Document Type : Original Article
Authors
Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background and Objectives: Addicts account for approximately 68.15% of AIDS cases in
Iran and injection drug users are considered as a major factor in the spread of AIDS in Iran.
The purpose of this study was to determine the effect of an educational intervention on the
perceived self‑efficacy, benefits, and barriers concerning AIDS preventive behaviors among drug
addicts in Khorramabad, Iran. Methods: This is a quasi‑experimental study carried out in 2013
on 88 addicts kept in rehabilitations center in Khorramabad. The data collection instruments
included a questionnaire on self‑efficacy, perceived benefits, perceived barriers, knowledge and
preventive behaviors regarding HIV. Data were analyzed by paired t‑test, independent t‑test,
Chi‑square and analysis of covariance. Results: Paired t‑test showed that the mean scores for
perceived benefits and barriers, knowledge and preventive behaviors significantly increased
in the intervention group after the intervention than before the intervention. But the increase
in self‑efficacy score was not statistically significant. Conclusions: The results of this study
showed that training and education based on the health belief model led to an increase in
knowledge, self‑efficacy, perceived benefits, performance and reduction in perceived barriers
in addicts. It is recommended that future studies should include strategies for enhancing
self‑efficacy and perceived benefits as well as strategies for reducing barriers to the adoption
of preventive behaviors.
Keywords
1. Taeri K, Kasaeian N, Nobari RF, Ataei B. The prevalence of
hepatitis B, hepatitis C and associated risk factors in intravenous
drug addicts (IVDA) with HIV in Isfahan. Journal of Isfahan Medical
School. 2008;26 (90).
2. Rahmati Najarkolaei F, Niknami S, Amin Shokravi F, Ahmadi F,
Jafari M, Rahnama P. The implication of health belief model in
planning educational programmes for preventing HIV/AIDS among
university students. Payesh. 2009;8 (4):349‑59.
3. KARIMI M, Ghofranipour F, HEYDARNIA AR. The effect of health
education based on health belief model on preventive actions of
AIDS on addict in Zarandieh. 2009.
4. Sanaei Moghadam E, Sargolzaie N, Karami Sh SM, Khosravi S,
Fadaie M. Knowledge, attitude and practice regarding blood
donation among Sistan and Baluchistan province blood donors
about HIV. Journal of Blood. 2009;6 (2):117‑23.
5. Dolan KA, Niven H. A review of HIV prevention among young
injecting drug users: A guide for researchers. Harm Reduction
Journal. 2005;2 (1):5.
6. Safdar S, Mehmood A, Abbas SQ. Prevalence of HIV/AIDS among
jail inmates in Sindh. Prevalence. 2009.
7. Amani F, Sadeghieh S, Salamati P. Features addicts referred to
their centers referrals Ardabil (Persian). J Iran Inst Health Sci Res.
2005;4 (5):55‑9.
8. Niknami S, Hatami A, Heidarnia A. The Effect of Health
Educational Program on Preventing AIDS in Self‑reported Addicts’Wives (Kermanshah 2004). Journal of Kermanshah University of
Medical Sciences. 2007;11 (2).
9. Health Mo. Recent Statistics on HIV/AIDS in Iran. Tehran: Center
for Disease Control. 2013.
10. Ghafari M, Niknami S, Kasemnejad A. Design and validity HIV/
AIDS questionnaire in teen Kermanshah. Journal of Behbood.
2005;11 (1):38‑43.
11. Fahoodi B. HIV/AIDS and Injection Drug Users Tehran. Tehran:
Nashrehseda Publication. 2003.
12. Zareban I, Hedarnia A, Rakhshani F, Jabbari H ,
Abdollahi‑Mohammad A. The effect of health educational program
on the knowledge and practice sailors towards HIV/AIDS in
Chabahar. J Univ Med Sci Health Serv. 2006;8 (1):29‑33.
13. Gashtasbi A, Vahanisadat M, Rezai N. Survey of knowledge
towards HIV/AIDS among Rasht city women. Armaghan Danesh J
Khorasanrazavi Univ Med Sci Health Serv. 2007;10 (1):29‑33.
14. Nojoomi M, Anbari K. Acomparison of quality of life in HIV/AIDS
patients and control group. Iran J Univ Med Sci Health Serv.
15 (1):169‑75.
15. Rhodes T, Platt L, Sarang A, Vlasov A, Mikhailova L, Monaghan G.
Street policing, injecting drug use and harm reduction in a Russian
city: A qualitative study of police perspectives. Journal of Urban
Health. 2006;83 (5):911‑25.
16. Sharifi‑rad G, Hazavei MM, Hasan‑zadeh A, Danesh‑amouz A.
The effect of health education based on health belief model on
preventive actions of smoking in grade one, middle school students.
Arak Medical University Journal. 2007;10 (1):79‑86.
17. Gahanloo A, Ghofranipour F, Vafaei M, Kimiagar M, Heidarnia A,
Sobhani A. Assessment HBM structures along with DBA1C
in diabetic patients with optimum and un‑favorable diabetic.
Hormozgan Medical Journal. 2008;12 (1):37‑42.
18. Karimy M, Hasani M, Khoram R, Ghaffari M, Niknami S. The effect of
education, based on health belief model on breast self‑examination
in health liaisons of Zarandieh city. Zahedan Journal of Research in
Medical Sciences. 2008;10:0.
19. Kinsler J, Sneed CD, Morisky DE, Ang A. Evaluation of a
school‑based intervention for HIV/AIDS prevention among Belizean
adolescents. Health education research. 2004;19 (6):730‑8.
20. Volk JE, Koopman C. Factors associated with condom use in Kenya:
A test of the health belief model. AIDS education and prevention.
2001;13 (6):495‑508.
21. Glanz K, Rimer BK, Viswanath K. Health behavior and health
education: Theory, research, and practice: John Wiley and Sons;
2008.
22. Rahmati F, Niknami S, Aminshokravi F, editors. Evaluation HBM
Model on planning preventive of HIV/AIDS in the students. Tehran
University. Proceedings of the 3rd National Congress on Health
Education and Promotion; 2008.
23. Lollis CM, Johnson EH, Antoni MH. The efficacy of the health belief
model for predicting condom usage and risky sexual practices in
university students. AIDS Education and Prevention. 1997.
24. Peyman N, Heidarnia A, Ghofranipour F, Kazemnejad A,
Khodaee GH, Amin Shokravi F. The relationship between perceived
self‑efficacy and contraceptive behaviors among Iranian women
referring to health centers in Mashad in order to decrease unwanted
pregnancies. Journal of Reproduction and Infertility. 2007:78‑90.
25. Murphy DA, Stein JA, Schlenger W, Maibach E. Conceptualizing the
multidimensional nature of self‑efficacy: Assessment of situational
context and level of behavioral challenge to maintain safer sex.
Health Psychology. 2001;20 (4):281.
26. Karimi M, Niknami S. Self‑efficacy and perceived benefits/barriers
on the AIDs preventive behaviors. Journal of Kermanshah University
of Medical Sciences (J Kermanshah Univ Med Sci). 2011;15 (5).
27. Pirzadeh A, GhR S. Effect of educational program on knowledge
and health belief model structures about acquired immune
deficiency syndrome (AIDS) among high school female student
in Isfahan, Iran. Journal of Gorgan University of Medical Sciences.
2012;14 (3):66‑71.
28. Lin P, Simoni JM, Zemon V. The health belief model, sexual
behaviors, and HIV risk among Taiwanese immigrants. AIDS
Education and Prevention. 2005;17 (5):469‑83.
29. Falck RS, Siegal HA, Wang J, Carlson RG. Usefulness of the health
belief model in predicting HIV needle risk practices among injection
drug users. AIDS Education and Prevention. 1995.
30. Yep GA. HIV prevention among Asian‑American college students:
Does the health belief model work? Journal of American College
Health. 1993;41 (5):199‑205.
31. Miri M, Fani M, MOTALEBI M, Nazemi H. USING HEALTH BELIEF
MODEL ST DS ON MEDICAL STUDENTS. 2002.
32. Karimy M, Niknami S, Hedarnia A. The effect of health educational
program on preventing AIDS in addicts prisoners Geserhesar
Tehran. Ghazvin J Univ Med Sci Health Serv. 2004;8 (1):40‑8.
33. Clark JN, Van Eck RN, King A, Glusman B, McCain‑Williams A, Van
Eck S, et al. HIV/AIDS education among incarcerated youth. Journal
of Criminal Justice. 2000;28 (5):415‑33.
34. Organization WH. New approaches to health education in primary
health care: Report of a WHO expert committee [meeting held in
Geneva from 12 to 18 October 1982]. 1983.
35. Hounton SH, Carabin H, Henderson NJ. Towards an understanding
of barriers to condom use in rural Benin using the Health Belief
Model: A cross sectional survey. BMC Public Health. 2005;5 (1):8.
36. Eshrati B, Asl RT, Dell CA, Afshar P, Millson P, Kamali M, et al.
Preventing HIV transmission among Iranian prisoners: Initial support
for providing education on the benefits of harm reduction practices.
Harm Reduct J. 2008;5 (21):1‑7.
37. Adih WK, Alexander CS. Determinants of condom use to prevent
HIV infection among youth in Ghana. Journal of Adolescent Health.
1999;24 (1):63‑72.
38. Mazloomy M, Mehri A, Morowatisharifabad M. The relationship of
health behavior with Self‑esteem and self‑efficacy in students of
Yazd Shahid Sadooghi University of Medical Sciences. Journal of
Kerman university of medical sciences. 2006;3 (2):111‑7.
39. Zamboni BD, Crawford I, Williams PG. Examining communication
and assertiveness as predictors of condom use: Implications for
HIV prevention. AIDS education and prevention. 2000.
40. Smith KW, McGraw SA, Costa LA, McKinley JB. A self‑efficacy
scale for HIV risk behaviors: Development and evaluation. AIDS
Education and Prevention. 1996.
41. Bandura A. Perceived self‑efficacy in the exercise of control over
AIDS infection. Evaluation and program planning. 1990;13 (1):9‑17.
42. Ghafari M. Comparing the efficacy of health belief model and its
integrated model in AIDS education among male high school
students in Tehran. Tehran: Tarbiat Modares university. 2007.
43. Kasen S, Vaughan RD, Walter HJ. Self‑efficacy for AIDS preventive
behaviors among tenth grade students. Health Education and
Behavior. 1992;19 (2):187‑202.
44. Momeni E, Karimi Z, Malekzadeh J, Moshfe H. The knowledge level
and attitude of pre‑university students of Yasuj city towards AIDS
in 2003. Dena, Quarterly Journal of Yasuj Faculty of Nursing And
Midwifery. 2006;1 (1):41‑9.
45. Karimy M, Sadatgoo L. Survey knowledge and atittude towards HIV
among Yazd City. Yazd J Univ Med Sci Health Serv. 2003;11 (1):5‑10.
hepatitis B, hepatitis C and associated risk factors in intravenous
drug addicts (IVDA) with HIV in Isfahan. Journal of Isfahan Medical
School. 2008;26 (90).
2. Rahmati Najarkolaei F, Niknami S, Amin Shokravi F, Ahmadi F,
Jafari M, Rahnama P. The implication of health belief model in
planning educational programmes for preventing HIV/AIDS among
university students. Payesh. 2009;8 (4):349‑59.
3. KARIMI M, Ghofranipour F, HEYDARNIA AR. The effect of health
education based on health belief model on preventive actions of
AIDS on addict in Zarandieh. 2009.
4. Sanaei Moghadam E, Sargolzaie N, Karami Sh SM, Khosravi S,
Fadaie M. Knowledge, attitude and practice regarding blood
donation among Sistan and Baluchistan province blood donors
about HIV. Journal of Blood. 2009;6 (2):117‑23.
5. Dolan KA, Niven H. A review of HIV prevention among young
injecting drug users: A guide for researchers. Harm Reduction
Journal. 2005;2 (1):5.
6. Safdar S, Mehmood A, Abbas SQ. Prevalence of HIV/AIDS among
jail inmates in Sindh. Prevalence. 2009.
7. Amani F, Sadeghieh S, Salamati P. Features addicts referred to
their centers referrals Ardabil (Persian). J Iran Inst Health Sci Res.
2005;4 (5):55‑9.
8. Niknami S, Hatami A, Heidarnia A. The Effect of Health
Educational Program on Preventing AIDS in Self‑reported Addicts’Wives (Kermanshah 2004). Journal of Kermanshah University of
Medical Sciences. 2007;11 (2).
9. Health Mo. Recent Statistics on HIV/AIDS in Iran. Tehran: Center
for Disease Control. 2013.
10. Ghafari M, Niknami S, Kasemnejad A. Design and validity HIV/
AIDS questionnaire in teen Kermanshah. Journal of Behbood.
2005;11 (1):38‑43.
11. Fahoodi B. HIV/AIDS and Injection Drug Users Tehran. Tehran:
Nashrehseda Publication. 2003.
12. Zareban I, Hedarnia A, Rakhshani F, Jabbari H ,
Abdollahi‑Mohammad A. The effect of health educational program
on the knowledge and practice sailors towards HIV/AIDS in
Chabahar. J Univ Med Sci Health Serv. 2006;8 (1):29‑33.
13. Gashtasbi A, Vahanisadat M, Rezai N. Survey of knowledge
towards HIV/AIDS among Rasht city women. Armaghan Danesh J
Khorasanrazavi Univ Med Sci Health Serv. 2007;10 (1):29‑33.
14. Nojoomi M, Anbari K. Acomparison of quality of life in HIV/AIDS
patients and control group. Iran J Univ Med Sci Health Serv.
15 (1):169‑75.
15. Rhodes T, Platt L, Sarang A, Vlasov A, Mikhailova L, Monaghan G.
Street policing, injecting drug use and harm reduction in a Russian
city: A qualitative study of police perspectives. Journal of Urban
Health. 2006;83 (5):911‑25.
16. Sharifi‑rad G, Hazavei MM, Hasan‑zadeh A, Danesh‑amouz A.
The effect of health education based on health belief model on
preventive actions of smoking in grade one, middle school students.
Arak Medical University Journal. 2007;10 (1):79‑86.
17. Gahanloo A, Ghofranipour F, Vafaei M, Kimiagar M, Heidarnia A,
Sobhani A. Assessment HBM structures along with DBA1C
in diabetic patients with optimum and un‑favorable diabetic.
Hormozgan Medical Journal. 2008;12 (1):37‑42.
18. Karimy M, Hasani M, Khoram R, Ghaffari M, Niknami S. The effect of
education, based on health belief model on breast self‑examination
in health liaisons of Zarandieh city. Zahedan Journal of Research in
Medical Sciences. 2008;10:0.
19. Kinsler J, Sneed CD, Morisky DE, Ang A. Evaluation of a
school‑based intervention for HIV/AIDS prevention among Belizean
adolescents. Health education research. 2004;19 (6):730‑8.
20. Volk JE, Koopman C. Factors associated with condom use in Kenya:
A test of the health belief model. AIDS education and prevention.
2001;13 (6):495‑508.
21. Glanz K, Rimer BK, Viswanath K. Health behavior and health
education: Theory, research, and practice: John Wiley and Sons;
2008.
22. Rahmati F, Niknami S, Aminshokravi F, editors. Evaluation HBM
Model on planning preventive of HIV/AIDS in the students. Tehran
University. Proceedings of the 3rd National Congress on Health
Education and Promotion; 2008.
23. Lollis CM, Johnson EH, Antoni MH. The efficacy of the health belief
model for predicting condom usage and risky sexual practices in
university students. AIDS Education and Prevention. 1997.
24. Peyman N, Heidarnia A, Ghofranipour F, Kazemnejad A,
Khodaee GH, Amin Shokravi F. The relationship between perceived
self‑efficacy and contraceptive behaviors among Iranian women
referring to health centers in Mashad in order to decrease unwanted
pregnancies. Journal of Reproduction and Infertility. 2007:78‑90.
25. Murphy DA, Stein JA, Schlenger W, Maibach E. Conceptualizing the
multidimensional nature of self‑efficacy: Assessment of situational
context and level of behavioral challenge to maintain safer sex.
Health Psychology. 2001;20 (4):281.
26. Karimi M, Niknami S. Self‑efficacy and perceived benefits/barriers
on the AIDs preventive behaviors. Journal of Kermanshah University
of Medical Sciences (J Kermanshah Univ Med Sci). 2011;15 (5).
27. Pirzadeh A, GhR S. Effect of educational program on knowledge
and health belief model structures about acquired immune
deficiency syndrome (AIDS) among high school female student
in Isfahan, Iran. Journal of Gorgan University of Medical Sciences.
2012;14 (3):66‑71.
28. Lin P, Simoni JM, Zemon V. The health belief model, sexual
behaviors, and HIV risk among Taiwanese immigrants. AIDS
Education and Prevention. 2005;17 (5):469‑83.
29. Falck RS, Siegal HA, Wang J, Carlson RG. Usefulness of the health
belief model in predicting HIV needle risk practices among injection
drug users. AIDS Education and Prevention. 1995.
30. Yep GA. HIV prevention among Asian‑American college students:
Does the health belief model work? Journal of American College
Health. 1993;41 (5):199‑205.
31. Miri M, Fani M, MOTALEBI M, Nazemi H. USING HEALTH BELIEF
MODEL ST DS ON MEDICAL STUDENTS. 2002.
32. Karimy M, Niknami S, Hedarnia A. The effect of health educational
program on preventing AIDS in addicts prisoners Geserhesar
Tehran. Ghazvin J Univ Med Sci Health Serv. 2004;8 (1):40‑8.
33. Clark JN, Van Eck RN, King A, Glusman B, McCain‑Williams A, Van
Eck S, et al. HIV/AIDS education among incarcerated youth. Journal
of Criminal Justice. 2000;28 (5):415‑33.
34. Organization WH. New approaches to health education in primary
health care: Report of a WHO expert committee [meeting held in
Geneva from 12 to 18 October 1982]. 1983.
35. Hounton SH, Carabin H, Henderson NJ. Towards an understanding
of barriers to condom use in rural Benin using the Health Belief
Model: A cross sectional survey. BMC Public Health. 2005;5 (1):8.
36. Eshrati B, Asl RT, Dell CA, Afshar P, Millson P, Kamali M, et al.
Preventing HIV transmission among Iranian prisoners: Initial support
for providing education on the benefits of harm reduction practices.
Harm Reduct J. 2008;5 (21):1‑7.
37. Adih WK, Alexander CS. Determinants of condom use to prevent
HIV infection among youth in Ghana. Journal of Adolescent Health.
1999;24 (1):63‑72.
38. Mazloomy M, Mehri A, Morowatisharifabad M. The relationship of
health behavior with Self‑esteem and self‑efficacy in students of
Yazd Shahid Sadooghi University of Medical Sciences. Journal of
Kerman university of medical sciences. 2006;3 (2):111‑7.
39. Zamboni BD, Crawford I, Williams PG. Examining communication
and assertiveness as predictors of condom use: Implications for
HIV prevention. AIDS education and prevention. 2000.
40. Smith KW, McGraw SA, Costa LA, McKinley JB. A self‑efficacy
scale for HIV risk behaviors: Development and evaluation. AIDS
Education and Prevention. 1996.
41. Bandura A. Perceived self‑efficacy in the exercise of control over
AIDS infection. Evaluation and program planning. 1990;13 (1):9‑17.
42. Ghafari M. Comparing the efficacy of health belief model and its
integrated model in AIDS education among male high school
students in Tehran. Tehran: Tarbiat Modares university. 2007.
43. Kasen S, Vaughan RD, Walter HJ. Self‑efficacy for AIDS preventive
behaviors among tenth grade students. Health Education and
Behavior. 1992;19 (2):187‑202.
44. Momeni E, Karimi Z, Malekzadeh J, Moshfe H. The knowledge level
and attitude of pre‑university students of Yasuj city towards AIDS
in 2003. Dena, Quarterly Journal of Yasuj Faculty of Nursing And
Midwifery. 2006;1 (1):41‑9.
45. Karimy M, Sadatgoo L. Survey knowledge and atittude towards HIV
among Yazd City. Yazd J Univ Med Sci Health Serv. 2003;11 (1):5‑10.
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