in non–medical universities is noticeably lower - 59.6% compared to 78.1% in the first group. VSMU students ranked printed materials (brochures, posters) in third place – over 60%, obviously due to the more frequent occurrence of visual propaganda during their stay in medical organizations. The second group included television in the top three – 58.7%. Less than half of the respondents in both groups received information from parents or relatives (49.6% / 48.1%), 29.9% / 27.9% discussed these issues with friends or acquaintances in the first and second groups.

To the question "Do you know your HIV status?" the students of the first group answered "Yes" in 83.2%, while the second group answered only 51.9%. These data coincide with those obtained during the study of Kirov students [5].

The level of awareness (for the same 15 correct answers to questions) among medical students as a whole was higher (80.1%) than in other universities (71.0%). Of the students in the first group, 99.3% answered the question "What is HIV?" correctly, while the second group answered only 87.5%. In the question "What is the connection between HIV and AIDS?" the trend remains the same - 92.7% of medical university students answered correctly, while 86.5% of non-medical students answered correctly. 97.1% of both cohorts analyzed unanimously chose the sexual route of infection. Blood transmission when using non-sterile needles and syringes for non-medical purposes was noted by 95.6% of students in the first group and 85.6% of students in the second group. The choice of the "injecting drug users" option as a risk group was distributed in almost the same proportion. The greatest difficulties were caused by the choice of "mother-to-child during pregnancy and childbirth" and "mother-to-child during breast-feeding" as known ways of HIV transmission. They were correctly indicated by only 83.2% / 40.9% of future doctors and 64.4% / 21.2% of students of the second group, respectively. At the same time, a fairly large number of students of non-medical specialties chose the variants of the transmission route "through animals and insect bites" - 14.2% and as a transmission mechanism – transmissible (with an explanation: transmission of infection through the bite of a blood-sucking insect) - 16.3%. 6.6% of VSMU students considered bite transmission possible. But at the same time, the transmission transmission mechanism was chosen incorrectly (without explanation in the question) already 39.4%. To the question "Which of the listed has a higher risk of HIV infection?" the first group showed good results in the answers ("Commercial sex workers" - 83.2%, "Medical personnel" - 78.1%, "Injecting drug users" - 95.6%, "Men who have sex with men" - 78.1%), whereas the second group responded accordingly. - 87,5% / 40,4% / 86,5 / 66,3%. To the question "Can a person become infected with HIV by having sexual relations for the first time?" both groups showed a high result - 96.4% / 87.5%.

Both medical students (44.5% chose the correct answer, and other students (29.8%) were poorly informed about the period of the seronegative window (the question sounded like the time of analysis in the period after the estimated risk, when infection can be assessed). At the same time, 95.6% and 88.5%, respectively, know about the need to start treatment immediately after the disease is detected.

The surveys of students conducted by the researchers in Chita, Kirov and Novosibirsk also demonstrated a higher level of awareness of future doctors in comparison with other universities [4, 5, 6].

To assess the attitude towards HIV-infected people, three questions were asked in the questionnaire, one of which had a personal answer. "How do you feel about the fact that HIV-infected people study with healthy people?" - 71.5% of the first group noted tolerance (if you add up the two options "This is normal" and "Does not cause any emotions"), in the second group - 62.5%. Less than 20% of those who did not think about this issue in both groups (19.7% - the first, 16.3% - the second), non-acceptance of HIV-infected people is most common in the second group. "If you find out that one of your acquaintances/friends/relatives is infected with HIV, what will you do?" the majority of both groups of students answered "I will communicate as before" - 78.8% / 70.2%, those who cannot answer this question accurately at this moment - 21.2% / 26.9%, and only students of the non-medical group have marks to this question in the answer "I will stop communicating and break off all relationships" - 2.9%. To the last question, "Do you have any experience communicating with HIV-infected people?", which the students could not answer to complete the questionnaire, the majority answered "No" - 46.7% / 63.5% (although these results are quite controversial due to the fact that in everyday life people are rarely interested in this status). The students who decided to skip this question turned out to be 42.3% in the first group, 29.8% in the second. Exact confirmation of communication with HIV-infected people was given by VSMU students - 9.5%, while for students of other fields - 3.8%. The first group had only 1.5% of those who answered "I don't know", while the second group had 2.9%. From all of the above, we can see that medical university students are more tolerant of HIV-infected people, which was also emphasized by E.V. Kuznetsova in her study [5].

Only the questionnaires for VSMU students had questions about the possibility of continuing their studies or working for an HIV-infected healthcare professional. To the question "If a medical university student is diagnosed with an immunodeficiency virus, should he be expelled?" 85.4% of the respondents could not give a definite answer. 40.9% voted for the exclusion of a healthcare worker with HIV infection from intravenous injections, 24.1% do not consider it necessary to do this, and 35.0% do not know. Obviously, there is a differentiated approach to issues of tolerance towards HIV-infected people, taking into account the implementation of virus transmission in the provision of medical care, but the level of legal literacy is insufficient. Almost all students assessed the high risk of doctors becoming infected during medical manipulations with a violation of the integrity of the skin (needle prick, cut) – 98.5%.

It proved difficult to analyze the level of awareness among the faculties of VSMU at this stage of the study. Of all the students, the majority turned out to be from the Faculty of Medicine and Prevention (MPF) - almost 57% of the 137 students who completed the survey. The dental faculty turned out to be the next in terms of the number of students - 16%, slightly fewer were students from the Faculty of Medicine - almost 15%. The Faculty of Pharmacology accounted for 8% of the total number. And the paediatric faculty turned out to be the smallest in terms of the number of students who completed the survey - 4%. From the data already obtained, it can be concluded that there are too few faculties other than the IPF to judge awareness, so this work needs to be continued with greater coverage and campaigning for questionnaires. Therefore, in this study, we will consider in more detail only the distribution of courses at the Faculty of Medicine and Prevention. The total number of participants was 78 people. The 3rd year turned out to be the most active - 27 people or 34%. The smallest number is possessed by 6 students - 1 person.

The 1st year students had difficulties with the known ways of HIV transmission "from mother to child during pregnancy and childbirth" and "from mother to child during breastfeeding", as well as with the mechanism of transmission, which can be attributed to the fact that students had just enrolled at VSMU and did not fully understand in their types. Different answers were chosen in the question "How long after the suspected infection should I take a blood test for HIV to assess the infection?", but at the same time, everyone unanimously chose the option of starting treatment "Immediately after the disease is detected." The overall awareness level of the 1st year was 79.26%.

The 2nd year has a slight similarity with the 1st year in terms of transmission routes (only 25% chose that HIV infection is transmitted "from mother to child during breastfeeding"). Already in the question "How long after the suspected infection should I take an HIV blood test to assess the infection?" the opinion was almost divided in half (5 people each voted for "The next day"/"After 3 and 6 months", and only 2 voted for "After a week). It was difficult to determine the actual transmission mechanisms, only about half named the correct ones. But they also voted unanimously for the treatment option "Immediately after the disease was detected." The calculated level of general awareness turned out to be lower than that of the 1st year - 78.13%.

Most of the 3rd year students of the IPF gave correct answers. As with other courses, the issue of mother-to-child transmission during breast-feeding turned out to be difficult - 59.3%. In another "difficult" question, "How long after the suspected infection should I take an HIV blood test to assess the infection?" most chose the option "In 3 and 6 months." Awareness of the course is 90.74%.

The 4th year students correctly chose the option along the path of transmission "from mother to child during pregnancy and childbirth," but only 20% chose "from mother to child during breastfeeding." This significantly affected the overall level of awareness - 88.75%.

The 5th-year and 6th-year students who completed the survey turned out to be fewer than 10 people (6 and 1, respectively) and it is quite difficult to draw any conclusions on them, given the small number of people. Nevertheless, there is an increase in knowledge about HIV infection with the transition to senior courses, which is also noted by other researchers [7].

Conclusions. The level of awareness of HIV infection among Voronezh students is higher among medical students (80.1%) than in other universities (71.0%). Taking into account the predominance of first-year students among all the surveyed, these indicators can be assessed as satisfactory. An almost equal number of correct answers were obtained for the prevailing transmission routes and risk groups, but there is less awareness of the risks of perinatal infection at all its stages. These issues should be more widely discussed during preventive measures or training sessions. Medical students are well informed about the risks of HIV infection in the provision of medical care, but a more detailed study of the legal aspects of this problem is required.

About the authors

Lubov Andreyevna Vlasova

Voronezh State Medical University named after N. N. Burdenko

Email: lyubov-vlasova-99@mail.ru
ORCID iD: 0009-0007-0740-4904

1st year student, 102 groups, Faculty of Medicine and Prevention

Russian Federation, 394036, Russia, Voronezh, st. Studencheskaya, 10

Tamara Nikolaevna Sitnik

Voronezh State Medical University named after N. N. Burdenko

Author for correspondence.
Email: sitniktn@mail.ru
ORCID iD: 0000-0003-2470-4099
SPIN-code: 7431-3504

Assistant of the Department of Epidemiology

394036, Russia, Voronezh, st. Studencheskaya, 10

References

Supplementary files

There are no supplementary files to display.