University of Medical Sciences & Technology

Faculty of Dentistry
Department of Research Methodology & Biostatistics
B.D.S. Proposal

Knowledge Attitude and Protocol of Dental students

regarding treatment of patients with HIV/AIDS in Nyanza,
Rwanda 2023-2024

Submitted in partial fulfillment for the BDS degree

By
Doaa Ibrahim Bashary (DN-2018-101)
University of Medical Sciences and Technology
5th Year
Batch 23
Supervised by

Co-Supervisor:

Submitted to the
Faculty of Dentistry
University of Medical Sciences and Technology
Table of content

Chapter 1 ……………………………………………………………………
1.1 Introduction ……………………………………………………………….….I
1.2 research question …………………………………………………………….III
1.3 Problem statement …………………………………………………………...III
1.4 Justification…………………………………………………………………...III
1.5 Study variables……………………………………………………………......III
1.6 Objectives……………………………………………………………………..III
1.7 Literature review ……………………………………………………………..IV

Chapter 2 …………………………………………………………………………
2.1 Study design ………………………………………………………………..XIII
2.2 Study population and sample size…………………………………………..XIII
2.3 Data collection………………………………………………………………XIII
2.4 Inclusion criteria………………………………………………………….…XIII
2.5 Exclusion criteria ………………………………………………………..….XIII
2.6 Plan for data analysis……………………………………………………..…XIII
2.7 Plan of investigation ……………………………………………………..…XIII

Appendices …………………………………………………………………....XVII
References …………………………………………………………………….XVIII
Chapter 1
 Background Review
1.1Introduction
With increasing numbers of people with HIV/AIDS receiving oral dental care, dentists ought to
be sufficiently informed about the illness and exhibit a professional demeanor. (1)

AIDS is defined as a group of symptoms brought on by an immune system compromise brought

on by HIV infection. HIV, in contrast to AIDS, is an infection that targets the immune system of
the body, namely the CD4+ white blood cells HIV infection is today recognized as a chronic,
manageable illness rather than a lethal or terminal disease. Despite being a devastating and
terrifying public health concern since it was first diagnosed as a disease in 1981, HIV infection is
still a difficult and pressing issue (2,3,4)

There are records of 75 million HIV infections worldwide, and roughly 32 million HIV-related
deaths. By the end of 2018, there were over 37.9 million HIV-positive individuals living in the
world. Globally, 0.8% of adults between the ages of 15 and 49 have HIV, while the distribution
varies greatly between nations and areas. (4)

Adolescents are in a critical developmental stage that could result in risky behaviors and
lifestyles, which are strongly linked to an increased risk of HIV infections. (5)

Dentists are susceptible to HIV-related hazardous disorders. HIV/AIDS patients often face
significant stigma, which has an impact on the care they receive, some dentists are deterred from
treating HIV/AIDS patients because of this risk of exposure, reducing the risk of HIV
transmission in the healthcare system requires both effective anti-transmission methods and
sufficient information, such as using universal precautions when handling blood, instruments,
and equipment. (6,7)

The world is currently working to address the HIV/AIDS epidemic and the discrimination that
goes along with it, despite worries about the harmful consequences of stigma related to HIV and
AIDS having been expressed since the mid-1980s. "Beliefs and/or attitudes marking or staining a
person or group of people as unworthy or discreditable" was the definition given to stigma.

I
Conversely, discrimination was described as "behaviors that stemmed from these stigmatizing
beliefs", the ending of this stigma associated with HIV/AIDS was the goal of the eighth World
Workshop on Oral Health and Disease in AIDS (WW8 AIDS), which took place in Bali in 2019.
(6,8)

Even if discrimination is illegal, many health-care workers still have a negative attitude about
HIV. For this reason, it is necessary to include HIV/AIDS patient infection management
strategies in the dentistry curriculum. (7,9)

Therefore, we are conducting a study to assess the knowledge, attitude and protocol of dental
students in UMST regarding treatment of patients with HIV AID

II
1.2Research question
What is the attitude of dental students towards providing comprehensive dental care for patients
with HIV and are there any guidelines currently being followed when treating HIV-positive
patients

1.3 Problem statement

HIV knowledge and attitudes among students has been indicated as a causal factor for increased
HIV infections among students and the general population

1.4 Justification
The purpose of this study is to assess the knowledge Attitude and Protocol of Dental students in
relation to treating of patients with HIV/ AIDS

1.5 variables
Dependant variable: knowledge attitude and adherence to treatment protocols of dental student
Independent variable: educational intervention or training programs

1.6 Objectives
1.6.1 General
 To assess the knowledge Attitude and Protocol of Dental students in relation to treating of
patients with HIV/AIDS
1.6.2 Specific
 To determine the level of knowledge among dental students regarding HIV transmission,
prevention and treatment.
 To assess the attitude of dental students towards patients with HIV, including any existing
stigmas or discriminatory beliefs.
 To evaluate the adherence of dental students to infection control protocols when treating HIV
positive patients
 To identify any gaps or area of improvement in the knowledge, attitude and protocol of
dental students in relation to HIV positive patients care
  To provide recommendation for educational interventions or training programs to
enhance dental students understanding and approach to treating patients with HIV

1.7 Literature review

In KSA, 2023, S. Alotaibi et al. conducted a cross-sectional study that involved 502 total
participants. Of these, more than half were male (57.4%) and the other half were female (42.6%).
Additionally, the study revealed that more than half of dental students attended private
universities (52.2%), while 47.8% attended public universities. The distribution of students' ages
was also shown, with (.8%) of them being under the age of 19, (98.2%) most students were
between 20 and 29 years old, and (1.0%), those between 30 and 39 years old. Additionally, it
displays the distribution of students by academic level, with the following examples: 10.0% of
students were from level 5, 11.4% from level 6, 13.1% from level 7, 13.5% from level 8, 10.6%
from level 9, 11.4% from level 10, 11.4% from level 12, and 6.4% from intern. The majority of
students (85.5%) and those who understood that "HIV/AIDS can be diagnosed with oral
manifestations" were both aware that "HIV/AIDS can be transmitted to dental workers."
Comparably, the majority of students (87.1%) and (84.7%) were aware that “the dentist must
provide dental treatment for HIV-positive” and “HIV can be transmitted through Needle injury.”
It was found that, respectively, 81.7% and 85.3% of the students were aware that "Medical staff
is more susceptible to HIV transmission" and "Hepatitis more transmissible than HIV/AIDS."
Less than half of the students (37.6%), (35.7%), and (33.1%) knew that "the Western blot is a 1t
specific test for diagnosing HIV/AIDS," "HIV can be transmitted through aerosols by hand
pieces," and "negative HIV tests indicate that people are virus-free," respectively. Additionally,
while fewer than half of the students (34.3%) were aware that "Saliva could be a vehicle for HIV
transmission," more than half of the students (63.1%) recognized that "HIV infection can be
tested. The majority of students (69.5%) and (73.3%) were aware that "Special sterilization
methods are used for HIV" and "Infection control methods for Hepatitis B and HIV are same." A
fifth of students (22.15%) who were asked about their attitudes on HIV/AIDS said that
"HIV/AIDS patients should be treated at a separate ward." The statements "You will perform
CPR if HIV/AIDS patients need it" and "Patients with HIV/AIDS can live in the same place with
others" were answered by more than half of the students (66.7%) and (76.1%), respectively. In
answer, less than half of the students (38.6%) said, "You can contract HIV by sharing food," and

IV
about less than fifth (16.7 %) knew that “Lichen planus is oral manifestations related to
HIV/AIDS”. (10)

A cross-sectional study on the Knowledge, Attitude, and Practice (KAP) of post-exposure

prophylaxis for fifth-year dental students at a private Egyptian university was also carried out in
Egypt in 2023 by Saleem H et al. The results showed that 404 students responded to the
questionnaire, 194 (48.0%) of whom were male and 210 (52.0%) of whom were female. The
pupils' average age was (22.69 ± 1.55) years. The majority of participants knew about PEP
beforehand, of these, 29.5% said they learned something from clinical training. According to
participants, the primary indication for PEP is needlestick injury (47.5%). The majority (70.4%)
stated that taking PEP within an hour of exposure is preferred. It's interesting to note that 6
(1.5%) of the participants had appropriate understanding, with a mean score of 0.45 ± 0.50. The
subjects' overall mean attitude score was 0.70 ± 0.46). There were 122 (30.2%) participants that
had a good attitude. PEP is crucial, according to the majority of participants (94%). Seventy-one
percent of the individuals had received an HBV vaccination. The majority of them (76.3%) said
they didn't take PEP after being exposed. Of the 143 participants, 32.5 percent did not know that
the PEP service and protocol even existed. Merely 1% of the individuals practiced PEP, as
indicated by the overall mean practice score of 0.45 ± 0.50. Results showed that PEP is
significant in 94% of cases. (11)

In Karachi, Pakistan on January of In 2023, 800 survey questionnaires were distributed by the
researchers to the participants; a total of n = 578 completed questionnaires were included in the
analysis. The bulk of responders were women (63.6%; n = 368). Over half (58.4%; n = 338) of
the respondents were employed in clinical or laboratory settings in the public sector. The
respondents' average age was 34.2 ± 11.3 years, and 43.7% of them (n = 253) said they had
fewer than five years of job experience. Continuous medical education (CME)/training (35.9%; n
= 208) was the respondents' primary source of information regarding PEP, followed by
peers/friends (173; 29.9%). Based on the HCPs' replies, the median (interquartile range, IQR)
knowledge score was 7.9 (6.5–9.3), indicating a 74.1% acceptable knowledge rate on PEP for
HIV overall. However, their knowledge was significantly associated with their experience (p =
0.006) and the nature of their job/occupation (p = 0.002). Physicians and medical students (OR =

V
1.68; 95% CI = 1.16–2.24; p = 0.001) belonging to private work settings (OR = 1.84; 95% CI =
1.33–2.35; p < 0.003) showed better PEP-related knowledge. In comparison, laboratory
technicians rendering their services in the public sector were found to be less conversant (OR =
0.60; 95% CI = 0.45–0.75; p = 0.005). There was no significant association with age (p = 0.96),
gender (p = 0.72), nor integer of exposures experienced by the respondents (p = 0.82) and PEP
knowledge scores. The major causes stated as a reason for exposure were: high workload
(44.2%; n = 256), shortage of protective barriers (33.2%; n = 192) and deficiency of knowledge
on standard precautions (17.6%; n = 102). Around 89% of HCPs thought that there should be
PEP guidelines present in the working areas, n = 407 (70.4%) of the respondents reported having
been exposed to risky circumstances during their work However, n = 380 (65.7%) took PEP after
exposure. A majority of respondents (60.8%; n = 352), considered the type of exposure, the
bodily fluid, the patient’s HIV status and the exposed person’s susceptibility as the factors to be
considerable for follow-up after occupational exposure. The major reasons for not reporting the
occupational exposures by the respondents were: lacking the knowledge of policies for reporting
(34.4%; n = 199), fear of stigma and discrimination (36.5%; n = 211), lack of support and
motivation to report (23.3%; n = 135) and lack of accepting the worth of reporting experiences
(12.8%; n = 74). More than half (53.8%; n = 311) stated that their institutions had a policy for
the management of HIV exposures; however, their response was significantly associated with the
type of organization they were employed by (p = 0.004). A significant difference was observed
in the knowledge score (9.34 vs. 7.41, p = 0.004) and practices (6.72 vs. 4.13, p = 0.001) of
HCPs having greater than 10 years of experience with those having less than 10 years of
experience. The Spearman correlation test revealed a weak, but significant positive association
between the knowledge and attitude of HCPs towards PEP (r = 0.214, p < 0.005). (12)

Z. S. YILDIRIM et. al. conducted a cross-sectional study in Turkey, 2021 which concluded that
the overall response rate to the questionnaire was 62.9 % (353 from 561students). The results
indicated that 56.4 % of the students were in preclinic. 43.6 % of the respondents of the surveys
were female. The total mean knowledge score was 56.26 % (good knowledge), as 56.91 % for
males and 55.44 % for females. The knowledge scores of 5.3 %, 20.7 %, 62.6 %, and 11.4 % of
the students were excellent, good, moderate, and weak, respectively. There was no statistically
significant difference between male and female students (p-value > 0.05). The range of the

VI
overall correct response rate was 2 to 28. When it came to the question "HIV infection can be
transmitted through; blood or tissue transplantation, needle stinging or open wounds, sexual
intercourse, and from mother to fetus and with mother's milk," the maximum value was 95.42%,
while the minimum value was 21.99%. These results were obtained from soaking in diluted
sodium carbonate (1:10) for 10 minutes to destroy the virus in the infected items. In reference to
oral symptoms, 34.47 percent accurately diagnosed gingivitis, 39.82 percent severe periodontitis,
and 48.43 percent oral candidiasis. There were no significant differences between attitude scores
by gender. The results showed the overall mean attitude score was 50.91 % (passive attitudes;
50.95 % for males and 50.86 % for females), with the following distribution: 35.8 % positive,
61.8 % passive, and 2.6 % negative attitudes. In other words, only 2.6 % had professional
attitudesThe attitudes score fell between 0 to 80. The statements "It is my right to know if my
patients are HIV positive" and "Treating HIV/AIDS patients means wasting national resources"
received greater favorable and negative attitude scores, respectively. Regarding gender, there
were no statistically significant differences (p-value > 0.05) in attitude scores. The Pearson
correlation coefficient showed that students' attitudes toward HIV/AIDS patients were more
positive when they scored higher on knowledge (r=0.257, p<0.0005). Our research revealed a
strong relationship (r=0.368, p<0.0005) between the students basic knowledge level and school
year. It means that the more advanced students had a higher basic knowledge (p<0.0005). (13)

Another cross-sectional questionnaire-based study was conducted by Alali FM et. al. in July of
2022 and they determined that (66.4%) of the participants were males, and (54.3%) were
preclinical, including first, second, and third year they also included clinical years (32.1%) and
internship (13.6%), (71%) of the respondents age was found to be between 18-24. The results
showed that the overall knowledge of the dental students regarding safety related to HIV was
39.5%, There were no statistically significant differences seen in the knowledge of HIV tests
following needle stick injuries between male and female dental students or among dental
students from different study levels (p > 0.05). Similarly, when it came to the three study levels
and the transmission of the virus through aerosols of hand parts, cardiopulmonary resuscitation,
or saliva, there were no significant statistical differences (p > 0.05). Notably, students in the
clinical level had the highest percentage of correct answers (43.1%) for the transmission of HIV
through saliva and cardiopulmonary resuscitation (42.3%), while dental intern students had the

VII
highest percentage of correct answers (32.7%) for the potential transmission of HIV through
hand piece aerosols.When asked about the validity of ELISA tests in the detection HIV infection,
the intern students significantly showed the best level of knowledge compared to clinical and
preclinical students. Likewise, female dental students showed a higher correct response level
(59.6%) compared to male students (42.8%) regarding ELISA as a trusted test for HIV infection
(p < 0.05). Additionally, female students exhibited better knowledge (44.9%) compared to male
students (33.8%) regarding transmission of the HIV through cardiopulmonary resuscitation (p <
0.05). The results also revealed clear association between study level and attitude-related
questions with the preclinical dental students showing a less positive attitude towards treatment
of HIV patients compared to clinical and internship students (p < 0.05) Moreover, attitudes of
female students were more positive regarding the following statements: it is an ethical issue for
an HIV-positive patient to be treated by a dentist, infection control procedures are very important
for the treatment of HIV patients and take a long time and may affect the work quality of the
dentist, routine dental care should be a part of the treatment of patients with HIV and the dentist
can make a decision to refuse to treat an HIV-positive patient (p < 0.05). However, no significant
difference was identified between male and female students regarding the acceptance to treat
HIV-positive patients, and all dental patients must be treated even if they have HIV/AIDS (p >
0.05) (14)

Abiadh AAS et. al. on October of 2022 in Saudi Arabia conducted a cross-sectional survey in
Um Al Qura university and determined that the response rate to the electronic survey was 65%.
More than 90% of the participating students correctly responded to the following items: needle
stick injury can transmit HIV, HIV/AIDS can infect dental workers, and medical workers had a
higher risk for cross-infection. More than 80% of the students correctly answered the questions
about diagnosing HIV/AIDS with oral manifestations, hepatitis B being more communicable
than HIV/AIDS, and enzyme-linked immunosorbent assay (ELISA) being a screening tool for
HIV. More than 60% of the participants knew about the meaning of a negative HIV test, saliva
being a vehicle for transmission of AIDS, infection control measures, and the presence of large
quantities of HIV in the saliva of HIV/AIDS patients. About 54% of the students correctly
answered the question for definitive testing for HIV/AIDS. The lowest correct response, about
44%, was for sterilization methods. more than half of the students (62%) strongly disagreed or

VIII
disagreed with the statement ‘Treatment of HIV/AIDS patients means wasting national
resources. About 64.81% of the participating students considered dental patients as potentially
infectious. Only 5% of the students were willing to discontinue their friendship with an HIV-
positive acquaintance. Approximately 70% of responders agreed or strongly agreed that
HIV/AIDS patients contributed to community health. A little more than or around one-third of
the subjects had a neutral opinion on the following: treating HIV/AIDS patients in a separate
ward, moral responsibility to treat HIV/AIDS patients, obligation to treat HIV/AIDS patients,
HIV/AIDS patients can live normal lives, being safe when treating HIV/AIDS patients, treating
HIV/AIDS patients, and performing cardiopulmonary resuscitation (CPR) for HIV/AIDS
patients. Only 39% agreed or strongly agreed that they had appropriate knowledge to manage
HIV/AIDS patients.The mean (standard deviation) for the total knowledge questions was 8.32
(1.60); the maximum possible score was 12. The mean was not significantly different (P-value =
0.13) between males (mean = 8.16 ± 1.66) and females (mean = 8.5 ± 1.53). Also, there was no
significant difference (P-value = 0.175) between pre-clinical (mean = 8.52 ± 1.66) and clinical
(mean = 8.21 ± 1.56) years. The mean (SD) score for the total attitude questions was 45.37
(7.02). Female students (mean score = 46.27) had slightly more favorable attitude (P-value =
0.05) toward HIV/AIDS than male students (mean = 44.4 ± 7.02). Students at the clinical years
(mean score = 46.6 ± 7.38) had more favorable attitudes (P-value = 0.0006) toward HIV/AIDS
patients compared to students who did not treat patients at the clinics (mean = 43.23 ± 5.78) (15)

In Sudan in 2020 a cross-sectional survey was conducted by Elsheikh NMA et. al. to asses final
year dental students’ perception and practice of professionalism and ethical attitude in ten
Sudanese dental schools and they concluded that the distribution of students according to their
state origin is almost equal between public and private (51% vs. 49%). However, students from
Khartoum State are more likely to attend private schools (60%) than students from other states;
this difference is statistically significant (P value 0.01). This could be explained by Khartoum
citizens' socioeconomic standing, as well as the fact that the majority of private dental schools
are in Khartoum State. It is worth noting that the response rate for each question in the
questionnaire was not consistent; so, we included those items having a response rate of more
than 80%. This may explain why the total response rate is variables. However, 43.4% and 56.6%
of the dental students in public and private schools, respectively, chose the dental college by

IX
their own will, while 80%% and 19.6%, respectively, by their academic level. This average
interest of the students in dentistry may justify that students who didn't select it by their own will
reflect the low interest and hence little knowledge or attitude (P value 0.00); but still, this
difference has no significant effect on their attendance and academic performance afterward
(P value 0.25). The opinion of the students toward ethics teaching and importance is generally
positive in both public and private schools. Importantly, both private and public Sudanese
dentistry schools include a strong emphasis on ethics in their curriculum. Nonetheless, just 26%
of all students would treat infectious infections themselves, preferring to refer them.All
characteristics analyzed indicate a generally good attitude toward ethical practice in both public
and private schools. Respecting patients' choices, on the other hand, is more advantageous to
public schools (with a significant P value of 0.01), whilst working in teams is more favorable to
private schools. (16)

Another descriptive cross-sectional study was conducted in Egypt, 2019 by Abou El Fadl RK et.
al. conducted a about Assessing the levels of HIV-related knowledge and attitudes toward HIV-
infected patients among undergraduate dental students and found that out of 367 dental students of
both genders who were randomly selected from the third, fourth, and fifth study years, 247 filled
the questionnaire with a response rate of 67.3% and >64% of the respondents were female
students. As reported by 67% of participants, academic lectures were the most frequently used
source of HIV- and AIDS-related information; only 37% denoted that they received information
from the Internet, only 30.5% knew that medical treatment for HIV is available in Egypt and
33.1% of participants correctly responded to the statement “HIV can survive up to 1 hour outside
human tissues” with highly significant differences between the responses of students from the 3
years (P<0.01) >84% of the respondents gave the correct answer to the statement “Infection
control measures to prevent hepatitis C infection can also prevent the transmission of HIV in the
dental setting” and the knowledge of students in year 4 was significantly the highest (P<0.01).
Only 35% of dental students correctly agreed that "the risk for HIV infection after needle stick
injury or after exposure of non-intact skin to HIV-contaminated blood is <0.5%." In year 4, 71%
of students correctly disagreed with the statement "Occupational exposure to saliva in the dental
setting can readily transmit HIV to the dentist;" compared to only 44% in years 3 and 5,
indicating a highly significant difference (P<0.01) in the level of knowledge between

X
respondents of the three academic years.. The difference in the level of dental students’
knowledge regarding some HIV-related oral manifestations was highly significant (P<0.01),
such that those in the third year were the least knowledgeable that oral conditions such as Kaposi
sarcoma (20%), non-Hodgkin’s lymphoma (8.8%), hairy leukoplakia (17.3%), thrombocytopenic
purpura (9.9%), and human papilloma virus (14.8%) could signal HIV infection Using Chi
square test, a highly significant difference was found between the attitudes of students from the 3
academic years when asked about the moral and legal obligation of dentists to treat PLHIV, their
willingness to perform mouth- to-mouth resuscitation, or deliver emergency dental care to those
patients when necessary as well as the obligation of patients to reveal their HIV status to dentists.
The students’ perceptions of their capabilities to identify HIV-related oral lesions and properly
manage infected individuals also varied significantly (P<0.01). On comparing the level of HIV-
related knowledge and attitudes toward treating infected individuals between students in the 3
academic years, a highly significant difference could be observed as Knowledge index, mean ±
SD of 10.37±4.8 for Third year , 13.79±3.8 for Fourth year, 14.09±4.3 for Fifth year, 12.71±4.6
in Total and an Attitude index, mean ± SD of 16.05±3.1 for Third year, 16.31±2.7 for Fourth
year , 13.92±3.4 for Fifth year and 15.48±3.2 in Total with significance at 1% (17)

Katwal D et al. conducted a cross-sectional questionnaire-based study in Nepal in 2019 to assess

the Knowledge, Attitude, and Practice of Dental Students Regarding Treatment of Patients with
HIV or AIDS and discovered that 93.6% of participants believed they should know if the patient
was infected with the human deficiency virus or not. In addition, 37.93% of students wanted all
of their patients to obtain a blood test for HIV. Ninety-six percent of students correctly identified
individuals at high risk of developing AIDS, such as hemophiliacs, homosexuals, bisexuals, and
IV users. They also provided the proper reaction to the sentence 'needle stick can spread HIV'.
Surprisingly, 75.53% of student had incorrect response and said HIV is more communicable than
Hepatitis B and 82% of students stated that there is a lot of HIV in saliva of HIV/AIDS patients.
Respondents differ significantly in their attitude towards dental treatment between HIV- and
HIV+ patients (p<0.05), with dental treatment more likely to be performed for HIV- patients
than the HIV+ patients. The odds ratio of various procedures on HIV- patients ranged from 2.35
for prophylaxis and crowns to 6.84 for extractions. Only knowledge regarding HIV status
affected the likelihood of providing periodontal scaling. It means a percent increase in their

XI
knowledge about HIV increases a likelihood of prophylaxis treatment for HIV+ patients by 1.04.
It also demonstrated that general negative views toward HIV patients have a significant impact
on the likelihood of offering all dental procedures to HIV patients with the exception of
orthodontics. For example, the odds ratio for prophylaxis treatment is 0.27, implying that every
one unit increase in overall negative sentiments reduces the likelihood of prophylactic treatment
(18)
by 0.73.

XII
Chapter 2
Methodology
1. Study design
Cross-sectional questionnaire-based study
2. Study population and sample size:
Sample size will be calculated using the formula
n = [DEFF*Np(1-p)]/ [(d2/Z21-α/2*(N-1)+p*(1-p)] .The total number of participants was found to
be 143. This was implemented into the formula with a confidence level 95%, this leads to a
targeted sample size of 105 participants
3. Data collection:
Data will be collected by self-administered close-end structured standardized questionnaire

4. Inclusion criteria
 3rd,4th and 5th year UMST dental students of UMST

5. Exclusion criteria
 Students who refused to participate in the study

6. Plan for data analysis:

Data will be analysed using statistical package of social sciences (IBM SPSS) by applying the
chi square test

7. Plan of investigation (How?):

The investigation will be carried out using questionnaire and the questions be distributed to
students by using online forms.

XIII
 References:
1. Amira Besbes, Wafa Nasri, Rabaa Nafti, Cyrine Bennasrallah, Knowledge, Attitudes and
Practices about HIV: A Pilot Study among Tunisian Dentists, World Journal of Dentistry,
10.5005/jp-journals-10015-1919, 13, 2, (155-160), (2022).

2. Knowledge and Attitudes towards behavior of HIV/AIDS Patients Management among

Dental Students: Observational Study ( November 6th 2023) by Saleem H et al

3. Knowledge, attitude and practice of medical students towards HIV patients in their pre-
clinical and post clinical years in Karachi, Pakistan: a dual-center cross-sectional study
(2020)
4. Alshouibi E, Alaqil F. HIV-Related Discrimination among Senior Dental Students in
Jeddah. J Int Soc Prev Community Dent. 2019 May-Jun;9(3):219-224. doi:
10.4103/jispcd.JISPCD_420_18. Epub 2019 Jun 7. PMID: 31198692; PMCID:
PMC6559049.

5. Knowledge and Attitudes towards HIV among Makerere University Students. (oct 2022)

6. Wimardhani YS, Ossa YF, Wardhany II, Maharani DA, Lee C. Indonesian Dental
Students' Attitudes, Knowledge, Preparation, and Willingness to Treat HIV/AIDS
Patients. Eur J Dent. 2022 Oct;16(4):867-874. doi: 10.1055/s-0041-1740350. Epub 2022
Jan 6. PMID: 34991164; PMCID: PMC9683872.

7. Alotaibi, S. ., Al hamwi, S. ., Albahli, H. ., Alharbi, F. ., Aldahyan, A. ., & Shenoy, M.

(2023). A comparison between the knowledge and attitude of private and public
universities dental student regarding HIV, Riyadh, Saudi Arabia. International Journal of
Health Sciences, 6(3), 1–12. https://doi.org/10.47941/ijhs.1260

8. Alshouibi E, Alaqil F. HIV-Related Discrimination among Senior Dental Students in

Jeddah. J Int Soc Prev Community Dent. 2019 May-Jun;9(3):219-224. doi:

XIV
 10.4103/jispcd.JISPCD_420_18. Epub 2019 Jun 7. PMID: 31198692; PMCID:
PMC6559049.

9. Shivanna MM, Naik S, Khanagar SB, Divakar DD, Patel II, Al Kheraif AA. Comparison
of knowledge, attitude and concern about HIV/AIDS patients among dental students: A
cross sectional survey. Afr J Reprod Health. 2021 Jun;25(3):113-120. doi:
10.29063/ajrh2021/v25i3.13. PMID: 37585848.

10. Alotaibi, S. ., Al hamwi, S. ., Albahli, H. ., Alharbi, F. ., Aldahyan, A. ., & Shenoy, M.

(2023). A comparison between the knowledge and attitude of private and public
universities dental student regarding HIV, Riyadh, Saudi Arabia. International Journal of
Health Sciences, 6(3), 1–12. https://doi.org/10.47941/ijhs.1260

11. Saleem H, Waly N, Abdelgawad F. Knowledge, Attitude, and Practice (KAP) of post
exposure prophylaxis for fifth year dental students at a private Egyptian university: a
cross-sectional study. BMC Oral Health. 2023 Mar 24;23(1):167. doi: 10.1186/s12903-
023-02890-7. PMID: 36964540; PMCID: PMC10039496.

12. Shakeel S, Iffat W, Naseem S, Nesar S, Rehman H, Yaqoob M, Rehman AU, Barrak I,
Jamshed S, Gajdács M. Healthcare Professionals' Practice of HIV Post-Exposure
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PMC8871552

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exposure prophylaxis for fifth year dental students at a private Egyptian university: a
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023-02890-7. PMID: 36964540; PMCID: PMC10039496.

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Robaian A, Noushad M, Kujan O, Alshehri A, Aljulayfi IS, Nassani MZ. Assessment of

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10.3390/healthcare10081379. PMID: 35893201; PMCID: PMC9330909.

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 Appendices (if any):
Time plan (Gantt chart) (When?):
Dates Feb- April May Jun July August
March 2024 2024 2024 2024 2024
2024
Activity
Research
Administrativ proposal
e Framework development
Proposal
Submission 30th
and
Approval
Data analysis Thesis
and Reporting Writing
Thesis
Submission
Manuscript
finalization

Budget:
Project Phases Total :
Phase 1: Data Collection

Internet connection 16,000

Phase 2: Data analysis

Software 10,000
Phase 3: Thesis and manuscript
Printing and CD Room Soft copy 10,000
Grand total: 36,000

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Informed consent
Please take a moment of your time to complete this questionnaire. It shouldn't take you longer
than 10 minutes to finish it. This information will only be used for research reasons, and its
privacy is guaranteed. Your assistance with this research will be much valued. You have the
choice of agreeing to or declining to take part in this study.

Questionnaire
knowledge
Age
Sex Male
Female
Education Level Semester 7
Semester 9
Semester 10
Which source was most helpful to you in School/ University
learning about HIV? Books
Internet
Friends/ family
HIV/ AIDS can be transmitted to dental Yes
workers? No
I don’t know
Could saliva be a vehicle for HIV Yes
transmission No
I don’t know
HIV/ AIDS can be diagnosed with oral Yes
manifestations? No
I don’t know
The dentist must provide dental treatment for Yes
HIV positive patients? No
I don’t know
Do negative tests indicate that people are Yes
virus free? No
I don’t know
Western blot a specific test for diagnosing Yes
HIV/ AIDS? No

XVIII
 I don’t know
ELISA is a trusted test for HIV Yes
No
I don’t know
HIV can be transmitted through aerosols by Yes
hand piece? No
I don’t know
Kaposi sarcoma is pathognomonic for Yes
HIV/AIDS? No
I don’t know
Lichen planus is an oral manifestation related Yes
to HIV/AIDS No
I don’t know
HIV can remain active in surfaces for days Yes
No
I don’t know
The major cause/ causes for exposure can be: High workload
Shortage of protective barrier
Deficiency of knowledge on standard
precautions
All of the above

Attitude
I would treat all cases (even infectious ones) Strongly Agree
myself up to my knowledge Agree
Somewhat agree
Disagree
Strongly disagree
I would consult/ refer all infectious cases for Strongly Agree
my safety and my staff’s safety Agree
Somewhat agree
Disagree
Strongly disagree
Do you thing that treating an HIV-positive Strongly Agree
patient is a moral and ethical responsibility of Agree
the dentist Somewhat agree
Disagree
Strongly disagree
I will willingly treat a patient if you know Strongly Agree
he/she is HIV-positive Agree

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 Somewhat agree
Disagree
Strongly disagree
HIV/ AIDS patients should be treated as a Strongly Agree
separate ward Agree
Somewhat agree
Disagree
Strongly disagree
You will perform CPR if an HIV/AIDS Strongly Agree
patient needs it Agree
Somewhat agree
Disagree
Strongly disagree
Patients with HIV/AIDS can live in the same Strongly Agree
place with others without infecting them (V) Agree
Somewhat agree
Disagree
Strongly disagree
If you treat an HIV patient, other patients Strongly Agree
would avoid rendering treatment from you Agree
Somewhat agree
Disagree
Strongly disagree
Dealing with staff fears about HIV/AIDS Strongly Agree
could be a potential problem for treating a Agree
patient with HIV/AIDS Somewhat agree
Disagree
Strongly disagree
Infection control procedures for treatment of Strongly Agree
the patients with HIV/AIDS could raise cost Agree
for dental practice Somewhat agree
Disagree
Strongly disagree
Infection control procedures are very Strongly Agree
important for the treatment of HIV patients, Agree
but its time consuming so we shouldn’t Somewhat agree
always follow them Disagree
Strongly disagree
I am confident of safely treating a person with Strongly Agree
HIV infection Agree
Somewhat agree
Disagree

XX
 Strongly disagree
I treat all patients as potentially HIV Strongly Agree
infectious? Agree
Somewhat agree
Disagree
Strongly disagree
Routine dental treatment should be a part of Strongly Agree
the treatment of the patients with HIV Agree
Somewhat agree
Disagree
Strongly disagree

Protocol
The occupational exposure to saliva in the True
dental setting can readily transmit HIV to the I don’t know
dentist False

You should get tested and test your patient True

after every needle stick injury I don’t know
False

In case of a needle stick injury from a Get tested

suspected case of HIV-infected person the Test your patient
first thing you do is Start PEP
Do nothing

In case of a needle stick injury from a known Get tested

case of HIV-infected person the first thing Test your patient
you do is: Start PEP
Do nothing

Needle stick injury has a very high risk of True

disease transmission? I don’t know
False

Anti-retroviral therapy (ART) is used for the True

treatment of both HIV and hepatitis I don’t know
False

Are HIV/AIDS patients at increased risk of True

complications from intra-oral dental There is no significant difference

XXI
procedures as compared with similar patients False
without HIV/AIDS

Project Number: Date of Submission:

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