The present study evaluated the knowledge and attitude of Iranian high school students towards HIV-positive and AIDS patients. The reports concerning rapid spread of AIDS in various populations have increased the level of anxiety over contagion among adolescents. This may explain why about 94% of the students expressed a wish to obtain more information about AIDS, and most surveyed students believed that AIDS could be a threat to their society. This finding is similar to that of American and European investigators one decade ago, when the AIDS epidemic was emerging [8
In general, the study revealed a variable lack of knowledge about HIV/AIDS among students. Female students demonstrated a slightly higher level of knowledge in comparison with male students; this difference is small and practically insignificant but consistent with the studies of Brook and Green et al [11
]. However, Agrawal et al found that boys had better knowledge than girls and their explanation for this finding was that boys feel freer than girls to talk about matters relating to sex and HIV/AIDS [13
The media (Television and radio) were the most common means of obtaining information about HIV/AIDS, but not the most credable sources. This was consistent with the study by Brook [11
]. "Newspapers and magazines" were associated with the most accurate knowledge about HIV/AIDS. Studies in Southeast Asia have shown that most media have done little to change existing cultural values and prejudice about the sexuality and the situation of people who are living with HIV or AIDS. They were good at educating people that HIV and AIDS exists but mainly in a frightening way because they have seldom given enough in-depth information to contextualize this information [14
]. Taking everything into account, media should apply new methods of AIDS education to improve public knowledge about HIV/AIDS.
Overall, there were many misconceptions about how HIV is transmitted, e.g. by shaking hands, using public toilets, using public swimming pools, etc. This problem was also addressed by previous investigators such as Agrawal et al, DiCemente et al, and Sikand et al [[13
], and [16
]]. However Brook et al have found relatively sufficient knowledge about transmission and "high risk group population" among Israeli high school students [17
]. In our study, a considerable proportion of respondents thought that there is a cure for AIDS. This is consistent with the findings of Agrwal et al, and can be attributed to the many false claims published in media and other modes of advertisement [13
]. Misinformation concerning a "cure" for AIDS is one of the risk factors for contracting the disease.
Though better knowledge does not necessarily lead to behavioral changes [18
], we believe that repeated talks with teachers and advisors in the classroom about this important subject would have some influence upon a certain percentage of the students.
In this study, there was a substantial negative (intolerant) attitude towards AIDS and HIV positive patients. About a third of the students expressed that they would avoid sitting near an infected student. This was found to be true in the study of Brook [11
]. In the study of Merakou only a small percentage of the students (5%) declared that they would reject their infected friends. This study was performed after 15 years of HIV/AIDS prevention in Grecian schools [21
]. Approximately half of students in our study expressed that an infected student should not be allowed to enter an ordinary school. Similarly this was reported by a third of Indian students in the study of Agrawal [13
]. This can be explained by the approximity of Iranian and Indian attitudes towards HIV/AIDS which is associated with the great taboo, sex (especially outside- marriage-sex). These are serious attitudinal problems aroused by lack of education about AIDS and need to be addressed.
The present study is in agree with the findings by Agrawal et al, Brown et al, Krasnik et al, and Ross et al [13
] who have reported a correlation between knowledge and attitude, but not with Brook, and Morton et al [11
The study reported here has confronted several limitations. First, in a religious society like Iran, the researchers are restricted in asking questions concerning students' sexual beliefs and behaviors. Second, the results of this study may only be generalized to similar populations of students. They may not be applicable to adolescents who are not attending school. Third, because of the self-report nature of the questionnaire, the honesty of students' responses may be questioned. However, the questionnaire was anonymous, which should have encouraged accurate and honest self-disclosure.