CHAPTER I

THE PROBLEM AND ITS SETTING

Rationale

Living in the 21st century, the era of technology, a wide variety of information can be accessed

by anyone. Considering the health challenges we face, learning them is much more convenient

since we have the advancements. Acquired Immunodeficiency Syndrome (AIDS) and the Human

Immunodeficiency Virus (HIV) continue to be global public health issues due to their increasing

number worldwide. Knowing this is a significant health problem, the stigma is progressive,

leaving some of us unenlightened. It is clear from the literature that misunderstandings about

HIV/AIDS persist extensively despite efforts to eradicate them. Increasing the stigma built in

society, many believe these biased opinions are correct, and with this, the misconceptions about

HIV/AIDS continue to exist.  

According to the World Health Organization (WHO), HIV weakens and targets the immune

system, causing the body's defense against infections and diseases to be more vulnerable,

gradually causing the individual to become immunodeficient. Having the recent rank of region

III on HIV cases in the Philippines, Cabanatuan city has the highest number of HIV cases.

Today, several investigations have revealed that to stop the spread of HIV/AIDS, depending on

health education to promote and sustain behavioral change lowers the likelihood of developing

or spreading the disease. Acquiring health knowledge and healthy attitudes and behaviors

regarding HIV/AIDS starts from school age. Because a significant proportion of the population is

in schools, they are important places and ripe grounds for health education and promotion

(Jeihooni et al., 2018).

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As for the WHO response, they consider the epidemiological, technological, and contextual

shifts to foster health education in response to increasing numbers of cases and to promote

awareness regarding this serious matter. Strategies and innovations through health education

about HIV and AIDS raise new knowledge for individuals who are confused, unfamiliar, and

misguided about the fallacies of these health issues. Researchers aim to address the

misconceptions and stigma surrounding HIV and AIDS among students at Phinma Araullo

Junior High School and how this affects students' knowledge of HIV/AIDS. 

Conceptual Framework

This research is a Descriptive Quantitative Study. It aims to determine the

misconceptions about HIV and AIDS by the awareness of 1 st year nursing students of PHINMA

Araullo University. The conceptual framework utilizes Input, Process, and Output Methods to

describe the structure of information, the flow of data, and the study's outcome. This study will

utilize survey questionnaires to determine the respondents' level of awareness, and as for the

sampling technique, systematic random sampling will be implemented.

INPUT PROCESS OUTPUT

1. Profile of the respondents This chapter provides  Results

a. Age information on the research  Conclusion

b. Sex method of the study, which is  Recommendation

2. Knowledge of the descriptive

respondents on HIV/ AIDS: quantitative research. The

a. HIV and AIDS researchers made this study

transmission possible by doing systematic

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 b. HIV and AIDS awareness random

3. Correlation between the sampling, distributing

respondents’ awareness of questionnaires, and examining

HIV/AIDS and demographic the data gathered. The

profile researchers also

4. Recommendations that can choose PHINMA Araullo

be involved in raising University for its accessibility

knowledge about HIV and since the researchers are from

AIDS the

institution.

Table 1. Paradigm of the Study

Theoretical Framework

This study is supported by the theory of Nola Pender (1982) on the Health Promotion

Model, where she stated: “that each person has unique personal characteristics and experiences

that affect subsequent actions.” On the other hand, Pender (1982) believes that there were three

areas in that health promotion focuses on individual characteristics and experiences, behavior-

specific and affect and behavioral outcome. Comprehensive knowledge about HIV/AIDS is

significant to behavioral changes and uptake of HIV services since human behavior can

positively affect by complete and relevant information Agu et al. (2020). Pender (2006)

interpersonal, situational, and behavioral influences were recognized as of high theoretical

importance and needed to be repositioned as having direct and indirect effects on health-

promoting behavior (Revised Model). Self-direction and self-regulation are the abilities to direct

3|Page
and control ones thinking and action, according to Bandura (1977, 1985) on Social Cognitive

theory.

Statement of the Problem 

This study entitled "Misconceptions on Human Immunodeficiency Virus and

Autoimmune Deficiency Syndrome in Health Education" specifically this study sought to answer

the following:

1. How may the demographic profile of the respondents be described in terms of:

1.1 Age;

1.2 Sex;

2. How may the knowledge of the respondents on HIV and AIDs be described in terms of:

           2.1 HIV and AIDS transmission

           2.2 HIV and AIDS awareness

3. Is there a substantial correlation between the respondents' awareness of HIV and AIDS and

their demographic profile? 

 4. Based on the study, what recommendations can be involved in raising knowledge about HIV

and AIDS? 

Significance of the Study

This study will provide new insights into HIV and AIDS through health education.

Specifically, this research will benefit the following:

For the Students. Through this research, students will give a chance to share their thoughts

about HIV and AIDS.

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 For the Community. This study benefits the community, spreads awareness, better

knowledge, and understanding develops and sustains safer behaviors, and reduces stigma and

discrimination toward people affected by or living with HIV and AIDS.

For the Health Advocates. The results of this research will provide helpful information to

advocates to further their campaign on spreading awareness of safe practices to prevent HIV

and AIDS and how to stop stigmatizing and discriminating against those affected by HIV and

AIDS.

For the Teachers. This study will be necessary for teachers to provide their students with the

knowledge and the ability to prevent and protect themselves from HIV and AIDS.

School Administrators. This research study will be beneficial to school administrations to

promote programs and advocacy to educate students about HIV transmission and the risk of

premarital sex.

Parents. This research will enable parents to know that they also have the responsibility to

guide and provide knowledge to their children about HIV and AIDS and the importance of

sexual health and safer sex.

Future researchers. The survey's baseline information will use in further research and

studies on the topic. 

Hypothesis

There is no relationship between the demographic profile and knowledge of the

respondents on HIV and AIDS.

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Scope, Delimitations, and Limitations 

Scope

The research study covered the common misconceptions about HIV and AIDS at Phinma

Araullo University first-year nursing students during the second semester of the academic year

2022-2023. The study's respondents were chosen from the population using Slovin's formula

accomplished by the researchers. 

Delimitations 

Will further be limited among 1st-year student nurses at Phinma Araullo University.

Limitation

The Researchers conducted the study at the Phinma Araullo University Campus; in

transferability, the findings will become limited for research. 

Definition of Terms 

The following concepts are defined to aid in understanding the study: 

a. Conceptual Definition

Student - a person formally engaged in learning, especially one enrolled in a school or

college

Human Immunodeficiency Virus (HIV) - is a virus that infects white blood cells,

weakening the human immune system.

Acquired Immunodeficiency Syndrome (AIDS) - is a set of disease symptoms that

arise in the later stages of immune deficiency caused by HIV infection.

Barrier - boundary or limit 

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 Epidemiological - studies the distribution and determinants of health-related conditions

or events in specific groups and their application to control health problems.

b. Operational Definition

Misconception- refers to the facts and fallacies that affect the student's knowledge or

understanding regarding HIV and AIDS.

Stigma- negatively imparts an idea or knowledge.

PLHIV- people living with HIV

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 CHAPTER II

REVIEW OF LITERATURE

This chapter talks about a review of studies and related material that are pertinent to

current endeavors.

Foreign Literature

HIV and AIDS 

According to the World Health Organization (WHO), HIV weakens and targets the

immune system, causing the body's defense against infections and diseases to be more

vulnerable, gradually causing the individual to become immunodeficient. The most severe form

of HIV infection, known as AIDS, takes many years to manifest if not treated. Adolescents are

inquisitive and free-spirited individuals who become more fascinated by unique and unusual

things as they gain more knowledge of the outside world. The most severe form of HIV

infection, known as AIDS, takes many years to manifest if not treated.

Knowledge about how HIV can or cannot be transmitted is essential in preventing AIDS.

Although correct knowledge about HIV and AIDS does not always correlate with increases in

safer-sex behavior, increasingly widespread understanding about sexually transmitted infections

(STIs), and HIV specifically, is considered an essential step towards behavior change. HIV and

AIDS continue to be shadowed by many misconceptions and misinformed opinions; for this

reason, it is essential to understand how accurate and inaccurate knowledge may contribute to

behavior patterns. (Population Council, undated). 

According to Agu et al. (2020), comprehensive knowledge about HIV/AIDS is

significant to behavioral changes and uptake of HIV services since human behavior can

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positively affect by complete and relevant information. Many teenagers lack comprehensive

knowledge about HIV/AIDS, and they are vulnerable to misinformation and misconceptions

about the mode of transmission and the method of how to prevent HIV. Misconceptions are

thoughts and beliefs that have been scientifically wrong, held by a group of people concerned

about a phenomenon. These misconceptions are primarily strong, resistant to change, deeply

ingrained in people's experiences, and impede individuals' learning. To raise awareness of

HIV/AIDS, teenagers continue to have many misconceptions regarding HIV prevention and

transmission despite the effort, which is progressively made possible by technological

improvements and easy access to social media. Evidence shows that most young people use

social media to communicate and easily believe the information they receive. Considering the

possible harmful outcome of spreading wrong beliefs on social media about HIV, it is essential

to analyze these beliefs for young people to understand what information needs to be exposed.

The literature clearly shows that misconceptions persist, despite efforts to reduce

misconceptions about HIV/AIDS. Many believe these biased assessments are correct and have

contributed to the stigma that has built up within society. Similarly, another study questioned 227

nursing college students and discovered that 18.5% had advanced stages, 60.8% had intermediate

levels, and 20.7% had poor stages of HIV/AIDS knowledge (Fraim, N. L., 2012).

 Education on HIV/AIDS

Today, several studies have indicated that controlling the spread of HIV/AIDS depends

on health education to motivate and reinforce behavioral change that lessens the risk of obtaining

or transferring the infection. The best interventions are those done with a thorough understanding

of the local epidemiology and drug use culture. Since most of the population attends school,

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schools are essential locations and ideal grounds for health education and promotion. We are

learning about health matters and developing good attitudes and actions about HIV/AIDS. The

effectiveness of health education programs, which in turn heavily depends on the implementation

of a suitable model for selecting educational programs and targeting health issues, determines the

value of these programs (Jeihooni et al., 2018).

As citing Khamisa, N., Mokgobi, M., & Basera, T. (2020), According to their findings, a

lack of awareness and negative attitudes regarding contraceptives and hazardous sexual conduct

is to blame for the high infection incidence among the young female population. By enhancing

their capacity to engage in safe sex, young people can be encouraged to engage in healthy and

safe sexual behavior. Knowledge of HIV and AIDS infection is required to change negative

attitudes toward condom use and other contraception. It will probably enhance awareness for

adopting HIV prevention techniques to deal with the rise in HIV and AIDS prevalence in

vulnerable populations. Knowledge facilitates familiarity and awareness of HIV and AIDS,

which influences attitudes resulting in support and motivation for prevention and behavior (safer

sex practices), thereby reducing the risk of infection.

Studies recommend that such misinterpretations are a result of the interaction between

societal impacts and individuals (Sano, Y., Antabe, R., Atuoye, K. N., Hussey, L. K., Bayne, J.,

Galaa, S. Z., Mkandawire, P., & Luginaah, I., 2016). CDC, the US Centers for Malady Control

and Anticipation 2015 evaluated that 1.2 million individuals within the U.S. were diagnosed with

HIV, and universally, one in seven was unaware they had HIV. With more than 34 million

deaths worldwide, HIV continues to be a severe public health issue. According to estimates, 1.0

million persons worldwide passed away in 2016 due to HIV-related causes.

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 Citing Andrew, P. O. et al. (2018), in planning our youthful individuals for grown-up life

ahead of them, instruction remains an excellent instrument for transmitting information almost

HIV and Helps avoidance. Information about HIV and Helps can serve as an instrument and

direct approach detailing the fundamental intercession in a battle to decrease the predominance

of HIV and other STDs; youthful people must be HIV-positive because they are a valuable

resource to society.

The Philippines is a conservative country where colonization has been an enormous

factor that in today's time affected the place on adapting the possible purposive changes like

introducing sex education. Culture, beliefs, and practices are a drawback to fully introducing the

new system that might benefit Filipinos, but with this, the country is not yet ready for change. 

Nursing on HIV/AIDS

Currently, nurse education and coaching on HIV aids and acquired immunodeficiency

syndrome, HIV aids suffer from several shortcomings and lack any accurate formalization in

their central governance manner students pursuing a bachelor's degree in nursing encounter

challenges while trying to teach effective HIV and aid healthcare management because of the

emphasized educational gap which is a significant a comparable conclusion can make from the

assertion that patients having HIV and aids treatment alternatives unquestionably have primarily

experienced inferior medical care due to highly negative or insufficient facts of these remedies

especially opposed to popular opinion (Ngcobo, S. J.,& Mchunu, G. G., 2019)

According to Frain (2017), there has been a decline in the amount of time spent teaching

about HIV and AIDS at different nursing schools, with undergraduate nursing students being the

most severely affected. Numerous have expressed unpreparedness in response to the many

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adverse effects this lack of essential HIV and AIDS healthcare knowledge has on nursing

students and those under their care.

Local Literature

United Nations reports that the Philippines is dealing with severe HIV cases that have

increased since 2008 compared to other Asian and Pacific Rim nations (Geronimo, 2016). As of

June 2018, there were 56,275 new HIV cases in the country (DOH, 2018). In line with

epidemiology. There are 31 instances, according to the Department of Health Bureau daily

reports. While there are in 2009, 2011, and 2013, just 2, 7, and 13 instances per day,

respectively, were documented (DOH, 2018). These occurrences are common in densely

populated places like Metro Manila, Metro Cebu, and the Calabarzon region. However, HIV

cases in rural areas also increase over time, just as in metropolitan areas. In Sorsogon, there were

11 reported HIV infections in 2014, 74 in 2017 (Barcia, 2017), and 26 other cases in 2018

(Arguelles, 2018).

The primary source of revenue for municipal governments is tourism. The increase in

HIV incidence is a clear and present hazard, given the geographic and economic conditions. The

widespread stigma associated with HIV is a significant contributor to the transmission of

infection. Negative societal views and conduct against or by those with the condition constitute

the stigma. Understandably, a lack of understanding about the illness, particularly its

transmission mode, etiology, and prevention, contributes to HIV-related stigma. Tomasszewski

(2016) asserts that the stigma associated with HIV discourages people from adopting

preventative actions like being tested and seeking treatment. Therefore, more individuals will be

in danger if it spreads widely. The lives of persons affected by HIV and those who live with

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them are harmed by HIV-related stigma, according to a review report of the Pacific Region HIV

Stigma Index. Moreover, despite technological and scientific advancements, prejudice makes

treating the HIV epidemic more difficult as stigma grows (Fiji Network for People Living with

HIV, 2018). Compared to rural areas, densely urbanized cities have a far higher prevalence of

HIV cases.

Nevertheless, there has been a steady rise in HIV incidence in rural regions in recent

years. The community may decide on the intervention measures required to lessen or eradicate

the stigma by understanding the amount of stigma. The study also looks at how demographic

factors affect how the stigma associated with HIV is perceived. In the Philippines, males are

becoming more and more susceptible to HIV diagnoses as they age. 94% of HIV infections are

in men, and 80% of cases are in those 34 years of age and younger (DOH, 2018). 

The Joint United Nations Program on HIV/AIDS (UNAIDS) defines it as a “dynamic

process of devaluation that significantly discredits an individual in the eyes of others. When

stigma is acted upon, the result is discrimination that may take the form of actions or omissions”

In addition, according to UNAIDS, discrimination is any arbitrary distinction, exclusion, or

restriction that affects a person. Whether or not such measures are justified typically but not

always because of an innate personality trait or perceived group membership in the case of AIDS

of a person with a confirmed or suspected HIV-positive status.

Philip et, al., (2014), surveyed healthcare students in Trinidad and Tobago and concluded

that stigmatizing attitudes of respondents depend on the mode of acquiring HIV, with a departure

to social norms (i.e., promiscuity) correlating to more significant stigma. According to a study by

Lopez et al. (2017), to address these causes suggested programs that concentrate on the

individual, environmental, and policy levels; PLHIV has experienced being denied appropriate

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healthcare services in the Philippine healthcare setting because of their HIV status. The study has

identified stigmatizing behaviors and discriminatory practices.

The Philippine National Youth Commission recently observed that the newest cases

reported in the nation are often those of young people, suggesting that young people are most at

risk for this disease. According to DOH data, 29 Filipinos contract HIV per day. Nineteen of

these 29 daily instances are between 15 and 25 years old. There were 682 new cases reported in

just one month of July 2015, up 17% from the prior month. Of these 682 new cases, 94% were

male, with an average age of 27. Sexual contact was the most frequent method of transmission

(663 cases), and 86% of instances involved men having sex with other men (Dongallo Jr et al.,

2017). Studies show that mother-to-child transmission (two cases) and needle sharing among

drug users are additional mechanisms of transmission (Dongallo Jr et al., 2017).

In a study by James et al. (2022), participants had insufficient knowledge and attitude

toward HIV/AIDS and a proportion of harmful practices among higher education students in

Pampanga, Philippines. Students received information on HIV/AIDS primarily from television

and social media, although sex education material also served as another common source.

HIV-related stigma in the Philippines

HIV-related stigma contributes to increased HIV risk and decreased promotion of HIV

care across all populations. Individuals living with HIV often experience stigma related to their

diagnosis within their communities, resulting in internalized shame and continued anticipation of

discrimination from all areas of their social life, which can result in adverse health outcomes. In

the Philippines, people living with HIV face a significant amount of perceived stigma due to

their serostatus—an aspect of their diagnosis that makes them appear sinful and immoral—

compared to other countries where the biggest epidemic occurs. The persistence of this

14 | P a g e
stigmatizing attitude contributes to the growing nature of the epidemic, along with poor

education about how to prevent infection while living in communities where many are still

resistant to changing behavior patterns.

Religious stigma

James et al. (2022), studied the influence of religious and cultural beliefs on sexual

behavior. The importance of virginity and avoiding premarital sex was associated with religious

doctrine or practice for Filipinos. One held belief of some individuals adhering to Catholic

doctrine is that HIV is a disease meant for gay men as a moral reparation for engaging in the sin

of homosexual activity. Since the Spanish-colonial occupation of the Philippines, Roman

Catholicism has maintained its strong presence there, with more than 80% of Filipinos

identifying as Roman Catholic, making it one of Asia's most prominent Christian countries

(Bustamante & Plankey, 2022).

Misconceptions of HIV

Misperceptions about the virus's mode of transmission and its aftereffects are rooted in

an intrinsic dread of it. Although most Filipinos know HIV exists, there are still widespread

misconceptions among the general public (Bustamante & Plankey, 2022). These include

persistent myths that washing one's genitalia can stop transmission, suggesting a dearth of

information regarding HIV (James et al., 2022).

The Positive Action, Foundation Philippines Incorporated, reported that many Filipinos

have a misconception of the mode of HIV transmission, such as the virus spreading through

sharing a handshake, getting bitten by a mosquito, and using the same toilet seat as someone

living with HIV.

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 CHAPTER III

METHODOLOGY

In this chapter, we performed how the research showed the procedures in this study. It

described how respondents were selected, the tools used, and how the data were analyzed using

the appropriate statistical tool for the treatment of the study. This chapter covered the research

design, data sources, tools for data analysis, and specific methodology.

Research Design

Descriptive research is to generalize findings from a representative sample of a cross-

sectional survey's sample population to a larger target. The descriptive study designs have this

Difference in that there is only one sample and no comparison group. On the other hand, based

on McNeill C. (2018), descriptive research aims to describe, explain, or validate the study's

hypothesis or objective. 

Locale of the Study

This study is conducted at PHINMA Araullo University found at Maharlika Highway,

Brgy. Bitas, Cabanatuan City, 3100 Nueva Ecija. The researchers choose this institution for its

accessibility since the researchers are from the institution.

Sources of Data

The primary and secondary sources were drawn in obtaining the essential data needed in

this research. The primary sources of data were sorted via Slovin’s formula from level 1 nursing

16 | P a g e
students where the sample size is 255 respondents. Books, articles, journals, unpublished theses,

and the internet were secondary sources of data.

Sampling Type and Techniques

The respondents of this study were the students from 1st year Nursing at Phinma Araullo

University, with a total of 700 students; 255 students were chosen from the population using

Slovin's formula. The researchers will use Slovin's formula to compute the sample size with 95%

confidence and a 5% margin of error. Systematic random sampling is a probabilistic sampling

method in that the researchers select members of the population at predetermined intervals (or k).

The respondent's answers will be the reference data for formulating a conclusion and

recommendation. 

Research Instrument

The data source the researchers used was the survey questionnaire distributed to the

respondents of the research study. The questionnaire's contents were composed of the student's

demographic profile, HIV and AIDS awareness, and transmission through a level of awareness

The researchers will use the data collected and will examine the results with the use of

statistical analysis of data. Data analysis and validation are significant through the help of the

item content.

Tools for Data Analysis 

After gathering the data needed, the researchers tabulated, summarized, analyzed, and

entered the gathered data in appropriate tables for analysis and discussion with the help of

statistical tools.

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 For the I-CVI, the number of experts who rate each item as “very relevant” or “somewhat

relevant” is divided by the total number of validators. The S-CVI is computed by taking the sum

of all I-CVIs and dividing it by the total number of items.

The Pearson Correlation Coefficient will use in computing the test-retest reliability.

The formula is:

N ∑ XY −(∑ X)( ∑Y )
r= 2 2
√ [N ∑ X 2−( ∑ X ) ][ N ∑ Y 2−( ∑ Y ) ]

Where:

N= Number of Respondents

X= Score in the First Test

Y= Score on Second test

Test-retest reliability coefficients vary between 0 and 1, where:

Score Interpretation

1 perfect reliability

≥ 0.9 excellent reliability

≥ 0.8 ˂ 0.9 good reliability

≥ 0.7 ˂ 0.8 acceptable reliability

≥ 0.6 ˂ 0.7 questionable reliability

≥ 0.5 ˂ 0.6 poor reliability

˂ 0.5 unacceptable reliability

0 no reliability

Table 2.1 Interpretation of Test-retest Reliability Coefficients

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 When scoring the respondents’ socio-demographic profile and HIV/AIDS transmission

through the level of awareness survey, a score of 1 for each correct answer and 0 for each

incorrect response. The researchers will then use frequency and percentage tools to analyze the

data. The percentage represents a part of the whole. The formula is:

F
P= x 100
n

Where:

P = percentage

F = frequency counts

n = number of participants

The scale for HIV/ AIDS transmission through the level of awareness, as presented in Table 2.2

Level of Awareness Percentage Score

Very Good ≥ 75%

Good 65% - 74%

Average 50% - 64%

Poor 40% - 49%

Very Poor ≤ 40%

Table 2.2 Scale for Level of Awareness

A score of more than 75% is interpreted as very good knowledge. A score of 65%-74% is

interpreted as good knowledge. A score of 50%-64% is interpreted as average knowledge. A

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score of 40%-49% is interpreted as poor knowledge. A score of equal or less than 40% is

interpreted as very poor knowledge.

Protection of Rights

Individual rights of protection are now the most significant task in the research. The

following are observed activities and events that carry out the subject's rights and protections.

Right to Confidentiality. Respondents in the study have the right to confidentiality, which

implies that researchers must preserve their obligation to keep health information private unless

there is a legal justification to do otherwise.

Right to Information. Respondents in research have the right to be notified about unforeseen

findings that affect overall knowledge. When deciding whether respondents should be informed

about unintended findings discovered on the researchers' initiative, one must consider the

respondents' expressed interest in receiving the information, their expectations about receiving

the information, the security of the information, and the potential benefit of the respondents.

Rights of Anonymity. It is essential for safeguarding and maintaining privacy and free

expression. The respondents are unidentifiable, uncontactable, and untractable. The identification

of a specific topic is unknown to researchers. People can express themselves anonymously

without fear of retribution.

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Agu, I. C., Mbachu, C. O., Okeke, C., Eze, I., Agu, C., Ezenwaka, U., Ezumah, N., &

Onwujekwe, O. (2020). Misconceptions about transmission, symptoms, and prevention of

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