Ever since the first case of HIV was recognized in 1981, HIV has spread across the continents to recognize itself as the most challenging disease to control. Acquired immunodeficiency syndrome (AIDS) is described as 'pandemic' of 21st century and Fiji island has not been able to save itself from it. As of February 2009, there were 294 confirmed cases of HIV positive patients but no report of how many developed into AIDS was provided . Compared to international number of cases, Fiji was ranked 137 with prevalence of 0.1% (ref). In Fiji, AIDS represents a condition which will lead to death and can be easily be transmitted. Despite health promotion and awareness by Ministry of health (Fiji), public view AIDS with a degratory attitude which not only affects peoples perception, but also patients undergoing HIV treatment. Health care professionals play a vital role in management of AIDS patient and understanding their attitude towards AIDS patient is of major concern. Pharmacist being the provider of pharmaceutical care, it must be presumed that attitude of a pharmacist should be of no bias or prejudice as they are providing care to a patient. Although pharmacists in retail and public sector deal with HIV patients on daily basis, there is lack of literature quantifying attitude of pharmacist or pharmacy students towards AIDS. Therefore, aim of this research is to study attitude towards AIDS among pharmacy students at Fiji School of Medicine. Moreover, majority of the pharmacy students in south pacific are trained at Fiji School of Medicine (FSM, now Fiji National University, College of Health science). Pharmacy students are selected for this research because eventually they will be called for care of AIDS or related disorders after they finished their programme. Hence, this study will help to implement any policy changes that may be needed to integrate amongst pharmacy students through means of health promotion and education through curriculum.
Background
Social sigma towards AIDS patient has been of major concern in South Pacific and it has shown to affect management and attitude of patient towards treatment according to study conducted by Pacific Islands AIDS foundation . Problem of sigma not only exist in Fiji, but also in countries around the globe. In 1987, World Health Organisation (WHO) classified AIDS epidermics in three phase which included the epidemic of HIV, the epidemic of AIDS, and the epidemic of stigma, discrimination, and denial. The last part is the most difficult of AIDS epiderminc. According to Peter Piot, executive director of UNAIDS found AIDS related sigma is the most 'continuing challenge' that seems to be affecting the world . Furthermore, lack of methodological tools and research in AIDS related sigma complex and diverse .
The most successful method used to test attitude was developed by in Health Psychology journal and was later validated in 1997 . It was named AIDS Attitude Scale (AAS) which contained 15 items carefully selected through their research and was further subdivide into 3 subscales namely Fear of contagion, Professional resistance and negative emotions. To prevent any social desirable answers by participants, items from Crowne-Marlowe Social Desirability (ref) was interspersed with the items.
Due to ever-increased demand for pharmaceutical care, more pharmacists are to be expected in clinical management of patients. Therefore, it becomes important to study attitude of pharmacy students towards diseases particularly socially sensitive AIDS. According to study done by Edward Krupat, pharmacy students showed negative attitude towards AIDS patient on contagion, emotion and professional resistance scales which also recommended change in education programme in the curriculum. However, no studies of such nature has not been done on pharmacy students in Fiji. It would be interesting to study attitude and relate it to independent variables such as gender and age and find if any association exists.
Methodology
Study Design
Descriptive study. Study will also try to link variables which may be related with positive and negative attitude towards people with AIDS.
Study area/setting
Fiji School of Medicine
Study Participants
Pharmacy students from years 1 - 4 enrolled in Bachelors of Pharmacy or Diploma in Pharmacy programme in year 2011.
Sample Size
Approximately 80 - 100. Sample size may vary as it is unknown how many students will enter year 1 in 2011 and those who may exit pharmacy programme.
Sampling technique
Stratified sampling will be used because common characteristic of the samples will be students who will be enrolled in Bachelors in Pharmacy or Diploma in Pharmacy programme in 2011.
Data Management
Data collection instruments, techniques and plan
AIDS Attitude Scale (AAS) will be used to measure attitude of pharmacy students towards AIDS. It is a 15 item instrument developed for medical and nursing students by for measuring attitude towards AIDS. ASS has been successfully used in various researches to measure attitude and has been reliable and there has not been any studies conclusive to depict uncertainty in ASS. For this research, AAS will be converted into a form of self administered questionnaire and distributed to pharmacy students.
Data Entry
Data will be enter into SPSS.
Data analysis/Design of analysis form
Responses from 1-3 will be categorized to indicate disagreement with each of the 15 items. Similarity, responses from 4-6 will be categorized to indicate agreement with each of the 15 items.
Statistical methods/analysis
Categorized data (i.e. disagreement and agreement) will be calculated of its percentage, against each 15 items in the following table format.
Items
n
n= disagree
n=agree
Contagion Subscale
Aids makes my job a high risk occupation
Despite all I know about how AIDS is transmitted. I'm still afraid of catching it.
I would not want my child to go to school with a child with AIDS
I would be willing to eat in a restaurant where I know the chef has AIDS
Even following strict infection control measure, it is likely that I would become infected
with HIV, if I were working with AIDS patients over a long period of time
Professional Resistance Subscale
I would rather work with a better class of people than AIDS patients
I would prefer to refer persons with AIDS to my professional colleagues
Given a choice. I would prefer not to work with AIDS patients
I would consider changing my professional specialty/position if it became necessary to
work with AIDS patients
It is best to train a few specialists who would be responsible for the treatment of AIDS patients
I don't want those at higher risk for AIDS such as IV drug users and homosexuals, as patients
Negative Emotions Subscale
I sometimes find it hard to be sympathetic to AIDS patients
I would feel resentful if AIDS patients accounted for a significant part of my caseload
I often have tender, concerned feelings for people with AIDS
I feel angry about the risk of AIDS which homosexuals have imposed on the straight community
a) Reliability of the scale will be tested by computing Cronbach's alpha and listed in the following table
Reliability Statistics
Cronbach's Alpha
N of Items
.022
4
Second part of analysis will be Pearson's Chi squared test to study any association between Contagion, Professional Resistance and negative emotions subscale against gender or year of the student.
Appendix
I. Questionnaire
