Knowledge of basics and ocular manifestations of HIV/AIDS among high schools learners in the Capricorn District of Limpopo Province, South Africa

Abstract

Human Immunodeficiency Virus (HIV) and the associated Acquired Immunodeficiency Syndrome (AIDS) are major public health concerns worldwide and present socioeconomic burden to many governments. To combat this scourge, a deep knowledge about this pandemic is required as one of the preventive methods. Also, the knowledge can serve as a tool to help those who are infected. HIV/AIDS is common among adolescents; therefore, one of the aims of this study is to establish the knowledge of basics of HIV/AIDS among high school learners in the Capricorn district of the Limpopo Province, South Africa.HIV/AIDS also affects the eye; identification of the ocular problem can sometimes help with the diagnosis of HIV/AIDS the condition. Therefore may have both sight and life-saving implications. The school curriculum and HIV/ AIDS awareness campaigns in South Africa do not include basic knowledge of the effects of HIV/AIDS on the eye; therefore an additional aim of this study was to establish the basic knowledge of the effects of HIV/AIDS on the eye among the participants, so that an informed recommendation can be made for the inclusion of the eye component in the awareness campaign and school curriculum. Methodology Following relevant research and ethics approval of the proposal, relevant permissions were obtained before the study commenced. A quantitative survey design was used for the study. Stratified random sampling method was used to select high schools and students that took part in the research. The participants were learners from 18 selected high schools in the Capricorn district of the Limpopo Province. A questionnaire containing demographic data, information on general and ocular effects of HIV/AIDS was used to collect information from the learners, following a pilot study involving 20 high school learners. Data was analyzed with Statistical Packages for Social Sciences (SPSS) computer program version 16. Descriptive statistics (range, mean, standard deviations and frequencies) was used to describe the findings, and analysis of covariance (ANCOVA) model was used to model the scores on each of the dependent variables i.e. general knowledge of HIV/AIDS and basic knowledge of the effects of HIV/AIDS on the eye. Results The participants were 2659 black South African learners in grades 10 to 12 in the high schools. Eighty eight percent were from rural high schools and (12%) were from a semi-urban high school. Their ages ranged from 14 to 28 years with a mean age of 17.82 and SD of ±1.766 years. The participants included (46.4%) males,(53.1%) females, and (0.5%) learners did not indicate their gender.The meaning of the acronym HIV was known by 63.6% of the participants, and these included 65.8% of the females and 61.5% of males. A lesser proportion (61.5%) knew what the acronym AIDS stands for. They included 70.9% of the females and 60.8% of the males. Knowledge about the different modes of HIV transmission varied from 87.0% (transmission through unprotected sex) to 62.5% (transmission from mother-to–child during pregnancy). Regarding the misconception on the modes of HIV/AIDS transmission, a majority (81.5%) of the learners knew that HIV/AIDS could not be transmitted from one person to another through hugging a person infected with HIV; this percentage includes 82.6% of the females and 80.3% of the males.Only two respondents (0.1%) out of the total population knew the meaning of window period in HIV and they were both females. Only about a third (33.2%) knew the difference between HIV positive and negative results. Majority (85.9%) knew that it is important for one to know his or her HIV status. However, only 5.6% knew the reason why people should know their HIV status. Many (60.1%) knew that the manifestation of HIV symptoms can take many years to develop on an HIV infected person, and 54.9% knew that immune system suppression is the first effect of HIV on the body. Knowledge of the effects of HIV on the body during the seroconversion phase (acute phase), varies from 29.9% (HIV can cause continuous nausea) to 73.0% (HIV can cause tiredness). On the facilities that can be used to test for HIV status, knowledge of the participants varied from 93.4% (knew that HIV test can be done at a hospital) to 34.2% (HIV test can be done at the offices of family general medical practitioner). Only a few (27.8%) knew that HIV/ AIDS can affect the eye. Many (65.5%) of the participants knew that an ophthalmologist or an optometrist should be consulted for ocular problems that are related to HIV/AIDS. Knowledge on the effects of HIV on the eye ranges from 20.6% (HIV can cause an itching and burning sensation in the eye) to 58.6% (HIV can cause severe headaches). Forty six percent knew that HIV can cause blindness. Less than half of the participants (46.9%) knew that exchanging contact lenses with the infected person could not transmit HIV from an HIV positive person. Generally the performance was poor on the ocular manifestation of HIV/AIDS. Young learners were more knowledgeable than the older ones, for both general knowledge of HIV/AIDS and knowledge of the effect of HIV/AIDS on the eye (p < 0.05). Gender of the participants was not statistically significant for both components of the survey (p > 0.05). The pattern of performance among the grades across the schools was not consistent for both components of the survey. Also ages of the learners and their grades did not correspond in terms of performance in this study. Conclusion and recommendations General knowledge of HIV/AIDS was fairly good, but the basic knowledge of the effects of HIV/AIDS on the eye was poor. Therefore, to improve the knowledge about HIV/AIDS of the target population people, there is a need for more awareness campaigns in the rural areas of South Africa. Also, it is recommended that basic knowledge of the effects of HIV/AIDS on the eye should be included in the awareness campaigns (e.g. TV, newspapers, radio, magazines, fliers and HIV/AIDS workshops) and should also be integrated into HIV education syllabus as early as primary level. Educators teaching life orientation and life skills should have regular continuing educational programmes to increase their knowledge on the subject of HIV/AIDS and its effects on organs of the body such as the eye.