The Role of E-Health Literacy From Social Media and Knowledge of HIVAIDS On HIVAIDS Preventive Behaviours

The Role of Social Media and the Effectiveness of Communication
Design Framework in HIV/Aids Prevention
Razlan Bin Abd Rauf
A research report submitted in partial fulfilment of the requirement of the

Master of Communication (Integrated Marketing Communication)
SchoolMedia
The Role of e-Health Literacy from Social of Communication
and Knowledge of HIVAIDS on HIVAIDS
Preventive Behaviours
Universiti Sains Malaysia
Razlan Bin Abd Rauf
April 2021
A research report submitted in partial fulfilment of requirement of the

Master of Communication (Integrated Marketing Communication)
School of Communication
Universiti Sains Malaysia
April 2021
3
TABLE OF CONTENTS
ABSTRACT .............................................................................................................................. 1
ABSTRAK ................................................................................................................................ 2
CHAPTER 1 ............................................................................................................................. 4
INTRODUCTION.................................................................................................................... 4
1.1 Background of the Study .............................................................................................. 4
Research Problem .................................................................................................................... 7
1.2 Research Objective ....................................................................................................... 9
1.3 Research Question ...................................................................................................... 10
1.4 Research Scope and Significance ............................................................................... 10
CHAPTER 2 ........................................................................................................................... 13
REVIEW OF LITERATURE ............................................................................................... 13
2.0 Definition of Social Media and Subject Matter Focus ............................................. 13
a) Role of Social Media in Information Seeking and Delivery........................................ 13
b) Role of Social Media in Persuasion ............................................................................... 14
2.1 Subject Matter Focus: Information on HIV and AIDS via the online platform ... 15
2.2 Theories and Model Framework ............................................................................... 16
2.3 Health Literacy and Preventive Behaviours............................................................. 18
CHAPTER 3 ........................................................................................................................... 20
RESEARCH METHODOLOGY ......................................................................................... 20
3.0 Research Methods and Research Design .................................................................. 20
Research Methods .................................................................................................................. 20
Research Design ..................................................................................................................... 20
3.1 Conceptualisation of variables ................................................................................... 21
3.2 Operationalisation of variables .................................................................................. 22
3.3 Hypothesis.................................................................................................................... 22
3.4 Statistical Analysis ...................................................................................................... 25
3.5 Sample of the study ..................................................................................................... 25
3.6 Instruments .................................................................................................................. 27
3.7 Methods ........................................................................................................................ 33
3.8 Data Collection ............................................................................................................ 34
3.9 Measurement of Studies ............................................................................................. 34
CHAPTER 4: .......................................................................................................................... 35
FINDINGS .............................................................................................................................. 35
4.0 Introduction ................................................................................................................. 35
4.1 Demographic Profile ................................................................................................... 35
4
4.2 General Knowledge, e-Health Literacy and Behaviour .......................................... 37
4.3 Descriptive Analysis of Variables .............................................................................. 38
4.4 Multiple Regression Analysis ..................................................................................... 40
4.4.1 Relationship between e-Health Literacy Is Positively Associated with
Preventive Behaviour on HIV and AIDS ............................................................................. 41
4.4.2 Relationship between Knowledge of the Diseases HIV and AIDS with
Preventive Behaviour............................................................................................................. 42
CHAPTER 5: .......................................................................................................................... 43
DISCUSSION, IMPLICATION AND CONCLUSION ..................................................... 43
5.0 Introduction ................................................................................................................. 43
5.1 Demographic Background of the Respondents ........................................................ 43
5.2 Discussion on Preventive Behaviour on HIV and AIDS ......................................... 43
5.3 The influence of e-Health Literacy on social media is significantly positive
associated with preventive behaviours in HIV and AIDS .................................................. 44
5.4 The influence knowledge of diseases HIV and AIDS is positively associated with
preventive behaviours in HIV and AIDS ............................................................................. 45
5.6 Implications ................................................................................................................. 45
5.8 Limitations of the Study and Recommendation for Future Research ................... 48
5.9 Conclusion ................................................................................................................... 49
REFERENCES ....................................................................................................................... 51
APPENDIX ............................................................................................................................. 56
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LIST OF TABLES AND FIGURE
Research Problem ................................................................................................................ 7
CHAPTER 2 ....................................................................................................................... 13
REVIEW OF LITERATURE ........................................................................................... 13
Figure 1: Research Model .................................................................................................... 24
Table 3.6.1: Item Indicators .............................................................................................. 27
Table 4.1 Demographic Profile of the Respondents (n=115) .......................................... 36
Table 4.2 Overall Mean Score for Using Social Media to Learn About HIV and AIDS
.............................................................................................................................................. 37
Table 4.3: Detailed Overall Mean Score and Standard Deviation Score ...................... 39
Table 4.4: Multiple Regression Analysis Output between the Two Independent
Variables and the Preventive Behaviour of HIV and AIDS ........................................... 42
Table 4.5: Summary of Hypotheses Testing .................................................................... 42
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DECLARATION
I admit that this work is my work except for excerpts from the summary of which I have
mentioned each source.
14 April 2021 Razlan Bin Abd Rauf

S-KOM0003/19
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ABSTRACT
The first cases of HIV in Malaysia were reported in 1986, and there was a sharp increase of 10
cases in 1990. After scientists introduced three combinations of Antiretroviral (ART)
treatments in 1995, there was a decrease in HIV cases. In 2018, the rate of new HIV cases in
Malaysia was 10 cases per 100,000 populations. Of these cases, a total of 47 patients involved
individuals under the age of 18. No treatment can eliminate the virus as a whole, but HIV can
be prevented or given early treatment before the onset of AIDS. So, early detection and safety
precaution to avoid being infected by the disease is essential. Social media has essentially
changed how people communicate and share information (Kaplan & Haenlein, 2009), and
health communication has indeed been immune to this information revolution (Kreps, 2011).
With the advent of Facebook, people, without having to meet, can interact with each other.
Nowadays, many new media facilities such as the internet, smartphones, and others have given
society a new dimension in understanding HIV and AIDS and its actions. There is very little
research on public awareness of HIV and AIDS and the role played by social media in dealing
with this disease. This study aims to explore the predictive part of social media use, the
knowledge of the diseases and e-Health literacy about public preventive behaviours on
HIV and AIDS in the Klang Valley area. A proportionate probability sampling will be utilized,
conducted through an online cross-sectional survey among social media users in Klang Valley.
The participants will complete the questionnaires based on designated areas of interest on social
media on HIV and AIDS. Basic correlations analysis and hierarchical multiple regressions will
be used to examine and explore the relationships among all the variables.
Keywords: Social Media Use, Knowledge of the Diseases, e-Health Literacy and Public
Preventive Behaviour.
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ABSTRAK
Kes HIV yang pertama di Malaysia dilaporkan pada tahun 1986, dan terdapat peningkatan
mendadak sebanyak 10 kes pada tahun 1990. Selepas para saintis memperkenalkan rawatan
tiga kombinasi ‘Antiretroviral’ pada tahun 1995, berlaku penurunan kes HIV dilaporkan. Pada
tahun 2018, kadar kebolehjangkitan kes HIV di Malaysia adalah 10 kes daripada 100,000
populasi. Daripada dapatan kes-kes ini, 47 orang pesakit yang dijangkiti adalah berumur di
bawah 18 tahun. Tiada rawatan yang boleh menyembuhkan jangkitan virus HIV secara
sepenuhnya, namun HIV boleh dicegah atau pemberian rawatan awal sebelum permulaan
kepada AIDS. Oleh yang demikian, pengesanan awal dan penjagaan kesihatan bagi
mengelakkan jangkitan terhadap penyakit adalah penting. Media sosial secara dasarnya telah
mengubah cara masyarakat berkomunikasi dan berkongsi maklumat (Kaplan & Haenlein,
2009), dan komunikasi kesihatan sememangnya ampuh terhadap revolusi maklumat ini (Kreps,
2011). Dengan kewujudan Facebook, setiap individu dapat berinteraksi, tanpa perlu berjumpa
secara fizikal, antara satu sama lain. Pada masa kini, banyak kemudahan media baru seperti
internet, telefon pintar, dan lain-lain telah memberi masyarakat dimensi baru dalam memahami
HIV dan AIDS serta tindakannya. Walau bagaimanapun, kajian mengenai kesedaran
masyarakat tentang HIV dan AIDS serta peranan yang dimainkan oleh media sosial dalam
menangani penyakit ini masih terhad. Kajian ini bertujuan untuk meneroka bahagian ramalan
penggunaan media sosial, pengetahuan penyakit dan literasi e-Health terhadap tingkah
laku pencegahan awam dan bagaimana hubungan antara penggunaan media sosial dan
tingkah laku pencegahan terhadap HIV dan AIDS dalam konteks Lembah Klang. Persampelan
kebarangkalian berkadaran digunapakai serta dijalankan melalui tinjauan atas talian secara
rentas dalam kalangan pengguna media sosial di Lembah Klang. Para peserta akan
melengkapkan soal selidik berdasarkan skop bidang kajian yang ditentukan di media sosial
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mengenai HIV dan AIDS. Analisis korelasi asas, dan regresi berganda secara hierarki akan
digunakan bagi menilai dan mengenalpasti hubungan antara semua pemboleh ubah.
Kata Kunci: Penggunaan Media Sosial, Pengetahuan tentang Penyakit, Literasi e-Kesihatan
dan Tingkahlaku Pencegahan Awam.
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CHAPTER 1
INTRODUCTION
1.1 Background of the Study
According to the AIDS Global Monitoring (2020), HIV and AIDS epidemic snapshot
in Malaysia 2019, 77,903 people live with HIV in Malaysia in which 66,369 of them are male
15 years old above, 11, 233 women 15 years old above and 301 children below 15 years old.
Besides, the newly infected with HIV in 2019 are 3,564 people and 986 people AIDS-related
deaths (Suleiman, 2020). HIV and AIDS cases in Malaysia are caused by injecting drug users,
sex workers, men who have sex with men, transgender, blood transfusion and organ transplant
and occupational exposure like the medical staff (Lim He, 2011). Azmi, (1997) highlighted
that 84 per cent of medical staff regard themselves as being at high risk of getting infected
through workplace exposure. Although medical technology has undergone tremendous
development in treating people wdiseasesthe understanding and awareness about the diseases
require a practical approach to inform the public on the importance of prevention. A higher
level of knowledge on specific conditions such as HIV and AIDS may impact prevention
control. As per the millennial era, the best media practically lets people know about HIV and
AIDS while reaching a mass audience.
Nowadays, many new media facilities such as the internet, smartphones, and others
have given society a new dimension in understanding HIV and AIDS and its actions.
Previously, only traditional media such as television, radio and newspapers provided
information about HIV and AIDS to the community. The internet allows such issues to be
collected, communicated and discussed openly with the public. Indirectly, it affects public
awareness of the dangers of this disease. The understanding of public awareness of HIV and
AIDS and the role played by social media in dealing with this disease should be emphasized.
The level of public awareness and knowledge on HIV issues is deficient. Community
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involvement in understanding and addressing the issue of HIV and AIDS is still low. Whether
a person feels close to those living with HIV and AIDS or not, they are interdependent and
need each other in whatever daily activities they go through (Tan Pei San & Norzaini, 2011).
Based on Maibach, Bonaguro and Kreps (1993, p.15-35) practical HIV and AIDS
prevention strategies "…must begin with careful campaign planning in which campaign
objectives are decided, the goal audience's particular requirements orientations examined, and
the target audience segmented into homogeneous organizations. The communication method
must be thoroughly analysed to determine effective and accessible communication channels,
design plan communications, and test these messages for use with target audiences. The final
requirement is that the campaign outcomes should be thoroughly evaluated; to identify
probable influences of the campaign on overall health behaviours as well as instructions of
future risk avoidance and wellness communication endeavours might be identified."
Social media's advancement allows users to easily share information and tell stories or
news through blogs, social networks, or forums in the virtual world. This internet is an integral
part of influencing the daily life of a person in this generation 4.0. Almost every detail of our
daily lives needs internet technology and social media, for example to purchase daily
necessities, interact with others, and generate income. Based on the chart of social media use
by citizens’ world, Malaysian society has broken the record of the highest place in the world
in using social applications such as WhatsApp and Facebook due to sophistication that can
record live video with other users. Social media's rapid development is now a factor because
all the world's population can afford to own a smartphone (Nadia Fauzi, 2017).
Social media has essentially changed how people communicate and share information
(Kaplan & Haenlein, 2009), and health communication has indeed been immune to this
information revolution (Kreps, 2011). As social media's general use expands, research related
to social media use for health communication purposes also increases in scope (Moorhead,
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Hazlett, Harrison, Carroll, Irwin & Hoving, 2013). Social media is the essential tool or
instrument used to convey information, build perceptions, and shape public attitudes about the
data presented. The media has proven to be a vital tool or intermediary in communicating
certain information and messages. The media's importance focus to convey information but
more than that because the media plays a role in shaping society's thinking patterns.
Therefore, through today's social media technology, all information is readily available
without borders, time and limits—similarly, information related to official affairs, news, health
and awareness about the environment. However, information disseminated through the internet
differs in technique from information published in newspapers or notices on signboards. Those
who provide information should count on current trends that require readers to read concisely.
It does not need a long description because netizens want to save time and want to know briefly
(Todd, 2018). Information and communication through the internet must have a design that is
in line with the changes in the 4.0 era commonly detailed yet simple. Hence, the scope of this
study involves the role of social media in HIV and AIDS communication. Social media's
essential in ensuring that people know and acquire knowledge of relevant content about HIV
and AIDS not to be stuck with ignorance that will cause them to be infected with the disease.
Social media usage is an essential aspect of communication in conveying information
to readers on the internet. The informant's responsibility is to design the best type of
information display to convey the message to netizens easily. The communicator is responsible
for connecting the communication in the form of a message through a clear vision for the reader
to get the information, especially within social media.
To ensure that the reader gets the message accurately, social media has to ensure how
the message can be transferred to the reader directly, clearly and easily. This aspect is essential
to ensure that the information reaches the reader. Using the social media platform require
formulation strategies and plans before designing the visual space to consider what attracts the
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reader's attention first (Lucy Todd, 2018). From the aspect of sentence structure, pictures, font
application and some elements in the display of information. All these effective
communications in social media must consider the reader's perspective to understand or
otherwise present data to disseminate. According to the information receiver, the message
arrangement is different and not the same according to the informant (Clare, 2019). Therefore,
the element that considers whether the reader understands the message to be conveyed or not,
not according to the informant's wishes but according to the reader's wishes following time 4.0
(John, 2017).
Hence, HIV and AIDS dissemination information needs to consider what attracts the
audience, the general interaction, and the psychological perspective behind how the design
elements affect the reader's feelings, emotions, and mind while reading the information (Clare,
2019). Through previous studies, communication aspects define simpler and simpler visuals to
express information strategically (Gwen et al., 2018).
Research Problem
In the most recent situation of HIV and AIDS in Malaysia, there are 77 per cent infected
by the disease between the ages of 20 to 40. The majority of the cases resulted from unsafe
sexual intercourse. This phenomenon cause’s worry to the Ministry of Health as those affected
are within the age cluster of youth. The Ministry of Health in Malaysia has to be more proactive
to stop AIDS in Malaysia by 2030. Previously, Ministry manages to control the number under
the cluster of Injection Drug User from 70 per cent in 2002 to 48 per cent in 2010 and only 3
per cent by 2018. However, the scenario of HIV infection in Malaysia has changed to sexual
intercourse without protection. Deputy Minister of Health, Dr Lee Boon Chye in 2019
highlighted that continuing education is required to alarm the public on the risk of infection via
sexual intercourse without protection. He also stresses that community empowerment on the
methods of approach, disseminating information and channel to deliver the information. The
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current trend can apply via the use of social media as a channel to communicate and deliver
information. It is very crucial to engage the public deeper understanding of disease knowledge
of HIV and AIDS.
On the other hand, recent social ills activity in Malaysia is related to ‘Sugarbook’, one of
the dating platforms which almost commonly directs individuals to possible illicit behaviour.
This online dating platform offers the sugar baby cash incentives, gifts, or materials as the
exchange system for the relationship. It leads to sexual intercourse between both parties of
giver and receiver. The type of relationship and behaviour may involve the relationship
between male versus male known as inverse relationship as long the sugar baby can pay off his
lust desire. Also, this phenomenon leads to illegitimate child and disease through free sex, such
as HIV.
According to Dr Rosnida, Infectious Diseases Specialist from UiTM Sungai Buloh, the
evolution of HIV refers to the treatment and prevention with a new study on intervention
effective control measure on the disease. Should the methods be implemented intensively, the
risk of infection may lead to the probability of infection to zero HIV cases. She stresses out
that the most crucial core approach on the efforts is to increase the public knowledge about
HIV and methods of prevention. Dr Rosnida also believes that negative stigma towards people
living with HIV and AIDS patient should not exist within the surrounding. “The main problems
with on stigma, not only violation of human rights but it leads to the negative impact on the
willingness of people living with HIV to come forward to medical facilities to get their early
diagnosis and treatment until negative impact to their families about the prevention. If the
people living with HIV receive early diagnosis and immediately take medication, it can reduce
the risk of infecting others”. Moreover, increasing public awareness and general knowledge
about HIV and AIDS may prevail the myth about the disease.
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As a result, it is essential to ensure the public are well-versed about the disease
knowledge on HIV and AIDS as the current phenomenon in Malaysia. However, it must
align the understanding of HIV and AIDS with the current trend in communicating
information on the disease. The main pool of populations infected with the disease currently
within 20 to 40 is youth communities who are mainly the user of social media. According to
Statista, 2020 social media users in Malaysia is 30.41 million. The total population in Malaysia
32.57 million in January 2021, as per data by datareportal.com. So the study will focus on the
use of social media as effective communication towards the prevention of HIV and AIDS.
Nowadays, various platforms are disseminating knowledge about HIV and AIDS, including
traditional media and government policy. An electronic platform such as e-Health literacy do
provide a mass of information about health and disease control by the registered body or
medical practitioner. However, it is vital to know the best tools in increasing public
awareness about the disease to resolve the problem as per highlighted.
1.2 Research Objective
This study aims to explore the predictive role of social media use, the disease
knowledge and e-Health literacy on public preventive behaviours and the relationship towards
preventive behaviours on HIV and AIDS in Klang Valley. Specifically, it appraises the effect
of social media tools via the mass media on the HIV and AIDS in Klang Valley. Besides, the
perceived advantages and limitations of utilizing social networking for HIV and AIDS
communication via social media use. Hence, the study aims to highlight the objective as per
below:
Research Objective 1: To investigate the relationship between e-Health literacy from social
media and preventive behaviours in HIV/AIDS
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Research Objective 2: To investigate the relationship between knowledge of HIV/AIDS and
preventive behaviours in HIV/AIDS
1.3 Research Question
This research studying within the context of the social media user in Klang Valley as
to know the direction of intention of people to preventive behaviours in HIV and AIDS via
social media use. Answering to the direction of this study, points of research questions were
listed as follows:
Research Question 1: What is the relationship between e-Health literacy from social media
and preventive behaviours in HIV/AIDS?
Research Question 2: What is the relationship between knowledge of HIV/AIDS and
preventive behaviours in HIV/AIDS?
1.4 Research Scope and Significance
In producing this study, the researcher has determined that this study will include all
respondents who use social media as the primary, intermediate relationship or communication
in their daily activities.
The way people communicate has changed over the past years. Most of us are spending
more times with social media. Social media design helps in facilitating the communication
process and social interaction among people. Moreover, most of the public health response
become the immediacy of the social media application. General-purpose social networking like
Facebook offers the opportunity to the normative pathway to reach prevention of particular
behaviours. Moreover, Facebook, which has a broader audience, focuses not only on social
relationship but also on preventive behaviours towards HIV and AIDS which mostly used by
the non-government organisation (NGO). The underlying mechanism on social media use to
10
behavioural health change is that the scope of HIV and AIDS on social media could increase
the public's fear and direct them to take preventive behaviours. Process of communication via
social media engage with the communication exchanges in terms of semantic features of
interaction, such as revealing clues about interest, norms, and willingness to engage in
preventive and risk behaviours.
The individual will be a cluster in social media relationships like friendship and group
of affiliation. It will be focusing on the behaviours enforcement among others upon the link to
the network in which individual will share certain behavioural traits. Generally, the social
media network's goals will establish a connection between how people "talk" and deliver idea
on social media that influence people to engage in preventive behaviours. Communication in
social media will lead to prevention risk behaviour. Moreover, it will link what people talk
about and the actual conduct on the prevention of HIV and AIDS.
This study's underlying factor, based on infectious diseases in this era of modernity, is
increasing in the health sector since the early 90s. The government and several organisations
involved in medicine and healthcare worldwide have devised a strategic plan to deal with
infectious diseases, especially HIV and AIDS, among Malaysians. According to the World
Health Organization (WHO), this plan develops and expanded on debates and strategy statistics
according to the World Health Organization (WHO) based on established guidelines including
strategies or action plans to deal with the disease, the response from viruses’ recovery from
those diseases. Emerging infectious diseases have a broad definition covering diseases such as
previously unknown AIDS, Ebola, recurrent infections such as tuberculosis, measles, pertussis,
existing diseases that have moved to new places of the West Nile virus, hepatitis. Conditions
can no longer under controlled by highly effective drugs such as malaria and illnesses that show
an increase in virulence, such as the Covid-19 Pandemic Virus (Dr Risma, 2020). The disease's
emergence includes several important aspects, including an increase in the world's population,
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population density in Municipal areas with poor hygiene, provision of unclean food and
beverages, and excessive use of drugs such as antibiotics. Hence, in this millennial age, social
media plays a very important role to communicate with the public in educating them on proper
management of such diseases like HIV and AIDS, Ebola, tuberculosis, measles, pertussis,
hepatitis and the Covid-19 pandemic. This includes intensive care on the personal hygiene and
prevention acts to any diseases.
Other scholars argue that designing an effective communication is essential in facing
challenges such as declining public awareness of HIV and AIDS. The show is done from hand
or television distribution to digital or various website sources to get the latest information
(Collins et al., 1999). The fundamental aspects highlighted also the effective communication
to educate the public about the disease. Furthermore, the emergence of viruses and bacteria
through HIV and AIDS has led to the expansion of communication and multimedia in the health
sector in general. Therefore, through this study, the researcher found that the problems in
disseminating information in social media are practical or otherwise through the vehicles of
the communication conducted. The extent to which the effect occurs, the dissemination made
and the number of netizens aware of the information.
Furthermore, in the communication of information regarding HIV and AIDS, the
researcher has emphasised several vital aspects, namely understanding the target audience,
planning effectively on the message or data to be disseminated to suit the target audience. The
information communication management needs to consider resources or channels accepted and
have official certainty, such as direct information. The study adopts a model by Li & Liu, 2020,
on Social Media Use, e-Health Literacy, Disease Knowledge, and Preventive Behaviours in
Covid-19 Pandemic: A Cross-Sectional Study on Chinese Netizens which predicted public
preventive behaviours during COVID-19 outbreak in Chinese contexts.
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CHAPTER 2
REVIEW OF LITERATURE
2.0 Definition of Social Media and Subject Matter Focus
Many companies or agencies use social media platform as it is easy to access at flexible
times. Furthermore, individuals can choose their own free time to read the information without
waiting or missing data. Social media can also provide advantages or support in features or
tools that allow the company or person to disseminate information to other netizens based on
keywords or fields of interest based on what people might search on the internet (Andreas,
2010).
a) Role of Social Media in Information Seeking and Delivery
Social media is one of the internet technologies that all the people of the world actively
use to obtain information, disseminate information and verify the authenticity of the data
presented. It is the latest technology that most appeals to the younger generation to tell them
about any information or news. Moreover, people nowadays are so occupied with the gadget
that they engage a lot with social media in each of seconds. The conventional methods of
information seeking and delivery via printed media such as newspaper, book, and magazine
are less popular than the evolution of technology in our daily lives. Social media such as
Facebook, Instagram, and YouTube become prominent to everyone whose current and latest
information can access their fingertips. Based on previous studies, they use the uses and
gratification approach to research and analyse the study results to the extent of the user's
personality in filtering the information sought on Facebook. A study in Germany with 1525
Facebook users participated in this study. It mainly confirms the filtering of information
through 3 types of properties, extraversion, neuroticism and openness, as predictors in the
block-wise regression model. The researcher stated that searching for information on social
13
media depends on the behaviour of the individual. If the individual is positive thinking and can
receive the data, the data is accepted positively (Kai Kaspar, 2019). The behaviour of
individuals nowadays is more directed to information seeking in social media nor the accuracy
of the information. These concepts of the flexibility of information seeking and sharing enable
all relevant information reaches to the receiver expressly. Some people who look for
information on any topic or latest news will come across social media before other platforms
such as search engine or traditional media.
b) Role of Social Media in Persuasion
The meaning discussed by the past review in their study uses social media for visual
persuasion in propagating the establishment to change individual perceptions of something and
information towards what the researcher wants to base on the study's objectives (Hew Wai
Weng, 2018). Hence, social media can openly shape the audience's thoughts and turn those
thoughts into a desire to start a protest or action together. Social media allows individuals to
disseminate information creatively and attract the public's attention through various text,
visuals, and videos. Social media information dissemination aims to invite netizens to be aware
and alert with that information and indirectly convince them to change the habit from negative
to a healthy lifestyle. Foucault discussed this process in detail, a normalization method that
indirectly carries the meaning of effort to invite and persuade others. It does not force directly
in a state of softness and build awareness spontaneously. Relaxed mood until the individual is
convinced and can receive the information (cited by Hew Wai Weng, 2018). Thus, giving a
positive result can influence the individual's thinking and enable the individual to disseminate
the thought or information to the closest contacts in a chain using social media (Ran Huang et
al., 2017). Here, it does involve health communication for HIV and AIDS while persuading
14
others to preventive behaviours as effects of information on the diseases leverage in social
media.
Nowadays, many health experts are constantly sharing information via social media
like Instagram, Facebook and YouTube. This approach indirectly persuades people to get
accurate information about health and disease that creates awareness of it. People are more
confident when professional or expertise on the subject matter is disseminating information via
this platform to access at any time and situation. When people view any shared data in social
media, it indirectly persuades their cognitive level to think about the importance of information
shared. On the other hand, people also tend to find the easiest way to obtain information on
something by browsing social media instead of getting consultation from expertise.
2.1 Subject Matter Focus: Information on HIV and AIDS via the online platform
HIV stands for human immunodeficiency virus, which acts to cause harm to the human
immune system by damaging the white blood cells that function to prevent and kill infections
in the human body. It makes the human body vulnerable to various viruses and cancers easily.
At the same time, AIDS is the final stage of HIV found by only a small number of patients with
HIV. AIDS stands for acquired immunodeficiency syndrome (Susan, 2020). The growth of
technology mediated-communication platforms, like social media, is essential in the
modification of contemplating. They provide the potential of disseminating tailored wellness
communications to entirely strongly defined organizations (Chou, Hunt, Beckjord, Moser, &
Hesse, 2009). Nevertheless, the effect of social networking within the context of HIV and AIDS
specific communication, and the consequent challenges for interaction approach advancement,
appear still reasonably unexplored.
As the connection between technology and business for overall health is rapidly
developing Venkateswaran, 2011 argues that sociable media's energy for health
15
communication is becoming more apparent. However, the use of social media in disseminating
information about health and diseases needs to be comprehensive compared to other contents.
For example, in the current scenario during the era of pandemic Covid-19, social media can
tag people in following the latest update about the disease. The same approach can be applied
to shout out about the epidemic of HIV and AIDS as the disease still exists within the
communities. Medical treatment can treat HIV early before the final stage of AIDS, which may
lead to fatality. However, awareness of the disease's decreases or ignore as it overlaps with
other media issues such as ineffective communication vehicles used to disseminate the
information.
2.2 Theories and Model Framework
According to Social Cognitive Theory, human being learns behaviours via observation,
modelling and motivation. In this theory, people will learn from others from now and then.
Among the two ways of learning, behaviours are direct experience and observations of others.
It encompasses four processes such as attention, retention, motor reproduction and
reinforcement and motivation. Triadic reciprocal determinism influences the individual
cognitive that affect other behaviour. An individual with internal competencies of mental,
emotional and physical will learn from the environment as the external factors that result in
behaviour that lead to action and decision. In this study, social media affects people cognitively
as their internal competencies that later direct those to specific behaviour on the move or
decision. According to Lin and Chang, (2018), Social Cognitive Theory emphasizes that human
behaviour is shaped and controlled by personal cognition in a social environment. Bandura
further proposes two types of expectation beliefs, such as outcome expectations and self-
efficacy, and suggests that they are the two major cognitive forces that will guide an
individual's behaviour.
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There are four goal attainment and motivation within Self Cognitive Theory: self-
evaluation, self-observation, self-reaction, and self-efficacy. All of these four processes are
interdependent to accomplish a mission via the human cognitive process. The evaluation
process is the first step in which humans compare their performance to desired aims to achieve
specific goals. Then it will move to observation by observing and monitoring themselves to
reach their goals. The subsequent flow will be the action taken when they start to modify their
behaviour based on the evaluation made. Lastly, it comes individual self-efficacy on their
beliefs or capacity to execute behaviours to produce specific performance attainment.
Performance attainment is something on accomplishment or achievement that attained.
According to psychologist Albert Bandura who originally proposed the concept, self-efficacy
is a personal judgment of how well or poorly a person can cope with a given situation based
on their skills and the circumstances they face.
Social media tools design continuously make people addicted to it in which influence
human cognition. It will capture as much as peoples' attention on it used from evaluation to
observation. The attention drives people towards addictive behaviour on social media usage as
they would like to know what is happening in the world. For example, when people post about
the potential behaviour risk of HIV and AIDS on social media that appear on other people's
news feed as it is frequently appearing. Hence, self-reaction take place, which modifies people's
behaviour to practise a healthy lifestyle. This social media technology also will help people
change their state of consciousness to preventive behaviours of HIV and AIDS as per their
belief under their capacity.
Reviewing the information posted on social media as Facebook will interfere with the
medium and long-term preventative action goals. The information has to be something
important that engage with human cognition, such as the importance of preventive behaviour
of HIV and AIDS.
17
2.3 Health Literacy and Preventive Behaviours
Social media's internal assets become the predictors of preventive measures, including
knowledge about the health, capabilities, and skills employed, known as "Health Literacy".
Health literacy is the ability to obtain, read, understand, and use healthcare information in order
to make appropriate health decisions and follow instructions for treatment. The attribute of
health literacy becomes essential for predicting health promotion and prevention. According to
centres for disease control and prevention, personal health literacy is the degree to which
individuals can find, understand, and use information and services to inform themselves and
others' health-related decisions and actions (Rudd, 2021). This health literacy framework
develops as people nowadays seek out, apprehend, value, and utilise any health information. It
does cater to the public needs via the use of electronic health literacy known as e-Health
literacy. This platform engages with online technology in communicating about the disease to
the public.
Social media is a platform that connects communication between individuals through
the technology of unlimited internet use and boundaries. This platform acts as an interactive
field in sharing information, ideas, and reference materials for selected individuals or audiences
to note that information and up to date with the latest news (Obar and Wildman, 2015).
Electronic health (e-Health) literacy is the combination between media and information
literacies which later applied under e-Health publicity. Therefore, information on social media
filtered according to the individual's wishes and criteria is seeking health information for the
purpose. The information sought gives functional implications to users. e-Health literacy
positively engages people with health problem such as HIV and AIDS in maintaining their
health status lead to quality of life.
It is essential to know that preventive behaviours result from the information
dissemination via social media or knowledge of the diseases within human cognitive capacity.
18
Application of the Social Cognitive Theory may determine how the leveraging of HIV and
AIDS information in social media may predict people's preventive behaviour. Moreover, health
literacy playing a role in determining the information to receive by the social media user co-
relate with modifying behaviour to prevention.
According to Choi, Yoo, Noh, & Park, 2017, self-efficacy for MERS moderated the
relationship between social media exposure and risk perceptions of MERS. The increased
effect of social media in elevating risk perceptions of MERS was pronounced for individuals
with high levels of self-efficacy. This interaction suggests that social media exposure could
contribute to a decrease in optimistic confidence bias for individuals with higher levels of self-
efficacy, which in turn can increase their risk perceptions of MERS. On the other hand, one's
information processing mode has been found to moderate the effects of media on his or her risk
perceptions (Ho, Scheufele, & Corley, 2013). Starting with the popularity of Facebook as a
social media for get to know each other and share information on social networks, now it has
become popular all over world for educational purposes. In certain situations, especially threat
situations such as COVID-19, information needs to be communicated and worked on as quickly
as possible. Delays in receiving information can trigger greater problems and harm. As cited
from Director General of Health Malaysia, MOH’s constant live updates on current situations
and corresponding statistics do not pass by unnoticed. More Malaysians are now keeping watch
of MOH’s various channels on the Internet and social media to stay connected and informed
(S.M. Suraiya, B. Sri Tharan & Kimi, I. Affendi, Z. Zanariah, 2021). In the current situation,
in the face of the Covid-19 pandemic, access to information is crucial in ensuring the well-
being and health of the people is preserved. Thus, social media use could interact with
information processing mode in order to interpret the differential information. As a result, it is
likely that the interaction between social media and information processing mode plays a role
in shaping ones' perceptions.
19
CHAPTER 3
RESEARCH METHODOLOGY
3.0 Research Methods and Research Design
Research Methods
Research Methodology is a scientific knowledge that studies the ways of doing
observations with complete, precise thinking through the stages scientifically compiled to find,
calculate, compile and analyse and summarise the data so that can use it to discover, develop
and test the truth of knowledge (Creswell, 2013). Knowledge learned using the correct
procedure and accurate methods through searching, calculating, organising information and
analysing information. Thus, the study can formulate to collect data to produce new idea and
knowledge. Furthermore, this research method is a procedure or steps to gain scientific
expertise or build a systematic study and be understood by researchers and other communities
(Marvasti, 2018). So the research conducted is a systematic way to compile the research
technique to implement the method. The data results are legit and used by other researchers as
a reference through correct steps. Several other communities can understand the research
methods as a source of concern for the research methods implemented. Research methodology
can positively impact researchers and other readers alike (Marvasti, 2018). Thus, the use of
correct and appropriate study methods is essential to avoid confusion throughout the study.
Research Design
This research adopted a quantitative approach, especially the cross-sectional, survey-
based design, to get logical and reliable knowledge for the specified variables. For this study,
it was indispensable to provide data on the entire population. The usage of quantitative methods
in a study will assign a value to each measurement unit, whether it is more, less or the exact
20
value according to the variable (Creswell, 2013). The nature of the research objectives was
most well catered to by correlational-based design, testing the relationship among variables.
Correlation is a statistical reading that explains the relationship between two variables,
whether the variables have similar values to each other or vice versa. The correlation value is
determined by reading the number 0.1 and above. If the reading shows a negative 0.1, then the
value is an error or does not correlate (Chen & Popovich, 2011).
3.1 Conceptualisation of variables
The chief variables of the study were the social media use in preventive behaviours
about HIV and AIDS. The social phenomenon in the study was about using social media to
gain formal information besides social networking during leisure times. The statement
specifically focused on the knowledge of HIV and AIDS, which created awareness among
people due to preventive behaviours. The researcher operationalised social media use on
elements, which individually engage with social media to learn about the knowledge of
diseases or e-Health literacy resulting on HIV and AIDS preventive behaviours. On the other
hand, as referred to in the research question, what is the relationship between e-Health literacy
and knowledge of HIV/AIDS from social media and preventive behaviours in HIV/AIDS?
This conceptualisation split into two principal concepts of variables that constitute
preventive behaviour. These concepts are knowledge of the diseases and e-Health literacy. In
examining HIV and AIDS prevention, the study confined to one aspect, such as preventive
behaviour. The researcher refined it by studying a hypothesis or theory of Social Cognitive
Theory as a topic such as learning behaviour dependency on social media towards preventive
behaviours. Then, the researcher narrowed down and focused on specific research questions
highlighted to examine relevant predicting behaviour through the study. To further investigate
21
and explain the process of conceptualising variables, the hypothesis would predict further what
would happen should particular behaviour, such as learning from social media, is employed.
3.2 Operationalisation of variables
Operationalisation of variables refers to social media user being observed on the
learning process of knowledge of HIV and AIDS that lead to preventive behaviour. This term
variable may determine whether the correlation may lead towards positive or negative
correlation. The social media user will be a group that projects the predictive behaviour of
prevention in HIV and AIDS. It may lapse along the period of social media use and the
frequency of usage. The operationalisation variables are observed to reach preventive
behaviours based on HIV and AIDS shared in social media. Respondents of the study may
indicate in the survey as the awareness towards prevention of HIV and AIDS generated via the
access of the information in social media.
3.3 Hypothesis
In this research, the hypotheses were derived based on the research questions and research
objectives as follow:
Hypothesis 1: There is positive significant relationship between e-Health literacy from social
media and preventive behaviours in HIV/AIDS
Hypothesis 2: There is positive significant relationship between knowledge of HIV/AIDS and
preventive behaviours in HIV/AIDS
By looking at the current media landscape trend that dramatically changes media use within
the new media environment and looking at the Malaysia scenario, people receive news of
further information through multiple channels such as traditional and online media. Based on
the statistic, Facebook's rate-focused in Malaysia from 2017 until 2019 has reached 23 million
22
users across the peninsular, Sabah and Sarawak. The number of Facebook users expected to
rise to 25.95 million by the time it comes in 2021 (Statista, 2020). Tobergte, 2010, stated that
internet-based applications have significantly reduced the cost to collect, distribute, and access
information, save resources, and create new mechanisms in integrating organizations with users
together. The use of Facebook is one of the cost-savvy for the public to collect information and
connects organizations to their audience. Social media is the primary channel to improve the
information delivery system with users' involvement, such as students actively in development
affairs and student activities at the university level. In this regard, it should enhance the social
media use among people related to the delivery of information to HIV and AIDS to provide
helpful information to all individuals and make social media a sharing platform related to the
disease.
In Malaysia, the official media acts as formal information by the government or any
government agencies. Professional social media exist based on news and professional domain.
For example, Money Matters in TV3 highlighting the topic of the economy. Aggregated social
media is a type of media that assemble and segregate news and information by various agencies.
It can be on the scope of the economy, sports, politics and others, while public social media,
known as interpersonal social media that produce and distributes messages on an individual
basis.
Moreover, with the distinguishing features based on social media, it brings various
effects to the audience. For example, the website-based content will help the audience with
safer sex literacy by sharing information via social networking platforms. Traditional media
such as newspaper and radio acts as an effective medium with crisis management compared
with social media. Meanwhile, social media happen to have an impact on any related
intervention with public health. Thus it can be applied when the younger generation strongly
relies on social media for information seeking. Examining the factors affecting health
23
information exchange could advance our understanding of how to sustain information sharing
and information-seeking behaviours in social media and maintain social media success (Lin &
Chang, 2018). On the other hand, the designated information or messages transferred via
trusted online personal broadcasting. It will be able to direct users' attitudes or intentions to
change. Based on previous studies, social media acts as an essential platform for their users to
discover social media's potential as the primary source of information exchange, especially
Facebook (Kai Kaspar, 2019). Initially, Facebook was a platform for connecting users without
borders and time limits. However, Facebook has developed over the years, making it one of
the essential sources in accessing various latest information, including knowing current news
or posts that involve awareness about things that happen worldwide (Marketa, 2019). William
argues that this matter included using social media to seek information, deliver the message,
and connect people to gain the amount of information source (cited by Kai Kaspar, 2019).
The combination between knowledge of the diseases and e-Health literacy associated
with individual personal health status. As independently related to knowledge of the diseases
and e-Health literacy which impact the disease knowledge through the indirect channel. For
example, sexual transmitted diseases knowledge known to be contributed information with safe
sex protection to prevent HIV and AIDS.
e-Health Literacy
from Social Media
Preventive
Behaviours in
Knowledge of HIV/AIDS
HIV/AIDS
Figure 1: Research Model
24
3.4 Statistical Analysis
The socio-demographic would be analysed using descriptive statistics such as frequency
or percentage of gender, age, level of education, household income, marital status, health status,
and locality. These are the category variables on the category variables described based on
count and percentage, which would then be dummy coded and set one group as a reference
group. Pearson correlations analysis will be used for this study. It examines the correlation
between control variables and independent variables and dependent variables; meanwhile, the
mean and standard deviation used to analyse the continuous variables. The test statistic
measures the statistical relationship between knowledge of the diseases and e-Health literacy
towards preventive behaviour in HIV and AIDS. The relationship between knowledge of the
diseases and e-Health literacy will determine the magnitude of association or direction of
relationship be positive or negative in predicting the preventive behaviour within social media
user.
3.5 Sample of the study
Among the socio-demographic variables in this study consist of gender (male and
female), age (18-30, 30-40, 40 above), level of education (SPM, Degree, Master and
Doctorate), and household income (RM 1000 and below, RM1000 to RM2000, RM2000 to
RM3000, RM3000 to RM4000 and RM5000 above). Besides, marital status (single, married
and divorced), health status (healthy or comorbidities) and location (Klang Valley Malaysia).
According to Global AIDS Monitoring 2020, among the top 5 states percentage of new HIV
infection in Malaysia, 2019 are Selangor 30.4 per cent and Kuala Lumpur 12.5 per cent. That
is the reason the study focuses on the area of Klang Valley.
25
Sampling size
The proportionate sampling method applies a sampling strategy in clustering to sub-
groups based on the distribution of gender and age Malaysia social media user, internet. The
sample selected for this study is purposive sampling, a selection that selects specific
respondents to obtain effective study results. Purposive sampling use as representative of the
study population as a whole. Therefore, the sampling technique used is according to the
Tabachnick and Fidell sampling technique (Tabachnick & Fidell, 2012). The Tabachnick and
Fidell sampling technique is a formula based on specific respondent values and represents a
population.
The formula is as below: -
N = > 50 + 8 (m)
N= > 50 + 8 (2)
N= >50 + 16
N = > 66
N = appropriate sample size
m = the number of independent variables
Therefore, the number of sampling used in this research is more than 66 samples and above to
provide reliable correlations.
According to Krejcie & Morgan, 1970 number of sampling to include 20 to 30% of the
population as a sample size in the form of a rule of thumb. Krejcie and Morgan state that, as
the population increases, the sample size increases at a diminishing (decrease) rate (plateau)
and remains, eventually constant at slightly more than 380 cases. Hence the sampling decided
above 100 to a maximum of 380 samples.
26
3.6 Instruments
The instruments were then tabulated in the Table 3.6.2

Table 3.6.1: Item Indicators
Variable Original Item Adopted/ adapted items Source
e-Health This brief scale assessed HL1: I know what health resources  Li & Liu,
Literacy from one’s perceived ability are available on the social media. 2020;
Social Media to find, understand, and HL2: I know where to find helpful
appraise health health resources on the social  Tan, Pan,
information from Web- media. Zhou,
based sources and apply HL3: I know how to find helpful Wang, &
knowledge to address health resources on the social Xie, 2007
health concerns (e.g., “I media.
know what health HL4: I know how to use the social
resources are available media to answer my questions about
on the Internet”, “I health.
know where to find HL5: I know how to use the health
helpful health resources information I find on the social
on the Internet”). media to help me.
The questionnaire HL6: I have the skills to evaluate
utilized in this survey the health resources I find on the
was based on the WHO social media.
AIDS program HL7: I can tell high-quality health
regarding sources of resources from low-quality health
information about HIV resources on the social media.
27
and AIDS beliefs and HL8: I feel confident in using
practices (KABP) in information from the social media
1988, as well as other to make health decisions.
related literature.
Knowledge Disease knowledge was KD1: I am aware of HIV/AIDS  Li & Liu,
of HIV/AIDS assessed by a self- diseases. 2020;
development KD2: I know HIV/AIDS is a
measurement consisted contagious disease.  Tan, Pan,
of 10 items (e.g. “The KD3: Sources of HIV/AIDS Zhou,
incubation period of infection is from people living with Wang, &
COVID-19 infections is HIV and AIDS. Xie, 2007
generally 3-7 days, with KD4: Sources of HIV/AIDS
a maximum of 14 days”, infection is from relatives of people
“The coronavirus living with HIV.
volume is about 3 KD5: Sources of HIV/AIDS
microns”). infection is from people having
The questionnaire casual contact with people living
utilized in this survey with HIV.
was based on the WHO KD6: I agree people can get HIV
AIDS program from sexual intercourse without a
regarding knowledge, condom.
attitudes, beliefs and KD7: I agree people can get HIV
practices (KABP) in from sharing needles among drug
users.
28
1988, as well as other KD8: I agree people can get HIV
related literature. from receiving blood from an HIV
infected person.
KD9: I agree people can get HIV
from mother to child transmission.
from having oral sex with an HIV
infected person.
from shaking hands with an infected
person.
from mosquito bite with an infected
person.
from sharing food together with an
infected person.
from sharing tools and official
utensils with an infected person.
from sharing public swimming
pools with an infected person.
29
Preventive Preventive behaviours IPB1: I aware A-B-C (Abstinence,  Li & Liu,
Behaviours were measured by 10 be faithful, and use Condoms) 2020;
in HIV/AIDS items of basic protective prevention method.
recommendations in IPB2: I aware not sharing needles  Tan, Pan,
COVID-19 pandemic will prevent disease. Zhou,
(e.g. “Washing your IPB3: I aware using condoms Wang, &
hands after going during sexual intercourse will Xie, 2007
home”, “Covering your prevent disease.
mouth and nose with a IPB4: I agree one of HIV/AIDS
tissue or sleeves when prevention method is from mother
you cough or sneeze”). to child.
The 10 items were IPB5: I agree that treating STIs
assessed by a self- promptly can prevent disease.
development IPB6: I agree that no donating
measurement. blood illegally can prevent
The questionnaire HIV/AIDS disease.
utilized in this survey IPB7: I agree avoiding mosquito
was based on the WHO bite can prevent disease.
AIDS program IPB8: I agree not sharing public
regarding knowledge, swimming pools with infected
attitudes, beliefs and person can prevent disease.
practices (KABP) in IPB9: I agree not sharing food with
1988, as well as other people living with HIV/AIDS can
related literature. prevent disease.
30
IPB10: I agree isolating people
living with HIV/AIDS can prevent
disease.
This study will use the online designated Google Survey Form based on the relevance
to the executed variable. The questionnaire developed, and deploy to selected participants.
• Preventive Behaviours
In terms of aspects of preventive behaviours, the items measured based on World
Health Organization's basic recommendations include practising safe sex while involving
intercourse, using protection such as condoms, and avoiding sharing drugs abuse by sharing a
needle. The study by Beeker, Guenther-Grey, & Raj, 1998, emphasizes two recently completed
multi-site HIV prevention intervention studies funded through the Centers for Disease Control
and Prevention (CDC) also exemplify paradigm drift. The AIDS Community Demonstration
Projects and the Prevention of HIV in Women and Infants Demonstration Projects (WIDP)
enlisted populations at risk for HIV. It uses to deliver community-relevant HIV-prevention
messages and condoms (or bleach kits for injecting drug users) to their peers and provide social
support for behaviour change (O'Reilly and Higgins, 1991; CDC, 1996). All the relevant items
later will be assessed on self-development measurement. According to the World Health
Organisation (WHO), the disease knowledge measures based on World Health Organisation
(WHO) campaign on HIV and AIDS. The questionnaire adopted from the study by Tan, Pan,
Zhou, Wang, & Xie, 2007, HIV/AIDS Knowledge, Attitudes and Behaviours Assessment of
Chinese Students: A Questionnaire Study
On the other hand, as per preventive measure promoted by the Ministry of Health
Malaysia. A pilot study conducted mainly to determine the validity and reliability before being
31
accepted with the actual survey execution. All the respondents involved in the survey deliver
their opinion to contribute to the findings. Their view on what extent they agree with the
statements related to the prevention of HIV and AIDS.
• Knowledge of the Diseases
Other factors besides e-Health Literacy are knowledge of the diseases that becomes the
main elements of health literacy. Knowledge of the diseases will enable people to identify
symptoms, cause, and available perceive risks of infectious diseases such as HIV and AIDS.
Once people have a better understanding of the disease knowledge, it will enable them by
improving the quality of health management as prevention to HIV and AIDS. It will be the
predictor to change one's health behaviours. Ministry of Health, Malaysia, targets 90% of HIV
treatment coverage by 2020. No treatment can eliminate the virus as a whole, but HIV can be
prevented or given early treatment before the onset of AIDS. So, early detection and safety
precaution to avoid being infected by the disease is vital. Hence, the Ministry of Health will
implement relevant safety measures to enhance the public's understanding of disease
knowledge that focuses on altering the public's traits and behaviours via public health
prevention.
The same assessment will use for knowledge of the diseases using respondent self-
development measurement (for example: "Sharing of needle for drug addicts prone to be
infected with HIV and AIDS"). The same instrument with preventive measure employ within
the study as per guidelines set up by the World Health Organisation (WHO) on prevention of
HIV and AIDS. Since the research focuses on the Malaysian context, it will focus on the
standard guidelines by the Ministry of Health, Malaysia.
e-Health Literacy
This variable assessed one's perceived ability to seek, understand, and appraise health
information on HIV and AIDS diseases, and the participants apply the knowledge indicate on
32
any related health concerns. Malaysia National e-Health focuses on being a nation of healthy
individuals, families and communities. Among the eight goals, Malaysia National e-Health
such as wellness focus, person focus, informed persons, self‐help, care provided at home or
close to home, seamless, continuous care, services tailored as much as possible, effective,
efficient and affordable services (Shaik Allaudin, 2008). The same questionnaire on this being
developed in English which associated with the prevention of HIV and AIDS based on the
WHO AIDS program regarding knowledge, attitudes, beliefs and practices (KABP) in 1988.
The available options will be using a 5-point Likert scale that ranges from "1 = disagree" up to
"5 = agree".
3.7 Methods
Design and Recruitment
The study will employ an online cross-sectional survey that applied proportionate
probability sampling methods to examine whether social media usage predicted Malaysian
social media users' preventive behaviours on HIV and AIDS.
115 respondents were chosen as a panel for this study. According to, Roscoe (1975)
indicated that the rule of thumb is at least 30 and below 500 for the choosing of the required
sample size. This sample size was to keep the error of the sample at an appropriate amount.
Matching the rule of thumb in deciding the degree of the statistical sample, 115 online surveys
were distributed in this study. They were selected from the Klang Valley area. A basic example
of a convenience sampling method is employed to respond on the Google Documents with
randomly selected participants. The email of Google Online Survey was sent through
Government Agencies, Private Sector, Non-Government Agencies and the public within Klang
Valley. Besides, the survey was also done share via personal ‘WhatsApp’ and posted on
LinkedIn and Facebook. Online sampling allows the possibility of identifying the targeted
33
respondents during the recruitment phase such as this study. Convenience samples are
sometimes regarded as ‘accidental samples’ because elements may be selected in the sample
simply as they just happen to be situated, spatially or administratively, near to where the
researcher is conducting the data collection (Etikan, 2016). As referred again to Global AIDS
Monitoring 2020, among the top 5 states percentage of new HIV infection in Malaysia, 2019
are Selangor 30.4 per cent and Kuala Lumpur 12.5 per cent. That is the reason the study focuses
on the area of Klang Valley.
3.8 Data Collection
The data collection process is conducted through random survey questionnaires and
according to the researcher's characteristics in the study's scope. The questionnaire will be
designed and distributed through Google Forms online to make it easier for respondents to
answer the questionnaire. Besides, it can save time and cost of distributing the questionnaire.
The sample will be analysed using SPSS software to obtain accurate study data.
3.9 Measurement of Studies
The instrument used to carry out this study is through questions research digitally. This
method is suitable for the process of data collection through quantitative requiring accurate
data. Moreover, this study concealing the identity of the respondent involved.
34
CHAPTER 4:
FINDINGS
4.0 Introduction
This chapter discuss about the findings of the study and results of hypothesis testing of
the research. It begins with descriptive analysis of the demographic profile of respondents or
the sample, and followed by summary of the use of social media on preventive behaviour for
HIV and AIDS. Subsequently, comparison of means scores between independent variables and
dependent variable will be shown. The results of hypotheses testing tabulated via multiple
regression and moderator analysis which being presented.
4.1 Demographic Profile
The present study was conducted with a collection of data from 115 samples within
Klang Valley area. Among respondents, 73 gender are female with a total number of 115
respondents while male respondents include of 42 from the total of 115 respondents. Besides
that, for the age group, 23 of them were 18-30 with a total of 115 respondents, 71 of them were
30-40 with made up of 115 respondents and 41 above were 21 which includes of 115
respondents.
A large percentage of the respondents 47% earn RM5000, 28.7% earn RM3000 to
RM4000, 11.3% earn RM2000 to RM3000, 8.7% earn RM 1000 and below, another 4.3%
respondents earn RM1000 to RM2000. In terms of education, majority respondents were
Bachelor Degree at 47.8%. Next, 23.5% of the respondents are Diploma, followed by Masters’
degree holders at 21.7% and PhD degree holders at 0.9 %. SPM holders which is 5.2% of the
total sample. For the marital status 40% of them were single, 53.9% of them were married and
6.1% of them were divorced. On the other hand, 95.7% of the respondents were healthy and
4.3% were falls under comorbidities.
35
Table 4.1 Demographic Profile of the Respondents (n=115)
Demographic Variable Frequency Percentage
Gender
Male 42 36.5
Female 73 63.5
Age
18-30 23 20
30-40 71 61.7
41 above 21 18.3
Education
SPM 7 6.1
Diploma 27 23.5
Degree 55 47.8
Master 25 21.7
PhD 1 0.9
Household Income
RM 1000 and below 10 8.7
RM1000 to RM2000 5 4.3
RM2000 to RM3000 13 11.3
RM3000 to RM4000 33 28.7
RM5000 above 54 47
Marital Status
Single 46 40
Married 62 53.9
Divorced 7 6.1
Health Status
36
Healthy 110 95.7
Comorbidities 5 4.3
4.2 General Knowledge, e-Health Literacy and Behaviour
First, the respondents were asked on ‘How long did you use social media to learn about
the information of HIV/AIDS every day?’, and the overall mean score that has been generated
was 1.41. This clearly means that out of the total respondents, they generally use social media
less than 1 hour in a week. Next, the study further extended the question by asking the
respondents ‘Which channel do you often use for getting the information of HIV / AIDS every
day?’ The mean score for this question was 1.41 and standard deviation was 1.083. Overall,
the respondents spent less than an hour to learn about the information of HIV/AIDS every day.
Table 4.2 Overall Mean Score for Using Social Media to Learn About HIV and AIDS
Questions N Mean Standard

Deviation
In the past few weeks, how long the use of social media 115 1.41 1.083
to learn about the information of HIV/AIDS every day?
The present research also seeks to understand the predictive role of social media on
public preventive behaviour. Majority of the respondents said that “Health resources are
available on the social media”, “The source of the disease knowledge in the social media is
helping them to know how about health information”, “Social media usage predictive role on
public preventive behaviour about HIV and AIDS”. This means that, generally respondents are
aware that social media provide information about HIV and AIDS. Overall, the respondents
spent around less than an hour to learn about the information of HIV/AIDS every day.
37
4.3 Descriptive Analysis of Variables
The first variable of the study is the e-health literacy in preventive behaviour and the
overall mean is 3.6239. The highest mean value was recorded for item “I know what health
resources are available on the social media” and “I know how to use the health information I
find on the social media to help me” with a mean value of 3.79 and 3.78. Meanwhile, the lowest
mean value for the variable is 3.3 for item “I feel confident in using information from the social
media to make health decisions” This means that the respondents liked the concept and have a
positive attitude towards e-Health literacy in HIV/AIDS prevention behaviour.
The second variable of the study is the knowledge of the diseases and the overall mean
is 3.2487. The highest mean value for the variable is 4.71 for item “I agree people can get HIV
from sharing needles among drug users” and the lowest mean value recorded for item “I agree
people can get HIV from shaking hands with an infected person” with a mean value of 1.48
and standard deviation value of 0.93 Next, the second highest item is “I agree people can get
HIV from sexual intercourse without a condom” with the mean value of 4.57. Next, followed
by the item “I agree people can get HIV from receiving blood from an HIV infected person”
with the mean value of 4.56 is recorded as the fourth highest with the standard deviation of
0.938.
The next variable is on HIV and AIDS prevention methods and overall mean variable
for this variable is 3.3087. It is recorded that the highest mean value is 4.51 for the item “I
aware not sharing needles will prevent disease” The lowest item is “I agree not sharing public
swimming pools with infected person can prevent disease” with the mean value of 2.19. Next,
“I aware using condoms during sexual intercourse will prevent disease” recorded the second-
highest which is the mean value of 4.15.
38
Table 4.3: Detailed Overall Mean Score and Standard Deviation Score
Variables Mean Standard Deviation Overall Mean

(SD) Value
e-HEALTH LITERACY
I know what health resources are available on the 3.79 1.072 3.6239
social media
I know where to find helpful health resources 3.77 1.012
on the social media
I know how to find helpful health resources on 3.71 1.082
the social media.
I know how to use the social media to answer
my questions about health. 3.69 1.079
I know how to use the health information I find 3.78 1.041
on the social media to help me
I have the skills to evaluate the health resources 3.52 1.012
I find on the social media
I can tell high-quality health resources from 3.43 1.043
low-quality health resources on the social
media.
I feel confident in using information from the 3.30 1.069
social media to make health decisions.
KNOWLEDGE OF HIV and AIDS
I aware of HIV/AIDS diseases 4.39 0.769 3.2487
I know HIV/AIDS is a contagious disease 4.23 1.018
Sources of HIV/AIDS infection is from 3.33 1.355
people living with HIV and AIDS
relatives of people living with HIV
people having casual contact with people
living with HIV
I agree people can get HIV from sexual 4.57 0.806
intercourse without a condom
I agree people can get HIV from sharing 4.71 0.672
needles among drug users
I agree people can get HIV from receiving 4.56 0.938
blood from an HIV infected person
I agree people can get HIV from mother to 4.17 1.172
child transmission
I agree people can get HIV from having oral 3.83 1.365
sex with an HIV infected person
I agree people can get HIV from shaking 1.48 0.930
hands with an infected person
39
I agree people can get HIV from mosquito 2.17 1.365
bite with an infected person
food together with an infected person
tools and official utensils with an infected
person
public swimming pools with an infected
person
HIV AND AIDS PREVENTIONS METHODS
I aware A-B-C (Abstinence, Be faithful, and use 3.90 1.221 3.3077

Condoms) prevention method
I aware not sharing needles will prevent 4.51 0.765
disease
I aware using condoms during sexual 4.15 1.028
intercourse will prevent disease
I agree one of HIV/AIDS prevention 3.71 1.183
method is from mother to child
I agree that treating STIs promptly can 3.64 1.133
prevent disease
I agree that no donating blood illegally can 3.93 1.212
prevent HIV/AIDS disease
I agree avoiding mosquito bite can prevent 2.43 1.332
disease
I agree not sharing public swimming pools 2.19 1.299
with infected person can prevent disease
I agree not sharing food with people living 2.23 1.333
with HIV/AIDS can prevent disease
I agree isolating people living with 2.38 1.315
HIV/AIDS can prevent disease
4.4 Multiple Regression Analysis
To understand the relationships between the independent variables and the dependent
variable, hypotheses testing was conducted using Multiple Regression Analysis. In the first
step the multiple linear regression analysis was run with the Independent Variable (H1- e-
Health literacy from social media and preventive behaviours in HIV/AIDS) as (H2- knowledge
of HIV/AIDS and preventive behaviours in HIV/AIDS). In the next step the null hypotheses of
H1 to H2 were tested by means of the first regression analysis model, which included all IVs.
40
Consequently, the null hypotheses assumed that there is positive relationship Knowledge of
HIV and AIDS on HIV and AIDS Preventive Behaviour. The following results are interpreted
through the linear regression analysis to prove the hypothesis.
Coefficients
Unstandardized Standardized 95.0% Confidence

Coefficients Coefficients Interval for B
Lower Upper
Model B Std. Error Beta t Sig. Bound Bound
1 (Constant) 1.122 .387 2.900 .004 .355 1.889
Health Literacy .000 .059 .000 -.005 .996 -.117 .117
Knowledge of .673 .112 .502 6.020 .000 .452 .895

HIV/AIDS
a. Dependent Variable: Preventive Behaviour in HIV/AIDS
4.4.1 Relationship between e-Health Literacy Is Positively Associated with Preventive

Behaviour on HIV and AIDS
For hypothesis 1, the result as displayed shows that the relationship between e-Health
Literacy towards Preventive Behaviour in HIV and AIDS is no significant and significant value
greater than 0.05. The relationship between e-Health Literacy towards Preventive Behaviour
in HIV and AIDS shows unstandardized Coefficients of β = 0.00 and p value of 0.996. This
means that a low correlation e-Health Literacy towards Preventive Behaviour in HIV and AIDS
predicts no preventive behaviour on HIV and AIDS. Thus, the null hypothesis is fail to reject
and H1 is rejected.
41
4.4.2 Relationship between Knowledge of the Diseases HIV and AIDS with Preventive
Behaviour
For hypothesis 2, Knowledge of the Diseases with Preventive Behaviour shows that the
relationship is positively significant and significant value greater than 0.05. The Knowledge of
the Diseases towards Preventive Behaviour had a p value of 0.000 and beta value of 0.673.
This clearly indicates that; the p value was lower than 0.05. Thus, the null hypothesis is rejected
and H2 is confirmed.
Table 4.4: Multiple Regression Analysis Output between the Two Independent
Variables and the Preventive Behaviour of HIV and AIDS
Model Summary
R Square 0.252
Independent Variables Beta t Sig.
e-Health Literacy 0.000 -0.005 0.996
Knowledge of the 0.673 6.020 0.000
Diseases HIV and AIDS
Table 4.5: Summary of Hypotheses Testing
Hypothesis Relationship Result
H1 There is no significant relationship between e-Health Literacy Not Supported

with Preventive Behavior in HIV and AIDS. due to
significant
level more
than .05
H2 There is positive significant relationship between Knowledge of Supported

the Diseases HIV and AIDS with Preventive Behavior in HIV
and AIDS.
42
CHAPTER 5:
DISCUSSION, IMPLICATION AND CONCLUSION
5.0 Introduction
This chapter discusses on the overall findings of the study. It covers four parts which
are the discussion of results and hypothesis, implications, limitation and recommendation, and
conclusion of the study.
5.1 Demographic Background of the Respondents
The demographics of this study showed that most of the respondents who involved in
the survey were female. The majority of the respondents had Bachelor Degrees and followed
by Diploma as their academic qualification which reflects that distribution of the sample
covering two different generations for example Generation Z and Generation Y. Majority of
the respondents earn less than RM 5000 and above as Generation Y was all working adults and
the rest was Generation Y and they earned more than RM 1000. This research had majority of
working adults and the rest were from fresh graduate and as well as SPM holders.
5.2 Discussion on Preventive Behaviour on HIV and AIDS
Nowadays, the trend of using social media and seeking information about health is on
the rise. This is most notable for HIV and AIDS prevention. The survey went deeper to
understand the trend of social media user on preventive behaviour of HIV and AIDS. The
question on how long did you use social media to learn about the information of HIV and AIDS
every day showed that approximately less than per hour every day. This may show of interest
preventive behaviour on HIV and AIDS on more regular basis but this shows that there is a
trend to search information about HIV and AIDS at least in daily basis. According to Sern,
Firdaus, & Zanuddin, 2016 the current explosion in social media use and popularity of viral
43
posts and videos for example via Facebook and YouTube, and Malaysia’s propensity for
sharing word-of-mouth information via mobile texting services such as WhatsApp are
particularly useful word-of-mouth social marketing aimed at changing attitudes. Public health
communicators need to leverage existing social marketing channels to further improve existing
mechanisms for improving HIV and AIDS campaign and public engagement. Based on the
analyses, there are a varieties of preferences learning about HIV and AIDS, different factors
may be the defining ones in their final decisions.
Generally, Malaysians are aware that HIV and AIDS are at the online media where they
spend most of their time to understand on HIV and AIDS which directs them to preventive
behaviour. e-Health literacy in HIV and AIDS prevention behaviour are more appeal than
traditional media, right now because usage is higher, and lower cost for engagement. By using
e-health literacy over traditional media, they could increase the preventive behaviour and thus
social media user will use more in future. As a conclusion, it can be said that Generation XYZ
and Millennial are somewhat aware of the real meaning of HIV and AIDS as they use the social
media which answer the research question.
5.3 The influence of e-Health Literacy on social media is significantly positive

associated with preventive behaviours in HIV and AIDS
Based on the result shown in chapter 4, the relationship between e-Health Literacy on
social media is significantly positive associated with preventive behaviours showed to be
significant, that is, at least less than an hour spend to learn about the information of HIV and
AIDS every day, the greater is the preventive behaviours in HIV and AIDS. This result is in
line with previous research on Roland, Toyin, & Ayoyinka, 2014 which reported young people
spend an overwhelming amount of time on media, and Oyero (2013) found that social networks
have become a primary source of information for young people. Hence, the strong association
44
between social media use time and preventive behaviours in HIV and AIDS may help public
health messages on social media should be frequent as these can be viewed frequently by youth.
On the other hand, the result is consistent with the research findings by Kalichman,
Benotsch & Suarez 2000, which showed that lower health-literacy patients will therefore be
more dependent on providers for information and may require more visits and tailored
communications.
5.4 The influence knowledge of diseases HIV and AIDS is positively associated with
preventive behaviours in HIV and AIDS
Based on the results in the correlation analysis shown in chapter 4, it is clear that disease
knowledge is important in influencing preventive behaviours in HIV and AIDS. The result is
consistent with the previous study by Agyemang, 2012 who mentioned that knowledge about
HIV/ AIDS is considered an important step in behaviour change, while misconceptions can
prevent individuals from making informed choices and taking appropriate action. Results are
also in line with various researches undertaken on Tee & Huang, 2009 also indicated that the
respondents in the present study scored well for the methods of HIV transmission, and their
level of knowledge is comparable with other Malaysian young adults.
5.6 Implications
Overall, it can be concluded that the use of social media as the effective communication
vehicles in HIV and AIDS prevention are important influencing the intention to prevention
behaviour for people in Klang Valley.
The present study provides several suggestions for health institutions. Firstly, this study
finds that e-Health Literacy and Knowledge of Diseases have a significant and positive impact
on preventive behaviours in HIV and AIDS, health institutions can use marketing
communication via various channels, such as television, broadcasting, magazines, pamphlet or
45
the internet to communicate information about disease knowledge and further evoke their
positive behaviour toward prevention of HIV and AIDS. In numerous past studies, researchers
have confirmed that social media use significantly and positively affect their behaviour as
effective communication in preventing HIV and AIDS. Furthermore, health institutions can
also recruit spokespeople, such as opinion leaders or respected public figures, to engage with
publics on the disease knowledge of HIV and AIDS, both for the betterment of society. This
strategy will ensure that relevant information reaches publics who are unfamiliar with HIV and
AIDS and in turn, successfully facilitate their preventive behaviour toward HIV and AIDS.
Additionally, it will also be possible effective way to increase public’s precautions methods.
Hence, the government and NGO’s can focus on creating the perception for both healthy
society as understand better about HIV and AIDS is a good lifestyle for them.
Next, Government should create more campaigns or educate them throughout the
advertising which able to influence the public understanding toward HIV and AIDS. In terms
of health institution, they should show out the organisation which is disseminating information
of disease knowledge in promoting the HIV and AIDS prevention is a good idea. Besides,
government can partner up with many NGO’s to educate publics on HIV and AIDS to raise
awareness on prevention of HIV and AIDS. Not only that, it is an added advantage for both
parties to be able to convey their health message to the intended target audience. For instance,
health institution may disseminate information through target segmentation by gender-based,
as the results have shown that female may respond more actively in HIV and AIDS prevention
than male do. Although the results showed that the e-Health literacy do not moderate the
relationship with the independent variables and the preventive behaviour, health institutions
may use this research result to focus on the same method on communication about HIV and
AIDS.
46
Moreover, increasing awareness education is important to young generations. It refers
to organize efforts to teach about how risk behaviour and particularly how human beings can
manage their behaviour from being infected with HIV and AIDS and to live sustainably.
Activities on awareness education are considered extracurricular activities and such as given
serious attention by many schools. This is caused by lack of understanding of the wide and
complex concepts in awareness education in prevention of HIV and AIDS that cover not only
extracurricular activities but also every aspect within education system. Since this young
generation has been well educated, therefore awareness education may be included in the
syllabus. Cultivating an attitude takes time. If publics are taught when they are small, it can
motivate their concern towards danger of HIV and AIDS and subsequently realize on
preventive behaviours of HIV and AIDS.
The online social network like Instagram, Facebook and Tik Tok have become popular
and even a “must have” account for youngsters and generation Y and Z to get connected with
their friends. Since social media use has been the best predictor, thus publics in this era believe
the influence from friends and family are important to them to generate preventive behaviour
of HIV and AIDS. Thus, the recent social media platform can be good medium for current
generation to share and comments and indirectly be exposed to knowledge of HIV and AIDS.
Health institution should use more online social networking for advertising and promoting HIV
and AIDS communication. In short, preventive behaviour of HIV and AIDS via social media
usage on public awareness issues maybe port in the social network in order to gain publicity.
Furthermore, it can increase health awareness and precaution concern among users of social
network as well.
47
5.8 Limitations of the Study and Recommendation for Future Research
Based on the research findings and limitation while conducting the research, some
suggestions are recommended for future research. The first limitation concerns on the study
samples, which are confined to people of Klang Valley only. Using quota sampling method,
which is a non-probability sampling technique, the result of the present study is limited only to
the respective samples and it is not to be generalise to the whole Malaysian population.
Secondly, the findings of this research are only limited to HIV and AIDS prevention.
Hence the study findings may not be applicable to other diseases categories such as Covid-19
pandemic as current study only focuses on prevention of HIV and AIDS and communication
message via social media. Thirdly, this research just depends solely on online survey instead
of triangulating the study using different research method. Lastly, due to time constraint, there
are only six variables have been identified throughout this research.
Therefore, the following are the recommendations for this study. Firstly, to conduct a
more accuracy and reliable data and result, future research needs to expand the amount of the
representative sample size, specifically more than 400. Secondly, one of the ways that could
be done is by conducting research of the online survey is not only target on 18 to 40 years old
but also can extend the survey to people in all the group such as the baby boomers as well as
the Generation X. Each of this age group might have different attitudes and perception toward
the use of social media in prevention of HIV and AIDS.
Another aspect that can be looked into for future research is that not only limiting to
specific geographical area to investigate this research. Hence, it is suggested that future data
collection should use random sampling method and data should be collected from all states of
Malaysia to ensure on the generalizability on the findings. This also can be done by conducting
the research through other region which are from rural or even compare them with other urban
48
resident. This is because rural areas have different cultures, mind-sets, and perceptions compare
with urban resident. Therefore, their behaviour toward prevention of HIV and AIDS would be
definitely different. Next, by not only focusing on HIV and AIDS for future study, researcher
need to refine disease categories studied to obtain greater limitation. Lastly, since the limitation
of the study is only six variables, thus future studies should expand by studying more variables
related to the topic.
5.9 Conclusion
In conclusion, “Prevention is better than cure” has become a slogan and being discussed
by people from all walks of life. The current study shows that the key to raise preventive
behaviour of HIV and AIDS among young adults and youth lies on three factors, which are
attitudes toward usage of social media, subjective norm, and perceived behaviour control. With
growing consciousness of healthy lifestyle, prevention in HIV and AIDS is paid much attention
to avoid many diseases. Therefore, health agencies must practice target segmentation in order
for them to be successful in creating awareness towards public. Based on the results, the study
shows that the social media user does have the behaviour of prevention in HIV and AIDS.
Health agencies can consider this group of public as one of their potential target markets.
Overall, the research project has met its objectives to test the relationship all the independent
variables towards the preventive behaviour of HIV and AIDS. It cannot be denied that the
young adults and youth behaviour toward prevention of HIV and AIDS play an important role
especially in creating awareness and shaping mentality of publics. Besides, this study has
included several limitations that have been faced by the researchers. Nevertheless, these
limitations have been supported by recommendations in order to increase the awareness of
publics as practicing healthy lifestyle in the future. In addition, according to the present
49
research results, Social Cognitive Theory has proven to be useful framework to predict social
media user in prevention of HIV and AIDS.
50
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APPENDIX
The Role of Social Media and the Effectiveness of Communication

In HIV/AIDS Prevention
From : Razlan Bin Abd Rauf
Student ID: S-KOM0003/19
Phone Number: 0132482831
Best regards and best wishes to the respected respondents. I am Razlan bin Abd Rauf from Universiti Sains
Malaysia.
This survey is intended to provide information on the role of social media and the effectiveness of
communication in HIV and AIDS prevention. These effects will be studied in terms of the role of social media,
general knowledge about disease and eHealth literacy in HIV and AIDS prevention behaviour.
● This questionnaire is not a test and there is no right or wrong answer and is not intended to test the
respondents.
● Any information provided in this questionnaire is considered confidential and will be used for research
purposes only.
● All the questions provided are single choice or fill-in-the-blank.
We ask for your cooperation in marking the answers honestly and sincerely as the information obtained from
this question is very important and useful for this study. Thank you.
56
SECTION 1: DEMOGRAPHIC PROFILE
Instructions: Please tick (/) indicate to the relevant one.
Gender: Male ( ) Female ( )
Age: 18 to 30 ( ) 31 - 40 ( ) 41 and above ( )
Education Level: SPM and below Diploma ( ) Degree ( )

( )
Master ( ) Doctorate ( )
Household income: RM 1000 and RM 1000 to RM2000 to RM3000 to

below ( ) RM2000 ( ) RM4000
RM3000 ( )
RM 5000 and
above ( )
Marital Status: Single ( ) Married ( ) Divorced ( )
Health Status: Healthy ( ) Comorbidities ( )
57
SECTION 2: GENERAL KNOWLEDGE, E-HEALTH LITERACY AND BEHAVIOUR
Instructions: Please tick (/) indicate to the relevant one
1. In the past week, how long did you use social media to learn about the information of
HIV/AIDS every day?
Less than 1 hour ( )

1-2 hours ( )
2-3 hours ( )
3-4 hours ( )
4-5 hours ( )
5 hours and above ( )
2. This part will mention about e-health literacy in HIV/AIDS prevention behavior. Read the
following sentences and choose the number that most fits your idea. The bigger the number
is, the more you agree with it. (1 =totally disagree, 5 =totally agree)
totally disagree totally agree
1) I know what health resources are

1 2 3 4 5
available on the Internet.
2) I know where to find helpful health
1 2 3 4 5
resources on the Internet.
3) I know how to find helpful health
1 2 3 4 5
resources on the Internet.
4) I know how to use the Internet to answer
1 2 3 4 5
my questions about health.
5) I know how to use the health information
1 2 3 4 5
I find on the Internet to help me.
6) I have the skills to evaluate the health
1 2 3 4 5
resources I find on the Internet.
7) I can tell high-quality health resources
from low-quality health resources on the 1 2 3 4 5
Internet.
8) I feel confident in using information from
1 2 3 4 5
the Internet to make health decisions.
58
3. This part will mention about general knowledge about HIV/AIDS. Read the following
sentences and choose the number that most fits your idea. The bigger the number is, the
more you agree with it. (1 =totally disagree, 5 =totally agree)
Num. Items totally disagree totally agree
1. I aware of HIV/AIDS diseases 1 2 3 4 5

2. I know HIV/AIDS is a contagious disease 1 2 3 4 5
3. Sources of HIV/AIDS infection is from people living with
1 2 3 4 5
HIV and AIDS
4. Sources of HIV/AIDS infection is from relatives of people
1 2 3 4 5
living with HIV
5. Sources of HIV/AIDS infection is from people having
1 2 3 4 5
casual contact with people living with HIV
6. I agree people can get HIV from sexual intercourse
1 2 3 4 5
without a condom
7. I agree people can get HIV from sharing needles among
1 2 3 4 5
drug users
8. I agree people can get HIV from receiving blood from an
1 2 3 4 5
HIV infected person
9. I agree people can get HIV from mother to child
1 2 3 4 5
transmission
10. I agree people can get HIV from having oral sex with an
1 2 3 4 5
HIV infected person
11. I agree people can get HIV from shaking hands with an
1 2 3 4 5
infected person
12. I agree people can get HIV from mosquito bite with an
1 2 3 4 5
infected person
13. I agree people can get HIV from sharing food together
1 2 3 4 5
with an infected person
14. I agree people can get HIV from sharing tools and official
utensils with an 1 2 3 4 5
infected person
15. I agree people can get HIV from sharing public swimming
1 2 3 4 5
pools with an infected person
5. This part will mention about HIV/AIDS prevention methods. Read the following sentences
and choose the number that most fits your idea. The bigger the number is, the more you
agree with it. (1 =totally disagree, 5 =totally agree)
Num. Items totally disagree totally agree
1. I aware A-B-C (Abstinence, Be faithful, and use

1 2 3 4 5
Condoms) prevention method
2. I aware not sharing needles will prevent disease 1 2 3 4 5
3. I aware using condoms during sexual intercourse will
1 2 3 4 5
prevent disease
4. I agree one of HIV/AIDS prevention method is from
1 2 3 4 5
mother to child
59
5. I agree that treating STIs promptly can prevent disease 1 2 3 4 5
6. I agree that no donating blood illegally can prevent
1 2 3 4 5
HIV/AIDS disease
7. I agree avoiding mosquito bite can prevent disease 1 2 3 4 5
8. I agree not sharing public swimming pools with infected
1 2 3 4 5
person can prevent disease
9. I agree not sharing food with people living with
1 2 3 4 5
HIV/AIDS can prevent disease
10. I agree isolating people living with HIV/AIDS can prevent
1 2 3 4 5
disease
Source:
1. Social Media Use, eHealth Literacy, Disease Knowledge, and Preventive Behaviors in the
COVID-19 Pandemic: Cross-Sectional Study on Chinese Netizens
2. HIV/AIDS Knowledge, Attitudes and Behaviors Assessment of Chinese Students: A

Questionnaire Study
60
RESULTS
DEMOGRAPHIC
Gender
Cumulative
Frequency Percent Valid Percent Percent
Valid Female 73 63.5 63.5 63.5
Male 42 36.5 36.5 100.0
Total 115 100.0 100.0
Age
Cumulative
Valid 18-30 23 20.0 20.0 20.0
31-40 71 61.7 61.7 81.7
41 and above 21 18.3 18.3 100.0
Total 115 100.0 100.0
Education Level
Cumulative
Valid Degree 55 47.8 47.8 47.8
Diploma 27 23.5 23.5 71.3
Doctorate 1 .9 .9 72.2
Master 25 21.7 21.7 93.9
SPM and below 7 6.1 6.1 100.0
Total 115 100.0 100.0
61
Household Level
Cumulative
Valid RM1,000 - RM2,000 5 4.3 4.3 4.3
RM1,000 and below 10 8.7 8.7 13.0
RM2,000 - RM3,000 13 11.3 11.3 24.3
RM3,000 - RM4,000 33 28.7 28.7 53.0
RM5,000 and above 54 47.0 47.0 100.0
Total 115 100.0 100.0
Marital Status
Cumulative
Valid Divorced 7 6.1 6.1 6.1
Married 62 53.9 53.9 60.0
Single 46 40.0 40.0 100.0
Total 115 100.0 100.0
Health Status
Cumulative
Valid Comorbidities 5 4.3 4.3 4.3
Healthy 110 95.7 95.7 100.0
Total 115 100.0 100.0
62
Statistics
Duration
N Valid 115
Missing 0
Mean 1.41
Std. Deviation 1.083
Variance 1.174
In the past week, how long did you use social media to learn about the
information of HIV/AIDS every day?
Cumulative
Valid 1-2 hours 12 10.4 10.4 10.4
2-3 hours 4 3.5 3.5 13.9
3-4 hours 1 .9 .9 14.8
4-5 hours 1 .9 .9 15.7
5 hours and above 4 3.5 3.5 19.1
Less than 1 hour 93 80.9 80.9 100.0
Total 115 100.0 100.0
63
DESCRIPTIVE ANALYSIS
Overall Descriptive
Descriptive Statistics
N Minimum Maximum Mean Std. Deviation
Health Literacy 115 1.00 5.00 3.6239 .88845
Knowledge of HIV/AIDS 115 1.93 4.33 3.2487 .46878
Preventive Behavior in 115 1.60 5.00 3.3087 .62892

HIV/AIDS
Valid N (listwise) 115
Descriptive Items
HL1 115 1 5 3.79 1.072
HL2 115 1 5 3.77 1.012
HL3 115 1 5 3.71 1.082
HL4 115 1 5 3.69 1.079
HL5 115 1 5 3.78 1.041
HL6 115 1 5 3.52 1.012
HL7 115 1 5 3.43 1.043
HL8 115 1 5 3.30 1.069
64
KD1 115 2 5 4.39 .769
KD2 115 1 5 4.23 1.018
KD3 115 1 5 3.33 1.355
KD4 115 1 5 2.56 1.339
KD5 115 1 5 2.75 1.438
KD6 115 1 5 4.57 .806
KD7 115 1 5 4.71 .672
KD8 115 1 5 4.56 .938
KD9 115 1 5 4.17 1.172
KD10 115 1 5 3.83 1.365
KD11 115 1 5 1.48 .930
KD12 115 1 5 2.17 1.365
KD13 115 1 5 1.83 1.213
KD14 115 1 5 2.21 1.301
KD15 115 1 5 1.94 1.118
65
PB1 115 1 5 3.90 1.221
PB2 115 1 5 4.51 .765
PB3 115 1 5 4.15 1.028
PB4 115 1 5 3.71 1.183
PB5 115 1 5 3.64 1.133
PB6 115 1 5 3.93 1.212
PB7 115 1 5 2.43 1.332
PB8 115 1 5 2.19 1.290
PB9 115 1 5 2.23 1.333
PB10 115 1 5 2.38 1.315
CORRELATION ANALYSIS
Mean Std. Deviation N
Health Literacy 3.6239 .88845 115
Knowledge of HIV/AIDS 3.2487 .46878 115
Preventive Behavior in 3.3087 .62892 115

HIV/AIDS
66
Correlations
Preventive
Knowledge of Behavior in
Health Literacy HIV/AIDS HIV/AIDS
Health Literacy Pearson Correlation 1 .197* .098
Sig. (2-tailed) .035 .296
N 115 115 115
Knowledge of HIV/AIDS Pearson Correlation .197* 1 .502**
Sig. (2-tailed) .035 .000
N 115 115 115
Preventive Behavior in Pearson Correlation .098 .502** 1

HIV/AIDS
Sig. (2-tailed) .296 .000
N 115 115 115
*. Correlation is significant at the 0.05 level (2-tailed).
**. Correlation is significant at the 0.01 level (2-tailed).
REGRESSION ANALYSIS
Model Summary
Adjusted R Std. Error of the

Model R R Square Square Estimate
1 .502a .252 .238 .54885
a. Predictors: (Constant), Knowledge of HIV/AIDS, Health Literacy
67
ANOVAa
Model Sum of Squares df Mean Square F Sig.
1 Regression 11.353 2 5.677 18.844 .000b
Residual 33.738 112 .301
Total 45.091 114
a. Dependent Variable: Preventive Behavior in HIV/AIDS
b. Predictors: (Constant), Knowledge of HIV/AIDS, Health Literacy
Coefficientsa
Unstandardized Standardized 95.0% Confidence

Coefficients Coefficients Interval for B
Lower Upper
Model B Std. Error Beta t Sig. Bound Bound
1 (Constant) 1.122 .387 2.900 .004 .355 1.889
Health Literacy .000 .059 .000 -.005 .996 -.117 .117
Knowledge of .673 .112 .502 6.020 .000 .452 .895

HIV/AIDS
a. Dependent Variable: Preventive Behaviour in HIV/AIDS
68
69
70

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The Role of Social Media and the Effectiveness of Communication

Design Framework in HIV/Aids Prevention

Razlan Bin Abd Rauf

A research report submitted in partial fulfilment of the requirement of the

A research report submitted in partial fulfilment of requirement of the

14 April 2021 Razlan Bin Abd Rauf

cases in 1990. After scientists introduced three combinations of Antiretroviral (ART)

dan Tingkahlaku Pencegahan Awam.

1.1 Background of the Study

through workplace exposure. Although medical technology has undergone tremendous

AIDS while reaching a mass audience.

must be thoroughly analysed to determine effective and accessible communication channels,

requirement is that the campaign outcomes should be thoroughly evaluated; to identify

probable influences of the campaign on overall health behaviours as well as instructions of

future risk avoidance and wellness communication endeavours might be identified."

differs in technique from information published in newspapers or notices on signboards. Those

Social media usage is an essential aspect of communication in conveying information

to get the information, especially within social media.

communications in social media must consider the reader's perspective to understand or

express information strategically (Gwen et al., 2018).

of HIV and AIDS.

awareness about the disease to resolve the problem as per highlighted.

1.2 Research Objective

media and preventive behaviours in HIV/AIDS

preventive behaviours in HIV/AIDS

1.3 Research Question

and preventive behaviours in HIV/AIDS?

Research Question 2: What is the relationship between knowledge of HIV/AIDS and

preventive behaviours in HIV/AIDS?

1.4 Research Scope and Significance

in their daily activities.

preventive and risk behaviours.

on social media that influence people to engage in preventive behaviours. Communication in

prevention acts to any diseases.

Other scholars argue that designing an effective communication is essential in facing

and the number of netizens aware of the information.

Furthermore, in the communication of information regarding HIV and AIDS, the

information communication management needs to consider resources or channels accepted and

Covid-19 Pandemic: A Cross-Sectional Study on Chinese Netizens which predicted public

preventive behaviours during COVID-19 outbreak in Chinese contexts.

2.0 Definition of Social Media and Subject Matter Focus

a) Role of Social Media in Information Seeking and Delivery

through 3 types of properties, extraversion, neuroticism and openness, as predictors in the

such as search engine or traditional media.

b) Role of Social Media in Persuasion

persuasion in propagating the establishment to change individual perceptions of something and

something by browsing social media instead of getting consultation from expertise.

technology mediated-communication platforms, like social media, is essential in the

modification of contemplating. They provide the potential of disseminating tailored wellness

appear still reasonably unexplored.

2.2 Theories and Model Framework

It encompasses four processes such as attention, retention, motor reproduction and

reinforcement and motivation. Triadic reciprocal determinism influences the individual

behaviour is shaped and controlled by personal cognition in a social environment. Bandura

beliefs or capacity to execute behaviours to produce specific performance attainment.

Performance attainment is something on accomplishment or achievement that attained.

on their skills and the circumstances they face.