1.

Background of the Study

In the world there are various types of diseases but more are curable and many are not
curable. HIV/ AIDS are the one of the major public health problem both in developed and
developing countries. HIV means Human Immunodeficiency Virus: Human -This
particular virus can only infect human beings. Immunodeficiency HIV weakens immune
system by destroying important cells that fight disease and infection. A "deficient"
immune system can't protect of the body, Virus A virus can only reproduce itself by
taking over a cell in the body of its host.

We know that HIV can hide for long periods of time in the cells of the body and that it
attacks a key part of immune system .The Body has to have these cells to fight infections
and disease, but HIV invades them, uses them to make more copies of itself, and then
destroys them. Over time, HIV can destroy so many cells of body that cant fight
infections and diseases anymore. When that happens, HIV infection can lead to AIDS.

The Human Immunodeficiency Virus (HIV) infection causes a gradual depletion and
weakening of the immune system. This results in an increased susceptibility of the body
to infections, such as pneumonia and tuberculosis and can lead to the development of
AIDS. It attacks people in their most productive years, destroys families
and communities, and places heavy financial burdens on the economy.
Most people infected with HIV do not know that they have become infected, because no
symptoms develop immediately after the initial infection but they are highly infectious
and can transmit the virus to another person. Acquired Immune Deficiency Syndrome
(AIDS) is the term applied to the most advanced stages of HIV infection. The majority of
people infected with HIV, if not treated, develop signs of AIDS within 8-10 years.

HIV is spread through sexual intercourse; blood transfusion; the sharing of contaminated
needles in health care settings and through intravenous drug use; and from mother to
infant, during pregnancy, childbirth and breastfeeding. Religious, cultural, political and
economic differences mean that different countries have different rates and profiles of
infection. However, society, which have high levels of poverty and large populations that

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engage in risky behavior such as unsafe sex and injecting drug use - have higher rates of
HIV infection. Conflict and displacement can lead to increased spread of HIV/AIDS as
social networks are disrupted and sexual exploitation is used as a weapon.

The AIDS epidemic is affecting Housewives and children in increasing numbers. Females
are biologically more vulnerable to HIV than males. For physiological reasons, women
are twice as likely as men to acquire HIV from a single act of unprotected vaginal sex. In
many countries, housewives and children are also socially and economically more
vulnerable. Social and cultural factors mean they are less likely to be able to control with
whom, when and how they have sex, and be educated in how to protect themselves from
the virus. Prevention measures are the only option to curb the spreading of the disease.

The most important is that HIV/AIDS is largely preventable. But halting the spread of the
virus requires the support of all elements that shape a persons life: The raise in
prevalence rates can be slowed only when the community works together to disseminate
the message of prevention efforts are crucial in the fight against HIV/AIDS. HIV/AIDS
education and prevention efforts are crucial in the fight against HIV/AIDS. Silence and
ignorance have only proven to be fertile grounds for the spread of infection.

The individual is the single most powerful advocate for and contributor to reversing the
tide of the HIV/AIDS pandemic. Understanding complete and accurate prevention
measures can provide a person with the tools to make good decisions, educate those he or
she knows and assume a personal responsibility to avoid infection or infecting others.
Good understanding must then be put into action by making choices that reflect strong
moral values and a commitment to protect others as well as oneself.

It is important to encourage communities to address HIV/AIDS within their own borders.

It is beneficial for families to discuss HIV/AIDS with parents protecting themselves and
educating their children .the following section provides basic information on how to
protect oneself and the greater community from HIV. The best method to avoid the
contraction or transmission of HIV/AIDS is to abstain from sexual activity except only
within the context of marriage between a man and women. Only for the marriage

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relationship is a certain protection against the sexual transmission of HIV as well as many
other damaging and painful consequences that result from sexual activity outside of the
marriage relationship.

The communicable diseases HIV/AIDS is direct cause of death, it has compounded the
suffering and threatened the mankind, as so far now there is no permanent cure for this
disease. Drugs so far developed, help only in containing the spread of the disease in the
immune system, but it is very expensive so it is beyond the reach of general people.
Hence prevention measures are the only option to curb the spreading of this deadly
disease. The first case of HIV/AIDS was recorded in Nepal in 1988. Due to ignorance,
illiteracy and unsafe sex habit easily carry the infectious HIV and transmit it to multi sex
partner. In order to check the spreading of such deadly diseases in the society, it needs to
develop suitable awareness and other intervention program to make them conscious about
the disease. In this context the study of the present Knowledge, attitude and practice
about HIV/AIDS and understanding of sexual behavior of school going children and
household women will give come insight about the present situation in this area.

The national Center for AIDS and STDs control (NCASC) shows present latest data (15
July, 2012), which shows that the HIV/AIDS situation of Nepal is rapidly spreading most
places of the country specially on Urban area therefore that the nation should have to take
proper initiation for further better step to eliminate HIV/AIDS. The table is given below.

Cumulative HIV Situation of Nepal ( Gov. of Nepal,

Ministry of Heath and Population), NCASC ( National
Centre of AIDS and STD Control)
Cumulative HIV and AIDS Situation of Nepal

Condition Male Female Total

HIV Positives (Including AIDS) 13,157 7,417 20,583

AIDS (Out of total HIV) 1850 777 2627

Source: NCASC, July 2012

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 Cumulative HIV infection by age group and sex

Age group (Years) Male Female Total

0-4 325 193 518

5-9 359 244 603

10 - 14 153 104 257

15 - 19 306 334 641

20 - 24 1,461 1,105 2,568

25 - 29 2,703 1,693 4,396

30 - 39 5,341 2,617 7,963

40 - 49 1,962 880 2,842

50 - above 547 247 795

Total 13,157 7,417 20,583

Source: NCASC 2012

The above table confirms the people infected and living with HIV/AIDS does not belong
to any specific age group but span all age groups i.e. children to adults. However, HIV is
mostly prevalent among the age group of 15-49 years which is the most productive age
group. Therefore HIV can be considered a major developmental problem and this clearly
indicates that this can lead to a situation of unbalance in the forthcoming days by
destruction the socio-economic structure of the society.
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2. Problem OF the study

Various contagious diseases like tuberculosis, malaria, jaundice etc. are uncontrolled in
the third world; in addition, the new disease- HIV/AIDS is emerging as a major public
health problem in developing countries like Nepal. Many people especially in the
developing world are still suffering from various deadly diseases due to lack of good
sanitation, safe drinking water and ignorance. It is transmitted through sexual intercourse
and use of contaminated blood. So far now there is no permanent cure for this disease.
Drugs so far developed help only in containing the spread of the disease in the immune
system, but being very expensive it is beyond the reach of general people. Hence
preventive measures (safer Sex practice-use of condom and avoidance of contaminated
use of blood) are the only option to curb the spreading of this deadly disease.

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Rapid urbanization, increased number of mobile population impact of mass media,
impact of western culture, poverty, ill health, low literacy rate, low empower of women
and children, prostitution and sexually transmitted infections seen to be favoring the rapid
spread of HIV/AIDS in country. Ignorance and misconception about HIV/AIDS is the
root cause of spreading of the disease.
The majority of AIDS cases and death will occur among young adults. As a result it will
lose potent economic labor forces in one hand and on the other hand increases the orphan
population creating the burden to the country. The AIDS pandemic in Nepal is therefore
likely to result in obstructing of the already fragile health infrastructure. Besides it will
have not only burden to affected families but will also have various health, social and
economic consequence to the country.
Insecurity permeated the lives and families of individuals affected by HIV/AIDS. But
AIDS also shatters the security of whole societies, communities and economies. Indeed,
it is one of the biggest obstacles to development itself. AIDS not only takes away the
present, but it takes away the present, but it takes away the future as well. That is the toll
of AIDS. UN secretary general kofi A. Annan (excerpts from his message on the world
AIDS day, 1 November 2001)
The pandemic of HIV/AIDS could be curbed through making people in high-risk groups
viz. household women, sex workers, Injecting drug users and children aware about the
prevention methods of these diseases. Therefore, it is very necessary and important to
understand their awareness level and risky behavior and practices of these high- risk
groups for making HIV/AIDS prevention programs a successful.

The study will provide valuable information about awareness level and risky behavior
and practices, and sero-prevalence rate among of female sex workers and their clients
working in Kathmandu Valley. It will have a great significance in planning and
developing future HIV/AIDS prevention programs in the country.

This study mainly concentrates on the extraction of the answer of the following research
question:
What are the level of knowledge, attitude and practices of HIV/ AIDS among the
school going children and Household women?
What is the source of their knowledge?
What factors affecting their knowledge, attitude and practice?
What is the level of gap between their knowledge and practices?
What is the conception/misconception about the mode of transmission of HIV/AIDS?

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 3. Objectives of the Study

The main objective of the study is to identify the knowledge, attitude and practice about
HIV/AIDS among the housewives and school going children in the study area. The
specific objectives are

To explore the level of knowledge on HIV/AIDS and practices among target

groups.
To find out the gap between knowledge and practices toward HIV/AIDS.

To examine the Socio-economic characteristics of the Respondents

4. Important of the Study.

HIV/AIDS is directly concerned with social issues especially in the developing countries
like Nepal. Studies have shown that more percent of HIV/AIDS related cases in Nepal
are mainly due to unsafe sexual intercourse, involved in multiple sex partners and un-
sterilized syringe use among IDUs. The socio-cultural and socio-economic condition has
played predominant role in the epidemic of HIV infection in our society. Knowledge,
attitude and practice (KAP) toward safe heterogeneous sexual relationship are quite
limited in the Nepalese society. The limited use of condoms in heterogeneous sexual
practice and unwillingness to use condom has a multiplier effect.

The significance of this study is related with the critical issues of HIV/AIDS and the
possibility of being infected among housewives and children. Very few researches and
studies have been carried out on the issues of HIV/AIDS. As this study will shows the
present condition of Knowledge, Attitude and practices on HIV/AIDS among housewives
and school going children, it will give some insight for further research in this area.

HIV/AIDS will have great social problem if not checked in time as it seen in some Africa
countries now. It will have extra burden of our country. The policy makers must pay
serious attention for this grave concern and government and INGOs / NGOs must have
strong commitment to wipe out HIV/AIDS infection from our society. For this, social
awareness raising and control program, the promotion, distribution and demonstration of

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condoms use must be launched throughout the country. For necessary behavior change
intervention programs such as income generating activities should be launched by the
concerned agencies to give housewives alternative income opportunity and on the other
hand increase the orphan population creating the burden to the country.

5. Limitation of the Study

Every person in our society wants to keep his or her sexual behavior secret. So sex
worker does not want to be exposed and identified in the society due to social taboo and
from fear of being expelled from the society. So, identifying the sex workers is the most
difficult task experienced by the researcher. The sample on observation survey was
designed in such a way that each and every sample on observation might represent the
whole population at their best, still the findings that are obtained may not be considered
completely errorless due to small sample size.
As the research is for partial fulfillment of master degree of Public Administration in
Management, the narrow theoretical knowledge and limited resources are not able to
cover entire study area.
The study is confined only in limited area of the valley, so one should be very much
careful to generalize and implement its findings in national basis. The information
depends upon the respondents memory hence it cannot be check the validity. These
envisaged limitations of the study might pose some problems in making generalization
especially in other similar areas. However it is hoped that this study will certainly
provided certain insights and information about the present knowledge, attitudes and
seroprevalence rate of HIV/AIDS at such high-risk groups.

6. Research Methodology
6.1 Research Design
The basic approach to the study is to find the present status of knowledge and attitude
towards HIV/AIDS and its practices in the selected study area therefore; it is base on
descriptive and exploratory research design. The knowledge and attitude of school
children and women toward HIV/AIDS is findout by applying exploratory research
design and the descriptive research design is employ to describe the sexual behavior of
respondents. The data collection technique is cross sectional in nature. The study is
conduct in Ichangu Narayan VDC of Kathmandu District.. The study focused only on the
school going children and household women of this area. For the collection of information
50 respondents will chose as the key respondents.

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6.2 Sources of Data

a) Primary data

b) Secondary data

The primary data is apply in order to attain the necessary require information for this
research study. The primary data is collect basically through field observation and fill up
questionnaire focusing the objective of this study and attempted to explore knowledge,
attitude and practices among respondents in consideration with HIV/AIDS.

As mention earlier, both qualitative and quantitative data is gather from School going
children and Housewives applying good data collection technique mainly personal
interview methods.

The Secondary data is take information about HIV/ AIDS from website

6.3 Population and Sample size

The study was conducted in Ichangu Narayan VDC of Kathmandu District. ward
number seven of the Icangu Narayan VDC was taken, their respective total population
was enlisted. By using a probability proportion to size technique 50 households were
selected randomly. But only those households at least one School going children was
interviewed. If the house had no school going children the other house was selected. In
this way, it was estimated to obtain the sample size of fifty households. For the purpose
of triangulation and implementation of information, key informants interview were
conducted in the VDC and for each cluster an observation checklist was also used. So the
actual sample size has remained only 50 households.

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6.4 Data collection procedure

Various techniques and methods were used to obtain the necessary data for this study. For
carrying research both qualitative and quantitative data were collected and analyzed.
Three instruments in Nepali language were used in the survey. The techniques employed
in this study for the collection of data as follows.

a) Household questionnaire: For the collection of information from 50 household

interviews questionnaire was used. The tool contained both the open and closed ended
questions. The required data was obtained by using individual interview schedule and
direct interview techniques. Individual questionnaire was prepared for the survey by the
researcher himself. This schedule interview was divided into two sections. The first
section of the schedule interview contained information on respondents characteristics
and marriage such as; caste, age, education, economic status etc. the second section of the
interview schedule was with regard to knowledge, attitude and practice (KAP) about the
HIV/AIDS information on the availability of the health service in the study area, sexual
behavior attitude and practices and health consciousness among respondents. The
questionnaire was used in the survey is presented in Annex - 1.

b) Observation checklist: The tool was used for the observation of the household
members towards the overall health problems and their behavior. The primary data
relating to living status, dress up and body language with respondents on HIV/AIDS was
collected and prepared by researcher himself being as a non-participant field observer.
Their existing living, dress up and body language was observed in micro analytical basis.

6.5 Presentation and Analysis

All the information mentioned in the questionnaire was edited first for consistency and
with the help of computer software (MS word and MS Excel) it was entered in the
computer and desired tables were taken out. The variables such as: education level, age
groups, ethnic group, economic status, possession of communication marital status etc.

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was considered for the presentation and analysis of data. Both singular and cross tables
was used top analyze the results. For this purpose, simple statically tools such as;
frequency and mean average are used in tabulation process. All interested in this subject
was interpreted the results in description manner to make understood the findings.

8. Organization of the Study

This Thesis will be divided in five chapters as follows :

Chapter One : Introduction

Chapter Two : Review of the Literature

Chapter Three : Research Methodology

Chapter Four : Presentation and Analysis

Chapter Five : Summary and Conclusion.

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