Rajiv Gandhi University of Health Sciences, Karnataka,

Bangalore

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT

FOR DISSERTATION

DISSERTATION PROPOSAL

“A QUASI EXPERIMENTAL STUDY TO EVALUATE THE

EFFECTIVENESS OF A PLANNED TEACHING PROGRAMME
REGARDING THE PREVENTION OF SEXUALLY
TRANSMITTED DISEASES AMONG SEXUALLY ACTIVE MEN
RESIDING IN UTTARAHALI, BANGALORE CITY”

SUBMITTED BY

Ms SAIDING PUII SAILO

1ST YEAR M.Sc. NURSING

ROYAL COLLEGE OF NURSING,

7th MAIN ROAD, FIRST BLOCK,

UTTARAHALI, BANGALORE-61
 Rajiv Gandhi University of Health Sciences, Karnataka,

Bangalore
PROFORMA SYNOSPSIS FOR REGISTRATION OF SUBJECT FOR
DISSERTATION

1. Name of the Candidate and Address Ms. SAIDING PUII SAILO

1ST YEAR M.Sc. NURSING
ROYAL COLLEGE OF NURSING,
7th MAIN ROAD, FIRST BLOCK,
UTTARAHALI, BANGALORE-61

2. Name of the Institution Royal College Of Nursing Bangalore

3. Course of study 1st Year MSc. Nursing,

4. Date of admission to course 1-6-2010

5. Title of the Topic:

“A Quasi Experimental Study To Evaluate The Effectiveness Of A Planned Teaching
Programme Regarding The Prevention Of Sexually Transmitted Diseases Among
Sexually Active Men Residing in Uttarahali, Bangalore”.

6. Brief resume of the intended work:

6.1 Need for the study Enclosed
6.2 Review of literature Enclosed
6.3 Objectives of the study Enclosed
6.4 Operational definitions Enclosed
6.5 Hypothesis of the study Enclosed
6.6 Assumptions Enclosed
6.7 Delimitations of the study Enclosed
6.8 Pilot study Enclosed
6.9 Variables Enclosed

7. Materials and methods

7.1 Source of data-Data will be collected from sexually active men in certain selected
areas in Bangalore City.
7.2 Methods of data collections- Planned teaching programme
7.3 Does the study require any interventions or investigations to the patients or
other human being or animals? Yes
7.4 Has ethical clearance been obtained from your institution?
Yes, ethical committee‟s report is herewith enclosed.

8. List of references Enclosed

 Rajiv Gandhi University of Health Sciences, Karnataka,

Bangalore

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

1. Name of the Candidate and Ms SAIDING PUII SAILO

Address 1ST YEAR M.Sc. NURSING
ROYAL COLLEGE OF NURSING,
7th MAIN ROAD, FIRST BLOCK,
UTTARAHALI, BANGALORE-61

2. Name of the Institution Royal College Of Nursing

3. Course of study and subject 1st Year MSc. Nursing

Medical surgical nursing

4. Date of admission to course 1-6-2010

5. Title of the Topic:

“A Quasi Experimental Study To Evaluate The Effectiveness Of A Planned

Teaching Programme Regarding The Prevention Of Sexually Transmitted Diseases
Among Sexually Active Men Residing in Uttarahali, Bangalore”.
6. BRIEF RESUME OF THE INTENDED WORK:

INTRODUCTION:

“The public do not know enough to be experts, yet know enough to decide
between them”

-Samuel Butler

The term sex can be taken to mean any mutual genital stimulation (i.e. all
forms of intercourse and "outercourse", e.g. without penetration). As with most forms
of sexual interaction, individuals are at risk for contracting sexually transmitted
diseases,and thus safe sex practises are advised.1

Sexually transmitted disease (STD), also known as sexually transmitted

infection (STI) or venereal disease (VD), is an illness that has a significant probability
of transmission between humans by means of human sexual behaviour,
including vaginal intercourse, oral sex, and anal sex. While in the past, these illnesses
have mostly been referred to as STDs or VDs, in recent years the term sexually
transmitted infections (STIs) has been preferred, as it has a broader range of meaning;
a person may be infected, and may potentially infect others, without showing signs
of disease. Sexually transmitted infections have been well known for hundreds of
years. Until the 1990s, STDs were commonly known as venereal diseases : Social
disease was another euphemism. The term STI—which refers to infection with any
germ that can cause an STD, even if the infected person has no symptoms—is a much
broader term than STD.2

Public health officials originally introduced the term sexually transmitted

infection, which clinicians are increasingly using alongside the term sexually
transmitted disease in order to distinguish it from the former. Safe sex is defined as
"Sexual activity engaged in by people who have taken precautions to protect
themselves against sexually transmitted diseases such as AIDS." It is also referred to
as safer sex, or protected sex, while unsafe sex or unprotected sex is sexual activity
engaged in without precautions to protect against sexually transmitted infections.3

Safe sex practices became more prominent in the late 1980s as a result of
the AIDS epidemic. Promoting safe sex is now one of the aims of sex education. The
risk reduction of safe sex is not absolute; for example the reduced risk to the receptive
partner of acquiring HIV from HIV seropositive partners not wearing condoms to
compared to when they wear them is estimated to be about a four- to fivefold.
Although some safe sex practices can be used as contraception, most forms of
contraception do not protect against all or any STIs; likewise, some safe sex practices,
like partner selection and low risk sex behaviour, are not effective forms of
contraception.Sexually transmitted diseases (STDs) are infections that you can get
from having sex with someone who has the infection. The causes of STDs are
bacteria, parasites and viruses. There are more than 20 types of STDs4

The older terminology of "venereal diseases" (VDs) largely has been superseded
in the past 50 years by "sexually transmitted diseases" (STDs), and more recently by
"sexually transmitted infections" (STIs). To some, venereal diseases came to be
viewed as a narrow and pejorative term limited to gonorrhea, syphilis, chancroid,
lymphogranuloma venereum, and granuloma inguinale, and related VD control laws.
The term sexually transmitted diseases more easily incorporate the many newly
discovered sexually transmitted agents and syndromes.5

STD includes diseases that are transmitted by sexual intercourse. Sexual

transmission requires the agent to be present in one partner, the other partner to be
susceptible to infection with that agent and that the sex partners engage in sexual
practices, which can transmit the pathogen. STIs differs from STD in that STD
conventionally includes infections resulting in clinical diseases that may involve the
genitalia and other parts of the body participating in sexual interaction e.g., syphilis,
gonorrhea, chancroid, donovanosis, non-gonococcal urethritis, genital warts, herpes
genitalis etc. STI, in addition, includes infections that may not cause clinical disease
of genitals, but are transmitted by sexual interaction e.g., all STD and hepatitis B,
human immunodeficiency virus (HIV), HTLV-1 etc. Nowadays, the term STI is
preferred, since it covers all the diseases that can be transmitted by sexual
intercourse.6

However, for all practical purposes, both STI and STD terms are used
synonymously. Sexually transmitted diseases are spreading very fast and this is
mainly due to the ignorance among people regarding various sexually transmitted
diseases. Many people who have some or the other sexual disease don‟t tell their
partner about it and end up spoiling their life too. Till the time one becomes honest
with their partner the whole scenario is not going to change. Worldwide several
people die due to the sexually transmitted diseases.
NEED FOR THE STUDY:

„The whole purpose of education is to turn mirrors into windows‟.

Sydney J. Harris

STDs or STIs (sexually transmitted infections) are infections/diseases that can

be transferred from one person to another through sexual contact. Some of the
Sexually Transmitted Infections are also transmitted through birth, intravenous
needles or breastfeeding.7

Gonorrhea is the second most commonly reported infectious disease in the

United States. Approximately, twice as many new infections are estimated to occur
each year as are reported. African Americans remain the group most heavily affected
by gonorrhoea. Over the past five years, the syphilis rate in the United States has been
increasing. Between 2004 and 2005, the national syphilis rate increased 11.1 percent,
from 2.7 to 3.0 cases per 100,000 population. The syphilis rate among men is now
nearly six times the rate among women Additionally, prior CDC research has
estimated that more than half of syphilis cases in recent years have occurred among
men who have sex with men (MSM).8

In Europe, data on Chlamydia often reflect testing patterns and not true
incidence rates. It is primarily transmitted among young people and is probably the
most common STD all over Europe. Estimates indicate that 70-75% of women
infected with Chlamydia trachomatis are symptom-free. 9

In the last 8-10 years, a parallel trend has been noted for gonorrhea and HIV
infection, reflecting a common mode of transmission, and similar risk groups for both
infections. Episodic outbreaks of syphilis occur in certain high-risk populations, such
as men who have sex with men (MSM), commercial sex workers and drug users.
Of the countries that report to the WHO, high levels of incidence (20-70/100 000)
have been reported over the last five years in the United Kingdom and the Russian
Federation, among others. The highest levels of HPV infection have been reported in
the United Kingdom (80-120/100000) and Ireland (100/100000) in 2000. Recently,
several outbreaks of lymphogranuloma venereum have been noted in several
countries, including Europe, the United States and Canada. It is primarily reported in
MSM, among whom the majority is HIV positive. 10

In 1996, the World Health Organizations (WHO) estimated the global annual
incidence of curable STDs (excluding HIV and other viral STDs) to be 333 million.
Of these 333 million cases, 12 million are attributable to syphilis, 62 million to
gonorrhea, 89 million to chlamydia, and 170 to trichomoniasis.

Sub-Saharan Africa bears the largest burden of these new cases, responsible
for 11 to 35% of all new cases of curable STDs. STD infections affect the most
vulnerable populations--women, children, and youth. Among women between the
ages of 15 and 44, STDs are the second leading cause of morbidity and mortality,
following only maternal causes. Many STDs are asymptomatic and are therefore
inadequately treated or left untreated altogether.Providing prompt and adequate
treatment for curable STDs is one of the most cost-effective methods to improve
world health, and can also significantly contribute to decreasing the HIV/AIDS
epidemic.

The STD epidemic threatens to compound the HIV epidemic currently

ravaging much of Africa. Research demonstrates that the presence of an untreated
STD can cause a person to be three to five times more likely to contract HIV.
Further, an individual who is infected with both HIV and a STD transmits HIV more
easily.11
 The 2006 estimates released by the National AIDS Control Organization
(NACO), supported by UNAIDS and WHO, indicate that national adult HIV
prevalence in India is approximately 0.36%, which corresponds to an estimated 2
million to 3.1 million people living with HIV in the country. The predominance of
HIV/STD infected individuals in India are men: estimates in 1994 indicated a male to
female ratio of 5:1, with female cases being mainly sex workers (Pais, 1996). More
recent estimates indicate a 2.5:1 ratio (UNAIDS, 2002). Heterosexual contact with sex
workers, both before and during marriage, has been considered the major source of
infection in men. There are 29 districts with high prevalence, particularly in the states
of West Bengal, Orissa, Rajasthan and Bihar.The 2006 surveillance figures show an
increase in HIV infection among several groups at higher risk of HIV infection, such
as people who inject drugs and men who have sex with men. The HIV positivity
among injecting drug users (IDU) has been found to be significantly high in cities of
Chennai, Delhi, Mumbai and Chandigarh. In addition, the states of Orissa, Punjab,
West Bengal, Uttar Pradesh and Kerala also show high prevalence among this
group.12

In 2005-06, National Family Health Survey (NFHS) III provided the HIV
prevalence for India and selected states, separately for men and women. Compared
with an HIV prevalence of 0.28 percent among the men and women age 15-49 in the
country, Karnataka has an HIV prevalence of 0.69 percent than in women, second
only to Andhra Pradesh among the states for which the estimate is available. The
IBBA in Bangalore Urban district estimated a prevalence of 19 percent among the
MSM and transgender. It was found 34 percent of the 321 respondents identified
themselves as Hijras, 28 percent as Kothis, 21 percent as Double Deckers and the rest
as others including Panthis. 13

A retrospective data analysis was carried out to find the trends in frequency and
distribution of different STDs in North Eastern (NE) India during 1995-1999. The
commonest STD was chancroid (25.7%) followed by condylomata acuminata (CA),
nongonococcal urethritis (NGU), lymphogranuloma venereum (LGV), syphilis,
gonorrhea (GONO), herpes genitalis (HG), mixed infection (MI) and balanoposthitis
(BP). HIV infection accounted for 9.62% of the total STD patients. A comparison of
the present data with that reported a decade back (1986-1990) revealed a sharp
decline in the incidence of syphilis, chancroid and GONO, whereas a conspicuous
upward trend in CA and NGU.14

A study was conducted on changing trends of the profile of STIs and HIV
seropositivity in STD clinic attendees over a 15-year period at a Regional STD Centre
in New Delhi and analyzed. The STI profile and HIV seropositivity were compared
between 1990-1993 (A), 1994-1997 (B), 1998-2001 (C) and 2002-2004 (D).
Antimicrobial resistance pattern of N. gonorrhoae was determined by standard
techniques and compared between the last three periods. Of the 78,617 STD
attendees, 12,709 (16.2%) had STIs. During period A, genital discharges and during
B, C and D, genital ulcerative diseases were predominant. Syphilis was the
commonest STI. There was significant rise in the cases of syphilis, herpes genitalis
and genital warts and reduction in that of chancroid, lymphogranuloma venereum
(LGV), donovanosis, candidiasis, trichomoniasis and bacterial vaginosis cases. The
number of cases with primary syphilis diminished significantly, with a concomitant
rise in secondary and early latent syphilis. A rising trend was observed in the HIV
seropositivity.15

The researcher working in the bed side as well as in the community settings
had a first hand experience of many male men who had STD but were not aware of
the importance of having safe sex and an absence of a proper sex education. While the
researcher was working as a staff nurse, a woman with severe case of STD was
admitted in the researcher‟s ward. She was left abandoned by her husband and on
further probing, came to light that she had gotten infected from her husband who had
been with multiple sexual partners. The woman succumbed to the disease due to delay
in getting proper treatment. The researcher was greatly affected by this incident that
the researcher became interested to prevent the risk of transmission of STD to other
innocent victims by educating the sexually active male on the various means of
prevention of the sexually transmitted diseases.
REVIEW OF LITERATURE:

Literature review can just be a simple summary of the sources, but usually it
has an organizational pattern and combines both summary and synthesis.

A cohort study was conducted to estimate the incidence of cases of

epididymo-orchitis seen in UK general practice contributing to the General Practice
Research Database (GPRD) and to describe their management between men aged 15-
60 years, consulting with a first episode of epididymo-orchitis. A total of 12 615
patients with a first episode of epididymo-orchitis were identified. The incidence was
highest in 2004-2005 (25/10 000) and declined in the later years of the study. Fifty-
seven per cent (6943) of patients were managed entirely within general practice. Of
these, over 92% received an antibiotic, with ciprofloxacin being the most common
one prescribed. Only 18% received a prescription for doxycycline. Most men,
including those under 35 years, had no investigation recorded and fewer than 3% had
a test for chlamydia.The results show a need for further research to understand the
pattern of care delivered in general practice.16

A study was conducted to comprehensively assess the prevalence of condom-

use errors and problems among male clients attending a public sexually transmitted
disease (STD) clinic. Men attending an STD clinic completed an anonymous
questionnaire. Seven errors and six problems were assessed. Summative scores were
tested for associations with three key variables. Of 834 condom-protected events:
19% were associated with „fit and feel‟ problems, 15% involved breakage, 14%
involved lost erection, 9% were associated with lost erection while applying condoms,
8% involved slippage during withdrawal and 7% involved slippage during sex. A
mean of 6.4 errors/problems were observed. Multiple types of condom-use errors and
problems may be highly prevalent among high-risk men attending public STD
clinics.17
 A cross sectional study was conducted to assess the association between
condom use errors in consistent condom users and the prevalence of various sexually
transmitted diseases (STDs) in an urban STD clinic between January 2001 and
January 2003, by women, men who have sex with women (MSW), and men who have
sex with men (MSM) by consistent condom users with or without a condom use error.
Prevalence rates were calculated for gonorrhea, chlamydia, trichomonas,
nongonococcal urethritis (NGU), and pelvic inflammatory disease. Among 1973
consistent condom users with error information available, any condom use error was
reported more commonly among women (57%) than MSW (48%), or MSM , with
breakage being the most frequently reported error. Condom use errors were common
among subjects reporting consistent condom use and for MSW, condom error was
associated with a significant increased risk of STD. These data support the premise
that correctness of condom use is an important methodologic issue in studies
assessing condom effectiveness.18

A study was conducted to explore the risk of HIV and other sexually
transmitted diseases (STDs) among married and cohabiting women in Mexico City,
Mexico, derived from their partners' sexual behaviors. Results were derived from the
first population-based household survey in Mexico that investigated male sexual
behavior. Analyses were restricted to sexually active married or cohabiting
men. Fifteen percent of the men reported extrarelational sex during the past year, 9%
reported condom use during last intercourse, and 80% perceived no HIV risk. Most
secondary partners were coworkers, mistresses, or friends. Targeted HIV and STD
prevention efforts appear necessary because a substantial number of women may be at
risk.19

A study was conducted to assess the effectiveness of outreach methodology

for contacting sexual partners of female sex workers for purposes of HIV/STD
prevention in Cotonou, Benin. 404 clients were recruited on-site at prostitution
venues, and provided urine samples for leukocyte esterase dipstick (LED), STD and
HIV testing before having sex with female sex workers. After having sex they
underwent an interview and physical examination. Prostitution site personnel and
boyfriends of female sex workers were also recruited. HIV-1 prevalence was several-
fold higher than in the general population in Cotonou, at 8.4, 12.2 and 16.1% in
clients, personnel and boyfriends respectively, and was associated with increasing age
and lack of condom use with female sex workers. Boyfriends of female sex workers
are of particular concern due to high numbers of partners, very low condom use rates
and high HIV prevalence. Study findings indicate that male sex partners of female sex
workers form a bridging population' for HIV/STD transmission both to female sex
workers, as well as from female sex workers to the general population of women,
particularly regular female partners.20
.

A 3 year cohort study was conducted to investigate whether knowledge,

perceived susceptibility, and perceived severity of HIV infection and sexually
transmitted diseases (STDs) are associated with the incidence of STDs and new HIV
infections among men who have sex with men (MSM) among 190 HIV-negative
MSM. Data was collected on the incidence of STDs and new HIV infections, as well
as on knowledge and perceived susceptibility to and perceived severity of HIV
infection and STDs. Knowledge and perceptions were assessed in self-administered
questionnaires. In the course of the 3-year study, six MSM, HIV-seroconverted and
78 participants were diagnosed with at least one STD. MSM seemed to be better
informed about HIV infection compared with STDs, and HIV infection was perceived
as more severe than other STDs. More research is needed to establish the specific
behaviors by which perceived severity of STDs/HIV influences the incidence of STDs
and HIV.21

A cross sectional study was conducted to determine generational differences in

male sexuality, which could predispose men's female sexual partners to STDs/HIV in
Harare, Zimbabwe among three hundred and ninety seven male adults aged eighteen
years and above. Fewer men in the 27-39 year age group when compared to men aged
18-26 years had two or more sexual partners. The greatest proportion of ever condom
users were men aged 27-39 years. In the event that they contracted HIV, 79.5%,
82.4% and 85.9% of men aged 18-26, 27-39 and 40 years and above respectively
indicated that they would disclose their HIV status to their wives. On the other hand,
men aged 18-26 years , 27-39 years and > or = 40 years indicated that they would
disclose their HIV status to girl friends or other sexual partners. It is recommended
that public health and behavioural scientists in Zimbabwe devote more time to
understanding the intricacies of male sexual behaviour at different stages of life. This
would provide the important insight needed to develop effective targeted interventions
to reduce the spread of STDs/HIV in Zimbabwe.22

A cross-sectional epidemiological study was conducted in 1994 to determine

the frequency of condom use in Mexico City among sexually active men aged 15-49
years old, and the association with sexual behavior and a history of or knowledge
about STDs. The 1377 men interviewed were of mean age 34.5 years, and
experienced their first sexual intercourse at mean age 17.7 years. 47% of the men
reported using a condom at least once in their lives and 81.6% were married. 79.4%
reported having a formal partner, 14.6% had relations with occasional partners, and
6.1% with both regular and informal partners. 26.4% used a condom during their most
recent sexual intercourse, 18.8% with formal partners and 62.5% with casual partners.
Condom use with formal partners was largely to prevent pregnancy, while condom
use with casual partners was to prevent the transmission of STDs. Young and single
men were almost twice as likely to use condoms as older married men. The main
predictors of male condom use were therefore being under 25 years old, having more
than 9 years of formal education, being of middle to high socioeconomic status, and
type of sex partners.23

A study was conducted on male adolescents and young adults in Jamaica

about symptoms of STDs and related sex behaviours. Overall, 9% of the sample
reported symptoms of STDs in the year before the interview. Rates of high-risk sexual
behaviors were high. Logistic regression analyses indicated that being older and
having multiple sex partners were associated with having symptoms of
STDs.Prevention programs should recognize that various factors can increase the risk
of contracting and transmitting STDs, including HIV. Interventions should be targeted
to those with high-risk behaviors that are conducive to continued participation in
high-risk sexual behaviors.24
 A study was conducted on purposely selected sample of 126 young men aged
between 16 and 26 in Chiawa, rural Zambia. The aim of the interviews and focus
group discussions was to explore views about sexual practices and attitudes towards
STD. Fifty-eight (59%) young men reported having had pre-marital or extra-marital
sexual partners during the past year. The maximum number was five partners for six
individuals. Forty-two (43%) had pre-marital or extra-marital sexual partners at the
time of the interviews. Focus group discussions revealed that perceptions of manhood
encouraged multiple sexual relationships. Twenty-two (23%) reported having suffered
from an STD in the past. Seventy-nine (81%) said they were likely to inform their
sexual partners if they had an STD. Although condoms were believed to give
protection against STDs by the majority (94%), only 6% said they always used
condoms. The data suggest that condoms were perceived to affect male potency.
These results show that STDs, multiple sexual relationships and unprotected sex are
common among the young men of Chiawa. Health messages that target the young
men should take into account the local perceptions and values that seem to sustain
risky sexual behaviour.25

A study was conducted at Cuttack in Orissa where 516 patients with STD were
analyzed during the period 1993 to 1994. Herpes genitalis (21.89%) was found to be
the commonest STD followed by syphilis (16.27%), chancroid (11.82%) and
granuloma inguinale (7.55%), gonococcal urethritis and genital warts (3.87% each).
LGV was found in 0.58% of cases, HIV infection in three cases only (0.56%). Other
miscellaneous infections like candidiasis (13.75%), trichomoniasis (2.7%) and
molluscum (2.14%) were responsible in 18% as a whole and nonspecific infection in
14%. In the year 1995-96, 460 (2.45%) STD cases were recorded in this center.
Frequency of different STDs observed in descending order was herpes genitalis
(28.82%), gonorrhea (8.26%), granuloma inguinale (0.43%) and genital wart (8.9%).
26
 A study was conducted in the STD clinic of the department of dermatology and
STD, JIPMER, Pondicherry, south India, between January 1993 and December 1997,
to estimate the incidence of different STDs and frequency of HIV seropositivity
among various STDs. The patients were from the neighboring Tamil Nadu state and
Pondicherry itself. The study group consisted of all new consecutive STD cases
having high-risk behavior and/or having present or past history of STDs, irrespective
of their age and sex. Out of the 1110 patients recorded, 168 were seropositive for
HIV, giving a prevalence rate of 15.14%. Annual breakdown revealed an upward
trend from 8.6% in 1993 to 23.52% in 1997. The mean age of the group was 29.8
years, with a male to female ratio of 3.63:1. When the STDs were broadly classified
into ulcerative and nonulcerative groups, the prevalence of HIV was much higher in
the group with ulcerative STDs (17.1%) than those with nonulcerative STDs (9.5%).
Genital herpes was the commonest STD followed by syphilis, condyloma acuminata
and others; 9.4% of the patients had concurrent infection with more than one STD.27
6.3 OBJECTIVES OF THE STUDY:

1. To assess the knowledge of sexually active men of both experimental and comparison
groups regarding the methods of prevention of sexually transmitted diseases by conducting
a pre-test.

2. To develop and conduct planned teaching programme regarding the prevention of

sexually transmitted diseases.

3. To assess the effectiveness of planned teaching programme regarding the prevention of

sexually transmitted diseases by comparing pre and post- test knowledge scores of
experimental group.

4. To administer the post-test for comparison group.

5. To find out the association between knowledge scores and selected demographic
variable among experimental and comparison group.

6.4 OPERATIONAL DEFINITIONS

1. Evaluation- It is the systematic collection and analysis of data needed to make

decisions, a process in which most well-run programs engage from the outset.

2. Effectiveness- A desirable change which is a result or consequence of providing a

planned teaching programme regarding the prevention of sexually transmitted diseases.

3. Planned teaching programme- It is a teaching programme on the prevention of

sexually transmitted diseases.

4. Prevention- The management of those factors that could lead to sexually transmitted
disease so as to prevent the occurrence of sexually transmitted diseases

5. Sexually Transmitted Diseases- Any disease transmitted by sexual contact; caused by

micro-organisms that survive on the skin or mucus membranes of the genital area; or
transmitted via semen, vaginal secretions, or blood during intercourse.

6. Sexually Active Men-Sexually active men refers to men who are able to perform
sexual acts and regularly engages in sexual practices with one or more partners.
6.4 HYPOTHESIS OF THE STUDY

H1. There will be a statistically significant difference between pre and post test knowledge
scores of sexually active men of the experimental group regarding the prevention of
sexually transmitted diseases.

H2. There will be a statistically significant association between knowledge regarding the
prevention of sexually transmitted diseases and educational status.

6.6 ASSUMPTIONS

1. The sexually active men possess some knowledge regarding the prevention of sexually
transmitted diseases.

2. Sexually active men‟s knowledge regarding the prevention of sexually transmitted

diseases can be measured using an interview schedule.

3. Sexually active men‟s knowledge regarding the prevention of sexually transmitted

method can be improved by administering a planned teaching programme.

4. Effectiveness of planned teaching programme can be assessed by pre and post-test

knowledge scores of the experimental group.

6.7 DELIMITATIONS OF THE STUDY

1.The study is limited to sexually active men in a selected area in Bangalore.

2. The study is limited to sexually active men 21-50 years of age in Uttarahali.

6.8 PILOT STUDY

The study will be conducted with 6 samples. The purpose of the pilot study is to
find out the feasibility for conducting the study and design and plan on statistical analysis.
6.9 VARIABLES

A concept which can take on different quantities values is called a variable

Dependant variable- Knowledge of sexually active men regarding the prevention of

sexually transmitted diseases.

Independent variable- Planned Teaching Programme

Demographic Variable- Age, Educational status, disease, socio-economic condition,

previous knowledge of sexually transmitted diseases.

7.0 MATERIALS AND METHODS

7.1 SOURCE DATA

The materials will be collected from sexually active men in Uttarahali area,
Bangalore City.

7.1 RESEARCH DESIGN

Quasi-Experimental Design

The design adopted for this study is quasi-experimental in nature. One group pre-
test post-test design with comparison group.

7.1.2 RESEARCH APPROACH

Evaluative Research Approach

7.1.3 SETTING OF THE STUDY

The study will be conducted in Uttarahali area, Bangalore City.

7.1.4 POPULATION

Sexually active men 21-50 years residing in Uttarahali area, Bangalore City

7.2 METHOD OF COLLECTION OF DATA

The data collection procedure will be carried out for a period of one month. This
study will be conducted after obtaining permission from the concerned authorities. The
investigator will collect the data by from both the experimental and comparison groups
using interview schedule to assess the knowledge as a pre-test and post-test. Effectiveness
of planned teaching programme will be assessed by comparing the pre-test and post-test
knowledge scores of experimental group. The Data collection instrument consists of the
following sections:

Section A: Demographic data

Section B: Questions to assess the knowledge regarding prevention of sexually transmitted

diseases

7.2.1 SAMPLING TECHNIQUE

Sampling technique adopted for the selection of sample is convenience sampling

technique.

SAMPLING CRITERIA

7.2.3.1 INCLUSION CRITERIA

1. Sexually active men residing in a particular area in Bangalore.

2. Men who are sexually active.

3. Sexually active men who are willing to participate in the study.

4. Sexually active men who are 21-50 years of age.

7.2.4 EXCLUSION CRITERIA

1. Sexually active men who are suffering from hearing and speech impediments.

2. Sexually active men who are of unsound mind.

3 Sexually active men who are not willing to participate in the study.

4. Men who are not sexually active.

5. Sexually active men who are selected for the pilot study

7.2.5 TOOLS FOR DATA COLLECTION

A structured interview schedule will be used to collect data from clients.

7.2.6 DATA ANALYSIS METHOD

The data collected will be analysed by using descriptive and inferential statistics.

Descriptive statistics: Frequency and percentage will be used for analysis of demographic
data and mean, mean percentage and standard deviation will be used for assessing the level
of knowledge.

Inferential Statistics: Inferential statistics will be done using Chi square test will be used
to find out the association between knowledge and demographic variables. Paired “t” test
for the effectiveness of Planned Teaching Programme.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTIONS

TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS?

Since the study is quasi in nature, interventions are required.

7.4 ETHICAL CLEARANCE

The main study will be conducted after the research committee of the college.
Permission will be obtained from the head of the institution. The purpose of the study will
be explained to the study subjects and assurance will be given regarding the confidentiality
of the data collected.
8. LIST OF REFER ENCES: [VANCOUVER STYLE FOLLOWED]

1. Sexual intercourse, available from URL:

http://en.wikipedia.org/wiki/Sexual_intercourse

2. Sexually_transmitted_disease, available from URL;

http:/ /en.wikipedia.org/wiki/ Sexually_ transmitted disease

3. Safe sex, available from URL; http://en.wikipedia.org/wiki/safe_sex.

4. Sexually Transmitted Diseases, available from

URL; http://www.nlm.nih.gov/medline plus/sexuallytransmitteddiseases.html

5. Judson F. Sexually transmitted infections; 2005:p. 1-4.

6. Bingham JS. Historical aspects of sexually transmitted infections:Sexually

transmitted infections. New Delhi; 2005. p. 5-17.

7.Sexually transmitted diseases(STD‟s), available from URL; http://india.gov.in/

8. Gerbase AC, Rowley JT, Mertens TE. Global epidemiology of sexually transmitted
diseases. Lancet 1998;351:2-4.

9. Centers for Disease Control and Prevention (homepage on the Internet). Trends in
reportable sexually transmitted diseases in the United States, 2005. Available from:
http://www.cdc.gov/std/stats/trends2005.htm.

10. World Health Organization (homepage on the internet). Trends in sexually

transmitted infections and HIV in the European region, 1980-2005. Technical briefing
document 01B/06 Copenhagen; 12 September 2006. Available from:
http://www.euro.who.int/Document/RC56/etb01b.pdf.

11. Sexually Transmitted Diseases (STD‟s) in Africa, available from

URL;http://library.unesco-
iicba.org/English/HIV_AIDS/cdrom%20materials/STD's/CD_STDin%20Africa.htm

12. Article, 2.5 million people in India living with HIV, according to new estimates,
available on URL;
http://www.who.int/mediacentre/news/releases/2007/pr37/en/index.html

13. HIV in Karnataka, AIDS-Acquired Immune Defeciency Syndrome, available on

URL;http://stg1.kar.nic.in/ksaps/HIV&AIDS/HIVInKarnatka.htm

14. Jaiswal AK, Banerjee S, Matety AR, Grover S. Changing trends in sexually
transmitted diseases in North Eastern India. Indian J Dermatol Venereol Leprol
2002;68:65-6, available on URL;http://www.e-ijd.org/article.asp?issn=0019-
5154;year=2007;volume=52;issue=2;spage=78;epage=82;aulast=Thappa

15. Ray K, Bala M , Gupta SM, Khunger N, Puri P, Muralidhar S, et al . Changing

trends in sexually transmitted infections at a Regional STD Centre in north India.
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http://www.e-ijd.org/article.asp?issn=0019-
5154;year=2007;volume=52;issue=2;spage=78;epage=82;aulast=Thappa

16. Nicholson A, Rait G, Murray-Thomas T, Hughes G, Mercer CH, Cassell J,

Management of epididymo-orchitis in primary care: results from a large UK primary
care database. Br J Gen Pract. 2010 Oct; 60(579):e407-22
17. Richard Crosby PhD , William L Yarber HSD , Stephanie A Sanders PhD ,Cynthia
A Graham PhD and Janet N Arno MD , Slips, breaks and „falls‟: condom errors and
problems reported by men attending an STD clinic.

18. Decker, Michele R MPH, ScD ; Miller, Elizabeth MD, PhD et al. Indian Men's
Use of Commercial Sex Workers: Prevalence, Condom Use, and Related Gender
Attitudes. JAIDS Journal of Acquired Immune Deficiency Syndromes. 53(2):240-
246, February 2010.

19. Pulerwitz J, Izazola-Licea JA, Gortmaker SL, Extrarelational sex among Mexican
men and their partners' risk of HIV and other sexually transmitted diseases, Am J
Public Health. 2001 Oct;91(10):1650-2.

20. Lowndes CM, Alary M, Gnintoungbé CA, Bédard E, Mukenge L, Geraldo N,

Jossou P, Lafia E, Bernier F, Baganizi E, Joly J, Frost E, Anagonou S.Management of
sexually transmitted diseases and HIV prevention in men at high risk: targeting clients
and non-paying sexual partners of female sex workers in Benin. 2000 Nov 10;
14(16):2523-34.

21. van der Snoek EM, de Wit JB, Götz HM, Mulder PG, Neumann MH, van der
Meijden WI.Incidence of sexually transmitted diseases and HIV infection in men who
have sex with men related to knowledge, perceived susceptibility, and perceived
severity of sexually transmitted diseases and HIV infection: Dutch MSM-Cohort
Study.Sex Transm Dis. 2006 Mar;33(3):193-8.

22.Olayinka BA, Alexander L, Mbizvo MT, Gibney L.Generational differences in

male sexuality that may affect Zimbabwean women's risk for sexually transmitted
diseases and HIV/AIDS. East Afr Med J. 2000 Feb; 77(2):93-7.
23. Hernandez-Giron CA, Cruz-Valdez A, Quiterio-Trenado M, Uribe-Salas F,
Peruga A, Hernández-Avila M.Factors associated with condom use in the male
population of Mexico City. Int J STD AIDS. 1999 Feb;10(2):112-7.

24. Norman LR, Uche C.Prevalence and determinants of sexually transmitted

diseases: an analysis of young Jamaican males. Sex Transm Dis. 2002 -32
Mar;29(3):126.

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transmitted diseases at VSS Medical College. Indian J Dermatol Venereol Leprol
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 Signature of the candidate.

10. Remarks of the guide.

11. Name and designation.

11.1 Guide

11.2 Signature

11.3 Co-guide

11.4 Signature

11.5 Head of the department

11.6 Signature

12. 12.1 Remarks of the chairman and

principal.

12.2 Signature.