Nursing Students` Knowledge and Attitude Regarding

HIV/AIDS
Hemn Kareem Qadir
Erbil Polytechnic University &Al-kitab University/Iraq

Background: There have been many cases of HIV/AIDS in Kurdistan Region-Iraq as mentioned by ministry of health in Kurdistan region-
Iraq, and it is increasing every year. The HIV/AIDS Training is not involved formally in the program of the university. This investigation
evaluated the knowledge and attitudes of nursing students` regarding HIV/AIDS in Erbil city.
Aim: To assess nursing students’ knowledge about HIV/AIDS, who are future nurses, and to identify their attitudes toward HIV/AIDS.
Methods: A cross-sectional descriptive study was conducted with 217 Erbil medical technical nursing students both stages both genders in
Erbil city-Iraq during the 2021-2022 academic year, they participated voluntarily to fill a questionnaire sheet knowledge and AIDS Attitude
Scale (AAS) developed by the investigator.
Results: A total of 217 nursing students participated in the survey. Their age ranges from (19-28 years) with mean age 21.69± 4.6 years,
only 25 participants (11.5%) were having high knowledge regarding HIV/AIDS, and only 3 of participants (1.4%) had high attitudes toward
HIV/AIDS.
Discussion: The majority of nursing students had medium knowledge of HIV/AIDS. Almost all of them have negative attitude toward
HIV/AIDS. Though, for the high proportion (65.9%) of low attitudes and (32.7%) with medium attitudes of nursing students, a review of
the recent instructive element on HIV/AIDS is essential. Minority of the nursing students have superior level of knowledge in regards to
HIV/AIDS and disappointed number had positive attitudes in regards to HIV/AIDS.
Conclusion: Improving basic knowledge of nursing students regarding HIV/AIDS is essential, nonetheless also fighting against HIV/AIDS
misconception. The current research illustrated that nursing students must learn more regarding HIV/AIDS. And the negative conception of
HIV/AIDS by the upcoming nurses should be addressed to advance the quality of nursing care.

Keywords: HIV/AIDS, Knowledge, Attitude, Students, nursing, nursing students

1. BACKGROUND Knowledge and attitudes regarding HIV/AIDS are parts of

the main points in the fight against this syndrome 3,4.
Human Immunodeficiency Virus (HIV) remain as a public Education and training on HIV/AIDS increase the knowledge
health problem. According to the WHO around 1.8 million of prospective nurses and qualifies them to progress a positive
people are infected in the glob newly, more than 36.5 million attitude towards persons living with HIV/AIDS 5.
people are living with HIV, and around 1.6 million of them
die annually 1,2. Address for correspondence: Hemn Kareem Qadir, Erbil Polytechnic
University &Al-kitab University/Iraq

Access this article online Received date: 18 August 2022 Accepted: 17 September, 2022
Published: 10 October, 2022
Quick Response Code:
Website: This is an open access journal, and articles are distributed under the terms of the Creative
www.pnrjournal.com Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to
remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is
given and the new creations are licensed under the identical terms.
DOI:
For reprints contact: pnrjournal@gmail.com
10.47750/pnr.2022.13.04.008

How to cite this article: Qadir H K, Nursing Students` Knowledge and Attitude
Regarding HIV/AIDS, J Pharm Negative Results 2022;13(4):70-77.

1 Journal of Pharmaceutical Negative Results ¦ Volume 13 ¦ Issue 4 ¦ 2022 70

 Hemn Kareem Qadir et al : Nursing Students` Knowledge and Attitude Regarding HIV/AIDS

Several prevention programs often emphasize on increasing HIV/AIDS

knowledge regarding the transmission of HIV, ignoring
other educational features 6,7,8,9 This eventually rises
2.2. Study instruments
stigmatization of society living with HIV/AIDS 10,11.
modified questionnaire have been used for data collection,
Stigma is a negative and bad attitude towards persons
consisted of three parts:
presented with HIV; stigmatizing attitudes linked with
misconception regarding the transmission of HIV 8,9,10. It Part one: include the demographic characteristics of the
is necessary to evaluate the attitudes and knowledge nursing participate Students`: {age, gender, residency (rural or
students in regards to HIV/AIDS. This assessment will urban), marital status, stage}
tolerate the establishment of suitable training regarding Part two: Questionnaire has consisted of (18) multiple-choice
HIV/AIDS. Theses specific program will improve the questions to evaluate knowledge of nursing students about
performance of nursing students to better deal with persons HIV/AIDS and the answers were (True, False, and uncertain).
with HIV positive.
Part three: consisted of AIDS Attitudes Scale (AAS) which
Numerous researches have assessed information and composed of (20) multiple-choice questions to assess the
attitudes of students about HIV/AIDS 12,13,14,15. Few level of nursing students` attitudes towards HIV/AIDS and
studies were conducted in the developing countries to the answers were (Strongly disagree, Moderately disagree,
evaluate the familiarity and attitudes of medical Slightly disagree, Slightly agree, Moderately agree, and
undergraduate students regarding HIV/AIDS; Uganda 16, Strongly agree).
South Africa 17 and Botswana 18.
The questionnaire used for this research was created on
Research by Whalen et al. stated that medical students obtainable literature 13,33, 34,35,36,37. Participants were
refused to deal with HIV/AIDS patients [19]. This refusal is asked not to discuss questions with their colleagues. If they
an unacceptable attitude for future medical staff which had requests, they were encouraged to ask the investigator.
demonstrates the extreme distress that HIV/AIDS increases.
Recent studies have examined medical staffs' knowledge,
fears, beliefs and attitudes regarding HIV/AIDS. Other 2.3. Data collection Method:
researches have investigated the willingness of medical
Data have been collected with the use of questionnaire plan
staffs to care for persons with HIV/AIDS 20,21. These
by investigator through spreading questionnaire form copies
investigations amply reveal the importance of develop
to the participants using both English and Kurdish languages.
educational programs on HIV/AIDS and the necessary to
The data were collected in Jan. 2022 to measure knowledge
educate medical and nursing students in the care of people
and attitudes of the attendance regarding HIV/AIDS.
presented with HIV/AIDS 22.
All contributors were informed of the objective of the study
If the knowledge’ level of nursing students, future nurses
and the involvement was anonymous and voluntary.
regarding HIV/AIDS is insufficient, integrating this
Participants were asked to take their time around 30 minutes
educational program into the curriculum in the faculty of
to answer the questionnaire completely. Prior to the start of
nursing is essential. Improving knowledge of nurses will the evaluation, the participants were informed of the
cause more positive attitudes and decrease stigma
technique of answering the questionnaire each part in detail
HIV/AIDS association 23.
to complete the form. Participants were asked After
HIV/AIDS knowledge amongst students of medical completion the investigator collected the answered sheets and
proficiency as seen in the literature, were identified as good then the data were entered to SPSS program for analyzing the
or high level 20,23,24, and proper attitude toward data.
HIV/AIDS 20,23,25,26. Other literatures in contrast have
showed low knowledge of medical students regarding
HIV/AIDS. 27,28,29,30,31,32. 2.4. Sample of study
To date no study have been conducted with nursing students Convenient sampling method has been used to gather data
in Erbil City /Kurdistan Region-Iraq. In this study, we aimed from 265 out of 350 nursing students both genders were
at evaluating the level of knowledge about HIV/AIDS and participated in this study which reveals more than 75% of the
attitudes towards people living with HIV/AIDS among total population, 217 participants were filled the form
nursing students in Erbil City/ Kurdistan Region-Iraq. completely and the others were excluded.

2.5. Setting of study

2. METHODS
The study was conducted at Nursing department of Erbil
2.1. Design of study Technical Medical Institute/Erbil polytechnic
A cross-sectional descriptive study design carried out to university/Erbil City/Kurdistan Region-Iraq.
evaluate knowledge of nursing students regarding

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 Hemn Kareem Qadir et al : Nursing Students` Knowledge and Attitude Regarding HIV/AIDS
the attitude scores < 60% (< 72) considered as (Low
attitudes), the scores of (72-95) considered as (Medium
2.6. Ethical considerations
attitudes) and scores ≥ 80% (≥ 96) were measured (High
Ethical attentions were a focal principle of data collection as attitudes). The inclusive knowledge and attitudes of the
the researcher obtained ethical consent from all participants investigation contributors were measured through the means
individually before collecting information for this study. of the overall score of each result adjusted on Bloom`s cut-
off point (60-80 percent). Measurement degree higher than
the cut of point was considered as having high level of
2.7. Inclusion and exclusion criteria knowledge, and respectable attitude 38, 39, 40, 41. Inferential
Inclusion criteria: all students both genders and both stages and descriptive statistics used with data base of Microsoft
of nursing department/ Erbil Technical Medical Institute/ Excel conjointly with Statistical Package for Social Sciences
Erbil Polytechnic University who accept to participate in (SPSS, Version 25) to find out the frequency and percentages
this study. of the demographic characteristics. Chi-square test were used
Exclusion criteria: students who refuses to participate, and to find out the association between the variables.
non-completed answers of the questionnaire have been P-value were used to identify the relationship between the
excluded. variables as followings:
P-value more than 0.05 indicates non-significant statistically
2.8. Statistical analyses relationship.

The questionnaire forms have been collected by the P-value equals or less than 0.05 indicates significant
researcher and analyzed according to the research statistically relationship.
objectives. Within the knowledge part; a score ‘1’ given for P-value equals or less than 0.01 indicates highly significant
each correct respond, whereas the (don`t know and statistically relationship.
incorrect) answers were assembled with ‘0’ score; while
within the attitude part, the scores of (1-6) were given for the
choices as ‘1’ reveals the lowest attitude and ‘6’ indicates 3. RESULTS
the highest attitude. Total marks were used to abundant the
degrees of both attitudes and knowledges, then qualitative 3.1. Demographic features of the participants:
analysis was conducted to abundant (Good, Medium and The study data retrieval recognized 217 nursing students as
Low scores). Consequently, the supreme probable score was the mean age of participants was 21.69 years ± 4.6 (range 19-
18 for the knowledge part and 120 for the attitude part in 28), 71% of participants were their age of 22 years or
occasion of responding all the requests perfectly. Percentile younger, 73.3% of them were male, 51.6 % were in there first
of scores were determined, and for the knowledge scores < class, and 82.5% were single. Table 1 precises the
60% (< 12) considered as (Low knowledge), the scores of demographic features of the respondents.
(12-14) considered as (Medium knowledge) and scores ≥
80% (≥ 15) were measured as (High knowledge); while for

Table 1: this table demonstrates the demographic characteristics of the nursing student participants.
Demographic characteristic Frequency %
Age groups
19-22 years old 154 71
23 years and older 63 29
Total 217 100
Gender
Male 159 73.3
Female 58 26.7
Total 217 100
Stage
First stage 112 51.6
Second stage 105 48.4
Total 217 100
Marital status
Married 38 17.5
Single 179 82.5
Total 217 100

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regards to HIV/AIDS, while 54.8% of them have moderate

3.2. Knowledge regarding HIV/AIDS among nursing
knowledge and 33.6% were presented with low knowledge as
student participants:
shown in table 2.
The current study represented only 25 nursing students
11.5% of the participants have high level of knowledge in

Table 2: this table demonstrates the frequency of the nursing student’s knowledge regarding HIV/AIDS.
Total knowledge
Scale Frequency %
Low knowledge 73 33.6
Medium knowledge 119 54.8
High knowledge 25 11.5
Total 217 100.0

with HIV/AIDS, while most of them (143 nursing students

3.3. Attitudes regarding HIV/AIDS among nursing
65.9%) were in low attitudes toward the HIV/AIDS patients
student partisipants:
as presented in table 3.
This research illustrates that almost none (3 nursing students
1.4%) of the participants have high attitudes toward patients

Table 3: this table presented the frequency and percentages of the participants attitudes toward HIV/AIDS.
Total attitudes
Scale Frequency %
High attitudes 3 1.4
Medium attitudes 71 32.7
Low attitudes 143 65.9
Total 217 100.0

status) and total knowledge of the nursing students regarding

3.4. This investigation studied the relationship
HIV/AIDS as P-value is mor than 0.05; while there was
between the total knowledge and the demographic
characteristics of the nursing student participants: significant statistical relationship between the stage of the
participants with their total knowledge on HIV/AIDS, as P-
There was no significant statistical relationship between value was less than 0.05, see table 4.
parts of demographical data (age groups, gender, and marital

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Table 4: the association between participants` demographical data and their total knowledge regarding HIV/AIDS.

Total knowledge
Age groups Low Medium High Total P-value
knowledge knowledge knowledge
19-22 Years 52 87 15 154
23 or older 21 32 10 63 0.422
Total 73 119 25 217
Total knowledge
Gender Low Medium High Total P-value
knowledge knowledge knowledge
Male 56 81 22 159
Female 17 38 3 58 0.08
Total 73 119 25 217
Total knowledge
Stage Low Medium High Total P-value
knowledge knowledge knowledge
1st stage 43 64 5 112
2nd stage 30 55 20 105 0.03
Total 73 119 25 217
Total knowledge
Marital status Low Medium High Total P-value
knowledge knowledge knowledge
Married 11 20 7 38
Single 62 99 18 179 0.325
Total 73 119 25 217

toward HIV/AIDS as P-value is mor than 0.05; however,

3.5. this research investigated the relationship
between the total attitudes of the nursing student there was significant statistical relationship between the
participants and their demographic characteristics: (gender, and marital status) of the participants and the
nursing students’ attitudes toward HIV/AIDS, as P-value is
There was no significant statistical relationship between (age less than 0.05, see table 5.
groups, and stage) of participants and their total attitudes

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Table 5: the relationship between nursing students` demographical data and their total attitudes toward HIV/AIDS
Total attitudes
Age groups High attitudes Medium Low attitudes Total P-value
attitudes

19-22 Years 2 47 105 154

23 or older 1 24 38 63 0.540
Total 3 71 143 217
Total attitudes
Gender High attitudes Medium Low attitudes Total P-value
attitudes
Male 2 60 97 159
Female 1 11 46 58 0.03
Total 3 71 143 217
Total attitudes
Stage High attitudes Medium Low attitudes Total P-value
attitudes
1st stage 1 29 82 112
2nd stage 2 42 61 105 0.061
Total 3 71 143 217
Total attitudes
Marital status High attitudes Medium Low attitudes Total P-value
attitudes
Married 2 16 20 38
Single 1 55 123 179 0.024
Total 3 71 143 217

4. DISCUSSION
With the deprived presentation of correct responds to many
Nursing students in Erbil polytechnic university measured
questions by nursing students, lecturers and education leaders
as future nursing staffs must have satisfactory knowledge
need to involve in setting up teaching units on HIV/AIDS
regarding HIV/AIDS infection. HIV knowledge is a very
transmission. This is significance for any upgrading of
valuable instrument for any suspected cases of HIV, to
nursing departments` teaching programs and the education
assess the scope to which the patients living with HIV
and attention of HIV/AIDS society.
required to be concerned for.
Most of participants had medium knowledge regarding
Nursing students` knowledge on HIV could play a main role
HIV/AIDS, but there were remained students who have a
in the Iraqi system of health care. They represent the
negative attitude regarding HIV/AIDS. Almost all of the
upcoming nurses of the country.
nursing students assumed that the patients with HIV/AIDS
The current study showed none encouraging outcomes: it deserve what they complain from and they have no rites as
showed only 11.5% of high knowledge, other patients in sense of respect and receiving medical helps.
This research indicated that only 1.4 % of the participants Other investigations have shown students with positive
showed high attitudes toward susceptible patients with attitudes regarding HIV/AIDS 31,43.
HIV/AIDS. Whereas other surveys measured more The current study found that minority of nursing students
optimistic attitudes towards patients alive with HIV/AIDS 2. have believe of mother-to-child transmission of HIV could
Al-Rabeei et al, indicated that around 64% of students stated take place and could transmitted by feces, urine, and through
that they are willing to work with HIV positive patients 42. oral contact. These answers confirm low knowledge among
The negative attitude is mainly coming from the fear of nursing students regarding the pathway of HIV transmission.
being infected with the virus 24. The nursing students` This result supported by other study done in Uganda 2, and
training but also the continuous medical and nursing training contrasted with Rickels et al. which found that more than 70%
of all health professionals is important to improve their of their students answered HIV can be transmitted through
attitudes and knowledge toward HIV/AIDS society. The fluids like urine 44. Our students are lack information
results of our students indicate lack information about regarding the danger of HIV transmission.
HIV/AIDS; nursing students should develop their
knowledge regarding HIV/AIDS and also improve their
attitudes toward HIV/AIDS society.

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