The current study extensively collected data on 82 data points to adequately assess the current knowledge, understanding, and views on HIV/AIDS.
1. Participant Age:
Section 2 - Upon stratification, the results show that a participant’s age does not have an impact on the level of knowledge about HIV/AIDS. The majority were correct in their choices, which is unlike a previously conducted meta-analysis that found that older adults were less knowledgeable and did not have easy access to information[19].
Section 3 - Older participants were found to be more socially accepting of HIV/AIDS patients but seemed critical of their lifestyle choices, with the majority believing that the patients were infected due to their carelessness.
Section 4 - The participant’s age did not affect their beliefs about blood donation. Most believed that high-risk individuals (LGBTQ+, physicians, and healthcare personnel) should be allowed to donate blood, as previous discussions suggest[20], but diseased individuals (IV drug users, HepB/C, syphilis, gonorrhea TB) must be barred from doing so, which is in agreement with the guidelines established by the National Blood Transfusion Council.
10. Main Source of Information
Similar to the Chinese study[21], a clear majority of the participants (45.8%) selected the internet as their main source of information about HIV and parents (0.7%) being the last source of information. A clear inadequacy of public health campaigns can be seen with Newspapers, Radio and Television only contributing a minor 5.6 percent.
Section 2: Knowledge about HIV/AIDS
We found that while most people are aware of the cause of the disease, almost half of them hesitate to classify it as a contagious disease. About 64.7% correctly agree that it is not a hereditary disease, as it can be acquired at birth but is not inherited from the parent[27]. A clear majority could not be reached on certain ethnicities having immunity against HIV infection, which is false, as research suggests that immunity towards HIV is thought to be due to a previous bubonic plague infection[28].
A 51% majority assume that HIV/AIDS is predominant in developing and underdeveloped countries, which is correct as the top ten countries with the highest HIV rates are developing African nations[4]. Slightly less than a quarter of the study population wrongly believes that HIV/AIDS is not a life-threatening condition.
Sixty-two point seven percent correctly answered that PLWHIV are usually asymptomatic in the earlier stages, which as per the HIV-KQ-8[18] questionnaire. Three-quarters of the study population rightly agreed that an HIV-infected individual has a lower resistance to other diseases[5]. A greater part of the study participants were accurate to disagree with the existence of an HIV/AIDS vaccine[29]. The majority were correct in knowing that ELISA, Tridot, and Western blot are used to diagnose HIV/AIDS[30]. Forty percent incorrectly believed that urine analysis, chest X-ray, complete blood count, etc are used to diagnose HIV.
Modes of HIV transmission are wide and varied; the bulk of the subjects were comparatively[7, 8, 10] better informed about the disease transmission from infected pregnant and lactating mothers, donor organs, blood, used razor blades, tattoo needles, and surgical and dental instruments. Unlike previous surveys[14, 15, 31], individuals were also aware that coughing, sneezing, hugging, sharing utensils, sharing clothes, combs, and mosquito bites do not transmit the virus.
Participants strongly and rightly believe that the virus could be transmitted from vaginal coitus[32] (92.3%) and anal coitus[33, 34] (80.5%) but are less certain about oral intercourse[35, 36] (67.0%). Similarly, individuals are aware of the disease transmission from blood (94.1%), vaginal fluid (85.8%), and sperm[37] (90.3%), but are less certain about breast milk[37] (68.4%) and are unaware about a rare form of transmission from saliva[38] (31.5%). Furthermore, participants are aware that the virus cannot be transmitted from urine, feces, tears, sweat, and nasal discharge[37, 38]. The observed results are similar to multiple studies conducted in Jordan[39], Indonesia[40], Thailand[41], etc.
More than half the study participants are unaware that antibiotics play no role in preventing the transmission of the disease, which is similar to multiple studies[39, 40, 41]. According to the current guideline, over 4/5th agree that HIV is a reportable disease[42, 43]. About 60% agree that the infection cannot be cured and can only be clinically managed which is similar to the survey conducted in Beijing[21].
Section 3: Personal beliefs towards HIV/AIDS
This section assesses the social stigma prevalent in Indian society. Three hundred sixty-eight
Individuals disagree with the idea of separate schools of PLWHIV, which differs from a Chinese survey, which found that only 20% were willing to co-habitat with an HIV-positive individual[44]. Amongst the rest, a considerable number of participants specified that they only agree with the statement because they believe HIV patients would get fewer secondary infections with decreased exposure to the general public, the same was echoed later in the questionnaire with 17.2% agreeing with isolation of the patients, which again differs from another study, which found that over half the participating school students were in support of quarantining HIV students to reduce the spread of the infection[45].
None of the participants refused to attend school with PLWHIV and were willing to be friends with them, which is encouraging as previous reports indicate that most individuals do not reveal their status for the fear of being shunned[46]. On the contrary, the opinion was split about having a PLWHIV as a partner, with over half being against the idea, which was similarly seen in the UK[47].
An overwhelming majority stated that they would use using the same chair as an HIV-infected individual. Slightly less than 50% agreed to have social contact with an infected person. Interestingly, more people (58%) were okay with sharing public toilets and swimming pools than mixing laundry (46.6%). This alludes to the possibility of misunderstanding about the possible routes of transmission. This incorrect opinion has been found in multiple studies conducted across the world[48, 49, 50].
Unfortunately, a majority believe that HIV is passed down due to carelessness and lack of proper protection. Similar criticisms were seen in among the Rwanda people[51], but participants agree that most healthcare workers and physicians are accidentally infected while treating HIV patients.
While the majority appears to be well versed in the transmission of the disease, few seem to suffer from misconceptions about the disease; over 80% of the participants disagree that HIV is a punishment from God, which was seen in a previous study[16]; and that positive people do not get infected by the virus[16]. Moreover, 90% disagree that their country does not have AIDS. But, 3 in 10 people believe that they will not get AIDS ‘come what may’, and 2 in 10 believe that married people pursuing an extramarital affair cannot get infected. Like an early study, 23% believe that being physically active makes them immune to HIV[16].
No clear majority could be found on if the list of PLWHIV should be made public, an argument about prioritizing patient privacy over public health and vice versa can be explored further. Likewise, 47% agree that individuals who do not reveal their infection must be jailed. The topic has been widely debated[52, 53]; some perceive that it would further stigmatize the patient[54], whereas others argue that it is necessary[55].
Concerningly, almost 90% of the participants agreed that they would not help a bleeding HIV victim. Overall, 299 participants expressed interest to learn more about the condition.
Section 4: Personal Beliefs on Blood Donation and HIV
Despite recent publications[56, 57] on rethinking policy on the sexual minorities being allowed to donate blood, the result was split on if LGBTQ + individuals should be allowed to donate blood with no clear majority. The participants agree with the suggestion of physicians and other healthcare personnel donating blood. On the other hand, they were tremendously against the idea of IV drug users, Hepatitis B, Hepatitis C, Syphilis, or TB individuals donating blood.