June 2008 - Volume 2, Issue 3

The knowledge of Non - Pilgrimage passengers who are on the point of leaving for abroad, about the ways of AIDS transmission and prevention of it

Maryam, Nooritajer*. Hekmat, Mana *Associate professor of Iran University of medical science.maryamnoorytajer@yahoo.com

ABSTRACT Introduction: International passengers are one of the most high risk groups to be exposed to AIDS, and should be aware of the dangers of this disease. The destination is not important but the passengers' knowledge is very important. Objectives: To determine the knowledge of Non-Pilgrimage, passengers, who are on the point of leaving abroad, about the ways of AIDS transmission and its prevention, conducted in Tehran's International airport. Materials and Methods: This is a cross-sectional study which determines the participants' knowledge about ways of AIDS transmission and its prevention and then the relationship between these and demographic characteristics have been measured. Samples: 200 of non-pilgrimage travelers who were going abroad have been selected via random selection in Tehran's airport. Results: Mean value (13.1) and standard deviation (4.32) showed that the knowledge of passengers was in the average level. X showed the positive relationships between knowledge and some variables like educational level, purpose of trip, continent of destination and the person's job (P < 0.05). Z statistical test and Pearson's correlation coefficient showed that there is a positive relationship between passengers' knowledge and their age (P < 0.05),(r = .14) and between passengers' knowledge and their informational sources.(P< 0.05), (r = 0.51) Conclusion: Findings showed that passengers did not have sufficient knowledge about AIDs (transmission and prevention of AIDS). So, their health knowledge must have been increased for health protection. Therefore training is one of the ways which can be used to increase passengers' knowledge. Key Words: The ways of AIDS transmission, the ways of AIDS prevention, non-pilgrimage passengers.

INTRODUCTION

The HIV virus has been spread throughout the world. In fact AIDS was diagnosed in 1981 when it became epidemic. It is one of the most dreadful infectious diseases in the 21st century. It decreases the human body's immune system and the infected patients don't have any resistance against different diseases and rare cancer⁽¹⁾. The first recorded case of AIDS appeared among homosexuals and injection drug abusers in western countries. The appearance of a totally different pattern of AIDS in Africa, the most deprived and poorest continent in the world⁽²⁾, have propounded the new epidemiologic dimensions of this mysterious disease. So, this problem has been considered in three different epidemiological dimensions with their relationships:
1- The virus suffering epidemic
2- The AIDS disease
3- The social, cultural, economical and political reactions epidemic⁽³⁾

About the first epidemic, HIV suffering persons were 12 million in 1993 and W.H.O has predicted that they will become 40 million in 2000⁽⁴⁾.
The second epidemic is AIDS that has increased in the world rapidly. The number of patients' were70,000 between the years 1981 - 1985 and unfortunately it became more than 1 million persons in the year 1999 with 45% of them from Africa⁽⁵⁾.

About the third epidemic, Shahnazarian, the quotation of Phibs, said: one of the main problems is the effect of AIDS on youth because the rate of 20-40 years olds acquitting AIDS is higher than the other age groups⁽⁴⁾.

Therefore AIDs has been propounded as an economical, social, political and cultural disease⁽⁶⁾.
W.H.O stated that there isn't anything more unexpected and complicated than AIDS in the last decades. It is also stated that 5 million new cases had been diagnosed in 1999 of which 2.1 million affected patients had died in the same year and 2 million cases are added to this number every year. It means that every second one person becomes affected with the HIV virus. It is also stated that there are 12 - 13 affected African women versus 10 men and the others are scattered in all over the world⁽⁷⁾.

According to the AIDS section of the United Nations organization, about 35.7 million persons at adult age and 2.1 million children at the end of 2003 are infected with HIV, and by 2004; nearly 4.8 million people had HIV infection.

The last report of the United Nation organization programs in November 2007; states there were 2,200,000 persons that had HIV infection and AIDS.
50% of these are under 25 years and will be dead before 35 years old, and the morbidity rate of HIV infection is increasing in the Middle East⁽⁸⁾.

In Iran at the end of autumn 2007, the management diseases center published that 16,090 person's have been recognised with HIV/AIDS. 16,682 of them havw HIV infection (15,686 men and 993 female) while 2,382 of them had AIDS (2,291 men and 91 women). Also at the end of summer 2007; 2,121 persons who had AIDS, died⁽⁹⁾.

It is reported that the transmission pattern of AIDs in the north of Iran is vua blood and blood products and in the south, it is via sexual contact with one of its factors the journey of southern persons to Arabic countries.

Jana tan stated that international passengers are one of the high risk groups who should be aware of the dangers of AIDS. Malek Afzaly stated that millions of Iranians travel abroad every year and at this time 60% of affected persons are those who were living abroad for some time. AIDS is one of the most important health problems all over the world which can affect international passengers, because suffering from this disease is dependent on people's behaviors⁽¹¹⁾.

The passenger's destination is not important but the passengers' knowledge about AIDS and its ways of transmission and prevention, is very important So, the researcher has tried to do this study with 3 objectives:

1) To determine the non-pilgrimage passengers' demographic characteristics
2) To determine the knowledge of non-pilgrimage passengers who are on the point of leaving abroad, about the ways of AIDS transmission and its relationship with demographic characteristics.
3) To determine the knowledge of non-pilgrimage passengers who are on the point of leaving abroad, about AIDS prevention and its relationship with demographic characteristics.
It is hoped that the findings could help in providing good and suitable educational programs.

MATERIALS AND METHODS

This is a cross-sectional study. In this research, first of all, demographic characteristics have been shown and then the knowledge of participants about the ways of AIDS transmission and its prevention have been shown and then their relationships have been measured. Data has been collected once and in one stage. The instrument of this study was a questionnaire which had two parts with 30 questions. In the first part, the questionnaire had 9 questions about participants' demographic characteristics related to the first objective. In the second part, there were 12 questions about the ways of AIDS transmission related to the second objective and 9 questions about the ways of AIDS prevention related to the third objective. In this research, for validity, with due regard to the objectvess, Content Validity has been used.

Samples of this study were 200 of non-pilgrimage passengers who wanted to travel abroad in Mehr Abad International airport of Tehran.

Sampling has been done in 2 stages. First of all, the lists of foreign passengers' flight have been prepared and then 4 days of the week have been chosen by chance and because the foreign flights were from 10 P.M until 8 A.M, after coordination with related official units, the questionnaires have been distributed among passengers who participated optionally. Admissive criterions of samples were:

1) Participants should be 20-60 years old
2) They should be inclined to participation and should be able to answer the questions.

Collected data has been analyzed with SPSS. Descriptive statistics have been used for drawing up Frequency distribution tables and percentages, mean value and standard deviation measuring. Inferential statistics have been used for understanding the relationships between variables. For understanding the correlation between Qualitative data X has been used, and for understanding the intensity of correlation between these variables contingency coefficient has been used. For Quantitative data Z statistical test and Pearson's correlation coefficient and leaner regression has been used and for showing the presence of a positive relationship between the mean value of the men and women's knowledge, t-test has been used.

The criterions of measuring the numbers of correct answers to the questions were on the basis of objects that equated to good, average and poor knowledge. So in the second object, the total correct answers between (9 - 12) were good, (5 - 8) were average and (0 - 4) were poor and about the third object, the total correct answers between (7 - 9) were good, (4 - 6) were average and (0 - 3) were poor.

RESULTS AND DISCUSSIONS

Findings about demographic characteristics showed that most of the participants (67.5%) were men. 83% of participants were between 20 - 39 years old of which the mean value and standard deviation were 33.3 and 8.28. About the educational level most of the samples (48%) were diploma graduates. 63.5% were married and 32% were single. Most of the passengers (52%) had non-governmental and 22% had governmental jobs. 22% of passengers were traveling to visit their families, 21% for trading and 19% for touring. 50.5% of passengers were traveling to Europe, 20.5% to Arabic countries, 14.5% to north and south Asia and 15% to U.S.A. About 49% of passengers had used informational sources to get knowledge about the ways of prevention and transmissions of HIV (the mean value was 1.85 and standard deviation was 1.005). 30.5% of participants had traveled abroad more than 3 times (the mean value was 2.46 and standard deviation was 1.18).

Findings about the knowledge of non-pilgrimage passengers about the ways of AIDS transmission and prevention showed that 49.2% of females and 48.1% of men had average knowledge. T-test did not show any positive relationship between the mean value of knowledge and sex but the Pearson's correlation coefficient showed positive relationship between age and knowledge (r = 0.14)(p <0.05). Most of the passengers (69.4%) who had used the same informational sources, had average knowledge and 73.3% of passengers who had used three informational sources had good knowledge.

Pearson's correlation coefficient showed the positive relationship between the numbers of informational sources and the knowledge of the ways of AIDs transmission (r=0.51)(p<0.05). Findings showed that 49.2% of passengers who had traveled abroad more than three times had good knowledge and 50.8% of passengers who were traveling abroad for the first time had average knowledge (Table 1). Pearson's correlation coefficient showed the positive relationship between the times of traveling and the passengers' knowledge about AIDS (r=0.23) (p<0.05).

Times of traveling to abroad

46.9% of participants who had diploma had average knowledge whereas 49.4% of passengers who had university education had good knowledge (Table 2). X showed the positive relationship between educational level and knowledge about the ways of AIDs transmission (p<0.05).

Educational level

72.4% of passengers who were traveling to the U.S.A had good knowledge and 55.5% of passengers who were traveling to Europe had average knowledge (Table 3). X showed the positive relationship between knowledge and the continent of destination (p<0.05).

Continent of destination

Poor                           6(6%)                     2(6.9%)               6(11.8)

Average                  56(55.5%)                6(20.7%)            35(50%)

Good                        27(38.6%)          39(38.5%)            21(72.4%)

50.4% of married passengers had average knowledge about the AIDs transmission but X didn't show any positive relationship between knowledge and marital situation.

About prevention of AIDs which was related to the third objective, t-test showed the positive relationship between the knowledge of women and men (p<0.05). 44% of passengers between 20 - 39 years old had average knowledge about prevention of AIDs. Pearson's correlation coefficient showed (r=-0.34) the reversed relationship between knowledge and prevention. Z statistical test showed that this relationship is positive (p<0.01).

Regression line (diagram 1) showed the equation of this correlation.
(Y = a + bX, a and b has been calculated from the related formula which is equal to Y = 7.13 - 0.6

46.9% of participants who had used the same informational sources had poor knowledge and the Pearson's correlation coefficient showed the positive and reversed relationship between the numbers of used informational sources and the knowledge of AIDS prevention (p<0.05) (r=- 0.67) and in this relationship the participants who had diploma had average knowledge. X showed the positive relationship between educational level and the knowledge of AIDS prevention (p<0.05).

More than half of the participants (51.3%) who had non-governmental jobs had average knowledge and 43.2% of passengers who had governmental jobs had good knowledge about AIDS prevention (Table 4). X showed the positive relationship between passengers' job situation and knowledge about AIDs prevention (p<0.05).

Table 4 Knowledge about the ways of AIDs transmission according to passengers' job situation (n=200)

Job situation

Knowledge       governmental        non-governmental        housewife

Poor                          10(22.7%)                 30(25.6%)                    14(35.9%)

Average                    15(34.1%)                 60(51.3%)                    12(30.8%)

Good                         19(43.2%)                 27(23.1%)                    13(33.3%)

CONCLUSION

Findings showed that most of the participants (67.5%) were men and 83% of participants were between 20 - 39 years old of which 42% of were between 20-29. Shahcheraghy said that the relationship between AIDS and society related to different factors one of which is age because in countries in which AIDS is epidemic, most of the affected persons are between 20-39 years old⁽¹²⁾.. All of the factors like society, economy, patterns of life cultures and politics which can increase the risk of AIDS should be recognized to provide prevention strategies⁽¹³⁾.

In this study, the maximum of good knowledge (67.3%) was from passengers who had used more than three informational sources but 71.3% of passengers who had used just one informational source, the source was mass media. Parsi nia, the quotation of W.H.O, said that Mass media should be accessible for people quickly because "Health for All" is the purpose⁽¹⁴⁾.

Mass media should remind the subjects and encourage people continually. More than half of the non-pilgrimage passengers (48.5%) who were traveling abroad had average knowledge about the ways of AIDs transmission. Knowledge has a very important role in health promotion, so people should have been aware about the role of healthy behaviors, so they perceive tha thealthy behaviors are the only way to be healthy⁽¹¹⁾.

For example, 37.5% of passengers believed that AIDS can transmit with insects and 23.5% believed that it can be transmitted via public toilets. Findings about the role of training about AIDS for increasing the knowledge of medical students' showed that before training 10% of students thought that insects can transmit AIDS but after training it became 1%⁽¹⁵⁾.

Since, AIDS become a very important problem all over the world, the person's destination is not very important but it is important that they have enough knowledge about AIDS prevention."
In this research, more than half of the passengers who were going to Asia had average knowledge about the ways of AIDS transmission. W.H.O stated that Asia is in the second epidemic phase and HIV virus is spreading very quickly⁽¹⁶⁾.

About half of the non-pilgrimage passengers(43.5%) who were traveling abroad had average knowledge about AIDs prevention and their knowledge had a positive relationship with characteristics like age, sex, level of education, job, continent of destination, the numbers of informational sources and the times of traveling.

Reyn said that with due regard to the epidemic phase of AIDs and developing of world communication webs and increase of international passengers, so passengers should have considered two important points. Firstly, recognizing the risk factors for avoiding HIV/AIDs and secondly, training the passengers in prevention of infection and suffering from AIDS. So, this means they should have been trained before traveling⁽¹⁷⁾.

Findings in this research showed that there is a positive relationship between passengers' age and educational level with their knowledge, so it is proposed that related personnel (Health, Educational, Cultural and Ministries) include useful information in text-books for informing students about AIDS and the ways of transmission and prevention of it.

Findings showed that passengers who were traveling abroad didn't have sufficient and suitable knowledge about AIDS and its modes of transmission and prevention, so it is proposed that personnel of the international airport with coordination of Health and AIDS Control Committee of Health Ministry give the passengers simple facts about AIDs. Pyda stated that for international passengers' health protection should have increased their health information, therefore training is one of the ways to increase knowledge. So passengers should have been trained for 1 or 2 minutes before flying, with suitable subjects⁽¹⁸⁾.

Because AIDS is a fatal disease and can affect every age, sex, race, especially the young generations, in all countries millions of passengers arrive and depart every year, so health training is very important.

Researchers hoped that other researches like "Investigation of passengers' educational needs about AIDs and its transmission and preventive ways", will be based on the results of this research.

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