THE RELATIONSHIP OF KNOWLEDGE ABOUT HIV/ AIDS AFTER THE PROVISION HEALTH EDUCATION TOWARDS THE EXAMINATION OF HIV TESTS ON BRIDE’S
CANDIDATE AT KUA KECAMATAN KIARACONDONG OF BANDUNG CITY ON MARCH - JULY 2019
Dessy Ayu Anestesiani*, Desi Trisiani, Nova Oktavia shizuka.dessy@gmail.com
Public Health Study Program of Bhakti Kencana University, Indonesia ABSTRACT
SDG’s is a sustainable development program that contains around 17 objectives where the 3rd goal of it is to terminate the epidemic of HIV/ AIDS. The progress reports of HIV/ AIDS in Indonesia have increased from 2015 and throughout 2018 there was recorded around 46,659 cases. The majority of HIV distribution was in the reproductive age group with a total around 73,135 cases and 29,828 people were women with the largest case are in the group of housewives. Therefore, it was important to conduct HIV screening to the candidate to prevent the virus transmission from mother to baby as early as possible. This type of research used was observational analytic cross sectional study. The population used was the bride candidate who registered at KUA Kecamatan Kiaracondong in 2018 with a total samples were 46 bride’s candidate. The sampling technique was quota sampling. The research instrument was in the form of questionnaire sheets. The results of this research showed that most of the bride’s candidate had good knowledge after being given health education about HIV/ AIDS, but the other respondents did not perform the test. The result of chi square obtained that there were a relationship of knowledge after the provision of health education about HIV/ AIDS towards the examination of HIV tests on bride’s candidate (p = 0.048). Conclusions, there is a relationship of knowledge after the provision of health education about HIV/ AIDS towards the examination of HIV testing on bride’s candidate at KUA Kecamatan Kiaracondong of Bandung City. Suggestions, it is needed to perform cross sector collaboration between KUA and health workers in community health centre or hospitals that can provide premarital health counseling and specifically about the screening of HIV.
Keywords: HIV, Bride’s candidate, HIV Test Examination.
INTRODUCTION
Sustainable Development Goals (SDGs) is a sustainable development program that contains 17 goals. The third goal of the SDGs is to guarantee healthy life and foster the prosperity of all people in all ages by 2030 namely improving reproductive health and maternal and child health; ending HIV/AIDS, malaria, tuberculosis and tropical diseases epidemics; reducing non-communicable and environmental diseases (Ermalena, 2017, BPS RI, 2016).
The new HIV infection case among Asia Pacific Countries with the greatest growth in the spread of HIV 2017 were India in the first place (31%), China in the second place (23%) followed by Indonesia in the third place with 18% (UNAIDS, 2018).
According to the HIV - AIDS & PIMS Development Report in Indonesia reported by P2P, it increased gradually in 2015 with 30,935 cases, in 2016 with 41,250 cases and 2017 with 48,300 cases,
while throughout 2018 there were 46,659 HIV cases (The Ministry of Health of Indonesia, 2018).
HIV positive and AIDS cases in West Java ranks fourth. The first position was East Java (8,608 cases), the second was DKI Jakarta (6,896 cases) and the third was Central Java (5,400 cases). From 2015 to 2018, HIV cases in West Java had a tendency to increase, namely in 2015 as many as 4154 cases increased in 2016 to 5466 cases and in 2017 as many as 5819 cases, while in 2018 it decreased so that it became 5,185 cases (The Ministry of Health of Indonesia, 2018).
Whereas in Bandung itself, HIV occupied the first position, followed by Bekasi (4,458 cases) and Bogor (4,333 cases). The discovery of new HIV cases in Bandung from 2015 amounted to 287 cases, in 2016 there was a slight decline with 285 cases and in 2017 with 273 cases (West Java Provincial Health Office, 2017).
From 2017 to September 2018, the number of reported HIV infections according to reproductive
age group (15-49 years) was 73,135 cases (89.4%) and 29,828 of them were women. The number of reported AIDS cases according to occupation among a group of housewives was 2700 cases, in which pregnant have the potential to transmit HIV infection to her baby (The Ministry of Health of Indonesia, 2018).
Data from the Ministry of Health of Indonesia in 2018 recorded 1,805,993 pregnant women undergoing HIV testing from a total of 5,291,143 pregnant women and as many as 5,074 pregnant women were stated to be HIV positive (Kemenkes RI, 2018).
More than 90% of infants are infected with HIV, contracting it from HIV positive mothers.
Transmission can occur during pregnancy, during labor and during breastfeeding. Pencegahan penularan HIV dari ibu ke anak (PPIA) or Prevention of Mother-to-Child HIV Transmission (PMTCT) is a very effective intervention to prevent transmission. The efforts to prevent HIV transmission from mother to child has been carried out in Indonesia since 2004, PPIA services and prevention of congenital syphilis are integrated with maternal and child health services (MCH or KIA) (Kemenkes RI, 2015).
According to BKKBN (2010), the ideal reproductive age for women to get married is 21-25 years and for men 25-28 years. In carrying out their roles as a couple, a husband and wife must have good physical and mental health. One indication that a prospective bride is healthy is that her reproductive health is in good condition.
Reproductive health is a condition that shows a person's physical, mental and social health conditions related to their reproductive functions and processes including not having diseases or disorders that affect the reproductive activities. In reproductive health, the division of social roles of women and men has a great influence on the health of women and men (The Ministry of Health of Indonesia, 2015).
Kiaracondong District Religious Affairs Office (Kantor Urusan Agama or KUA) is one of the KUAs in Bandung. The number of prospective brides who register at Kiaracondong District KUA is one of researcher’s considerations in choosing Kiaracondong District KUA as a research site.
Based on the results of an interview with one of the officers, KUA facilitates pre-marital guidance to the bride and groom. The material is outlined according to the marriage guidance module for the bride and groom. Submission of material about health has not been carried out because there is no collaboration with the Department of Health that can provide
material about health to the bride and groom. So far the implementation of HIV testing only in pregnant women in health services, not at reproductive age before pregnancy.
METHODS
The type of this research was an observational analytic study with a cross sectional study design.
The population was all prospective brides who registered in the area of Kiaracondong District KUA in 2018 which were 2216 prospective brides and as many as 46 prospective brides sample with quota sampling technique. The research instrument used was questionnaire with chi square analysis technique. The research location was carried out at Kiaracondong District KUA, Bandung and was carried out in June - July 2019.
RESULTS
Knowledge Overview of the Bride’s Candidate and Groom after Health Education about HIV/AIDS
Table 1. Frequency Knowledge Distribution of the bride’s candidate and Groom after Health Education
about HIV/AIDS at Kiaracondong District KUA, Bandung
Knowledge Male Female Total
n % n % n %
Good 14 46.7 16 53.3 30 100
Less 9 56.2 7 43.8 16 100
Total 23 50 23 50 46 100
Source: Primary Data 2019
Based on table 1, it can be explained that out of the 30 brides who had good knowledge were mostly female (53.3%) and out of the 16 brides who had less knowledge were mostly male (56.2%).
Overview of the Bride’s Candidate and Groom in Carrying Out HIV Test
Table 2. Frequency distribution of the bride’s candidate and groom in carrying out HIV test at
Kiaracondong District KUA, Bandung HIV
Testing
Male Female Total
N % n % n %
Willing 7 50 7 50 14 100
Not
Willing 16 50 16 50 32 100
Total 23 50 23 50 46 100
Source: Primary Data 2019
Based on table 2, it can be explained that out of the 32 brides who were not willing to be tested for
HIV, both men and women had the same percentage of 50%.
Relationship of HIV/AIDS Knowledge after Health Education and HIV Testing on the Bride’s Candidate and Groom at Kiaracondong District KUA, Bandung
Table 3. Relationship of HIV/AIDS Knowledge after Health Education and HIV Testing on the bride’s cCandidate and Groom at Kiaracondong District
KUA, Bandung Knowledge
after Health Education
HIV Testing
Total p value Not
Willing Willing
n % n % n %
0.048 Less 8 50 8 50 16 100
Good 24 80 6 20 30 100 Total 32 69.6 14 30.4 46 100 Source: Primary Data 2019
Based on table 3, out of 30 brides who had good knowledge after health education, almost all brides and grooms (80%) were not willing to be tested for HIV. Based on statistical tests using Chi Square, it was obtained p value 0.048 <α = 0.05, so it can be stated Ho rejected, it means that there was a relationship of knowledge about HIV/AIDS after health education and HIV testing on brides-to-be at Kiaracondong District KUA, Bandung.
DISCUSSION
Knowledge Overview of the Bride’s Candidate and Groom after Health Education about HIV/AIDS
Knowledge is the result of the idea that occurs through a sensory process, especially the eyes and ears of certain objects (Sunaryo, 2013).
In a short time (immediate impact), health education only results in a change or an improvement of public knowledge (Alhamda, 2015).
According Notoatmodjo (2014), the improvement of knowledge occurs because there are factors that affect the knowledge, education, age, occupation, experience, confidence and social culture. The lowest level of education of the bride and groom was elementary and the highest level of education was bachelor degree (S1), so the higher the level of education, the broader the knowledge.
However it does not mean that someone with low education has low knowledge, considering that knowledge is not only obtained from formal education, but also can be obtained from non-formal education.
People's occupation is very influential on the process of accessing information needed on an object (Notoatmodjo, 2014). Almost all brides who were respondents in this study already had a job.
Someone who has worked, the scope of the association would be wider so that it would be easy to get new knowledge from anyone and anywhere.
However it does not mean that those who have not worked have low knowledge, they can also get knowledge from other sources such as print and electronic media, which for now is very easy to access both types of sources.
HIV Testing on the Bride’s Candidate and Groom
According to Sunaryo (2013) in his book, Psychology for Nursing, the so-called human behavior is an activity that arises due to a stimulus and response and can be observed directly or indirectly.
Carrying out HIV test is behavior. Behavior is different from attitude, where attitude is a person's closed response to a stimulus or object, both internal and external so that its manifestations cannot be directly seen, but can only be interpreted first from the closed behavior (Sunaryo, 2013).
Based on the results of the study, the respondents agreed about the importance of HIV/AIDS screening. However when they asked directly about the readiness to carry out HIV test, as many as 16 pairs of prospective brides from 23 pairs of prospective brides were not willing to carry out HIV test even after being given health education about HIV/AIDS.
According to Sunaryo (2013), individual behavior does not arise by itself, but due to stimulation (stimulus), both from within (internal) and from outside (external) of the individual. From 7 pairs of brides who were willing to do the HIV test, it can be associated to the previous statement that the behavior of the bride and groom who were willing to conduct HIV test was influenced by the provision of health education about HIV/AIDS and the interest of the bride and groom themselves to find out their health condition, besides that health workers as the giver of the material also gives influence in changing the behavior of the bride and groom.
Relationship of HIV/AIDS Knowledge after Health Education and HIV Testing on the Bride’s Candidate and Groom at Kiaracondong District KUA, Bandung
The success of the provision of health education can be seen from the average score of
knowledge of each prospective bride that improved from before the provision of health education to after the provision of health education and the presence of the bride and groom who are willing to carry out HIV test. The above statement is supported by the results of Sari's research, et al (2012) which stated that there is an effect of oral (tooth brushing) health education using the game method of snakes and ladders simulation on changes in knowledge, attitudes and application of tooth- brushing actions in school-age children in Paron Ngawi Region elementary school.
Education will indirectly affect a person's behavior in maintaining his/her health. Usually, people who are educated (in this case people who take formal education) have a lower risk of illness or other health problems compared to people who are unfamiliar with health (Agustini, 2014). In this study, all the bride and groom take formal education.
Providing health education is not the only obligation that must be carried out by health workers. In this case, related to the research location in the KUA, the KUA also has the duty to provide pre-marital guidance in accordance with the existing module from the Ministry of Religion where the material also contains the information about reproductive health, but in reality not all KUAs is ready to carry out the mentioned duty.
KUA which supports the provision of health education programs has become one of the successes of distributing information evenly to the community, namely to the bride and groom.
Providing health education to bride and groom became spearhead in preparing various health conditions such as pregnancy, childbirth to breastfeeding and all complications related to reproductive health of women and men.
In this case, cross-sectoral cooperation is needed between the KUA and the public health office to be able to complement each other in the implementation of premarital guidance until finally the implementation of HIV screening on the bride and groom. In contrast to the implementation of premarital marriage guidance conducted by the Ministry of Religion which is part of the Islamic Community Guidance Program (BIMAS), where the delivery of material on reproductive health in the module has been delivered by health workers.
According to Mahmoodi (2016), in his journal entitled “The Effect of Marriage Counseling on The Knowledge of The Married Couples”, counseling conducted before marriage to the bride’s candidate and groom is very helpful in their married life to last
longer. The method used in this study besides education, there was also video screening.
Entering of family life, every couple needs the right knowledge to run the household. Related to reproductive health, it is necessary to plan whether a partner is ready to get pregnant or not, whether contraception is needed or not and what screening should be done in preparing for a healthy prospective baby later.
CONCLUSION
1. Most brides-to-be had good knowledge about HIV/AIDS after being given health education.
2. Half of respondents, both prospective bride and groom, were not willing to be tested for HIV.
3. There was a relationship of knowledge about HIV/AIDS after the provision of health education and HIV testing on the bride and groom.
REFERENCES
Agustini, A. 2014. Promosi Kesehatan. Sleman:
Deepublish.
Alhamda, S. & Sriani, Y. 2015. Buku Ajar Ilmu Kesehatan Masyarakat. Sleman: Deepublish.
Dinkes Provinsi Jawa barat. 2017. Profil Kesehatan.
Ermalena. 2017. Indikator Kesehatan SDGs Di Indonesia.
Kemenkes RI Ditjen P2P. 2018. Laporan Situasi Perkembangan HIV-AIDS & PMS Di Indonesia Juli-September 2018.
Kemenkes RI. 2016. Situasi Penyakit HIV AIDS Di Indonesia.
Kemenkes RI. 2017. Laporan Perkembangan HIV- AIDS & Infeksi Menular Seksual (IMS).
Kemenkes RI. 2018. Data Dan Informasi Profil Kesehatan Indonesia.
Kemenkes RI. 2018. Laporan Situasi Perkembangan HIV-AIDS & PIMS Di Indonesia Juli-September 2018.
Kemenkes RI. 2018. Profil Kesehatan Indonesia Tahun 2017.
Mahmoodi, G. (2016). The Effect of Marriage Counseling on The Knowledge of The Married Couples. International Journal of Medical Research & Health Sciences, 5, 7S:354-359.
Notoatmodjo, Soekidjo. 2014. Ilmu Perilaku Kesehatan. Jakarta: Rineka Cipta.
Puslitbang Bimas Agama dan Layanan Keagamaan Badan Litbang dan Diklat Kementrian Agama RI. 2016. Modul Bimbingan Perkawinan Untuk Calon Pengantin.
Sari, E. K. 2012. Pengaruh Pendidikan Kesehatan Gosok Gigi Dengan Metode Permainan Ular Tangga Terhadap Perubahan Pengetahuan,
Sikap Dan Aplikasi Tindakan Gosok Gigi Anak Usia Sekolah Di SD Wilayah Paron Ngawi.
Skripsi. Program Sarjana Ilmu Keperawatan Universitas Airlangga Kampus C Mulyorejo Surabaya.
Sunaryo. 2013. Psikologi Untuk Keperawatan.
Jakarta: Buku Kedokteran EGC.
UNAIDS. 2018. Data 2018 HIV.
