THE RESPONSIBLE BEHAVIOUR FOR NURSING STUDENTS
HIV and AIDS is a matter of concern because the number of cases has increased dramatically over the last ten years. Nursing students need to have appropriate knowledge and attitudes about HIV and AIDS because they are the future health care professionals, therefore will play a key role in prevention of spread and care of people with AIDS. The aim of the study was to explore the knowledge, behaviours and attitudes about HIV/AIDS of nursing students in Greece. Method and Material: A cross-sectional study was carried out in a nursing school of a Technological Educational Institute in Greece. A sample of 279 (N=279) nursing students agreed to participate in the study, giving a response rate of 77.5%. Data were collected using an anonymous questionnaire comprising four self-administered instruments: (a) the International AIDS questionnaire-Chinese Version (IAQ-C), (b) the source of HIV/AIDS information questionnaire, (c) Sexual behaviours/practices and attitudinal questions about AIDS and (d) demographic questions. Return of a completed questionnaire was considered as consent to participate in the study. Descriptive and inferential statistics were employed for the data analysis using SPSS version17. The significant level of p value was determined at p< 0.05 Results: Overall student nurses had fairly good knowledge about HIV and AIDS as well as a positive attitudes towards AIDS people (M=70.39;SD=18.43; possible range 18-90). A few items however presented contradictory results from the overall score of the knowledge scale. Of the respondents 39.8% believed that mosquitoes can transmit HIV and 38% believed the virus could be transmitted via the toilet seat. 56.2% reported that vaccination can protect them from AIDS. The majority of respondents (76.7%) hadn?t been taught about HIV/AIDS. Participants reporting a willingness to care for people with AIDS were significantly more knowledgeable and held more positive attitudes towards people with AIDS (P=0.001). The primary sources of information for the participants were television (80.7%), newspapers/magazines (64.6%) and internet (60%). 94.3% of the respondents stated that they were heterosexual and sexually active. Religious students were found to be less knowledgeable and held less positive attitudes towards people with AIDS when compared to students with no religious conviction (F=2.61; P=0.03). Conclusions: Student nurses? knowledge presented contradictory results which indicated that whilst overall scores confirmed the participants possessed fairly good knowledge, individual knowledge items demonstrated that they lacked some knowledge on the subject. Nursing curriculum programmes of nursing schools need to be restructured to ensure that students gain the necessary accurate knowledge and appropriate attitudes about HIV
Although it is considered that nowadays there is adequate knowledge about transmission of HIV, published figures show an increase in the number of HIV positive people and individuals suffering from AIDS . The increase in cases detected might be due to the reduction of information given to the general population . Healthcare professionals including nurses have significant responsibility for providing information about the transmission of HIV and for developing a strategic health programmes to reduce that transmission. Student nurses will have received some information about HIV and AIDS before commencing their undergraduate studies. Through their nursing education and clinical training they should acquire knowledge that will change their attitudes and influence their behaviours both in the prevention of transmission of the virus, and positive attitudes for effective caring for these patients.
With the continuing increase in the incidence of HIV and AIDS nurses require current knowledge and skills to ensure that they are able to provide high quality, effective care to people living with HIV and AIDS [3,4].
Studies carried out in the early nineties showed that nursing students had a low level of knowledge with respect to HIV and AIDS [8,9]. A study carried out in Turkey was found that the majority of nursing students had moderate level of HIV/AIDS knowledge . Lack of knowledge among nursing students found in other studies as well [11,12]. Bektas  found that some nursing students were not aware that there was no protection with vaccination. In addition found that there are many misconceptions about how HIV is transmitted e.g using the same toilet or bathroom etc. . This problem also stressed by previous researchers [13,14].
Male and older students were found to be more knowledgeable than female and younger students . Bliwise et al.  found that nursing students and first year medical students possessed greater fear of contagion, more negative emotions and professional resistance to care for these people. In contrast, to previous result Halpern et al.’s  study found that health care professionals and nursing students did not have fears of HIV/AIDS and did not judge individuals with HIV/AIDS in a negative way.
Previous experience in caring for an AIDS patient was found to increase the level of nurses’ knowledge and to reduce the fear of contagion . Knowing someone with AIDS resulted in a higher knowledge level and less fear of HIV/AIDS . Students who had previous experience in caring for an AIDS patient and had known someone with HIV/AIDS were willing to care for PLHIV .
Student nurses are usually more willing to care for patients who are not diagnosed with AIDS. Particularly students having negative attitude towards care for AIDS patient were worried about putting their family members and other relatives at risk .
Nursing students with negative attitudes were less willing to care for people with HIV/AIDS compared to those with positive attitudes [3,20]. Moreover, the higher the knowledge level regarding AIDS, the more positive were the attitudes and the higher was the willingness to care for AIDS patients .
Knowing someone with and caring for AIDS was also found to decrease the fear and increase the knowledge level and willingness to care for such a patient . This finding is similar to those reported by previous studies [17,18]. In Bektas’  study there was a substantial negative attitude towards AIDS and HIV positive patients. Nursing students found unwilling to care for AIDS patients which was linked to the fear of contracting HIV/AIDS which is consistent with earlier studies [17,18,21]. O’
Sullivan found that those who were least willing to care for HIV feared for their personal safety and did not feel adequately prepared to care for PLHIV . Goldenberg & Laschinger  did not found any association between nursing student age and their attitudes towards AIDS patients.
People’s attitudes towards AIDS may also affect their own sexual behaviours. A minimal concern about contracting HIV together with high sexual activity is associated with a lower level of safer sex practices . Female student nurses practice more safe sex compared to male nurses .
Studies investigated attitudes towards AIDS patients showed that people being afraid of HIV/AIDS had higher homophobia compared to those with less fear of HIV/AIDS [17,24]. Infection of HIV was often considered as a punitive consequence of a promiscuous sex life with nurses and nursing students having little sympathy for homosexuals suffering from AIDS . Lohrmann et al.  referring to a German study  reported that more experienced nurses did not discriminate between groups of AIDS patients in terms of lifestyles.
Results from Bektas  study underline the need to strengthen education on all aspects of HIV/AIDS. To improve nursing students willingness to care for PLHIV, particular emphasis should be placed on the training of nursing students as skilled nursing staff with humane attitudes towards PLHIV . The educational preparation of nurses has been known to affect the attitudes of the nurses and the effectiveness of the care provided to HIV/AIDS patients .
Namal  indicated that the subject of AIDS is not mentioned enough in medical and nursing schools and people with AIDS are simply identified as homosexual. Nurse educators should ensure the education on all aspects of HIV/AIDS is explicitly included in the curriculum and that the teaching reflects the needs of leaners.