HIV/AIDS Knowledge and Attitudes Scales for Teachers

Abstract

The HIV/AIDS Knowledge and Attitudes Scales for Teachers are a set of psychometric instruments designed to assess the level of factual knowledge and the affective attitudes of educators regarding HIV/AIDS disease and its implications for the school environment. These scales were developed by Patricia Barthalow Koch and Maureen D. Singer to address the critical need for qualified and comfortable educators capable of providing mandated HIV/AIDS education.

The instrument set comprises two main scales: the HIV/AIDS Knowledge Scale (35 items) and the HIV/AIDS Attitudes Scale (25 items). The Knowledge Scale is further divided into a General Knowledge section (18 true-false items covering disease process, symptoms, and treatment) and a Likelihood of Transmission section (17 items using a 6-point scale). The Attitudes Scale uses a 5-point Likert-type scale to gauge respondents’ viewpoints on persons with HIV/AIDS (PLWHA), discrimination, civil rights, and educational responsibilities. The scales are applicable for use with preservice students, in-service teachers, and related school professionals, such as counselors, to inform and structure effective professional development programs.

Keywords

HIV/AIDS, knowledge scale, attitude scale, teachers, school counselors, preservice education, transmission, Likert scale, psychometrics.

Authors

Patricia Barthalow Koch, Maureen D. Singer

Purpose

The primary purpose of the HIV/AIDS Knowledge and Attitudes Scales for Teachers is to serve as measurement instruments for determining the preparedness of school professionals to address the challenges posed by the HIV/AIDS epidemic within educational settings. Given the increasing prevalence of HIV among young people, and the corresponding mandate for comprehensive education, researchers sought a reliable tool to identify deficits in educators’ understanding and potential biases in their attitudes.

Specifically, the scales aim to determine teachers’ basic factual knowledge concerning the cause, transmission, and prevalence of HIV/AIDS, as well as their comfort level and support for implementing related educational curricula. The resulting data are crucial for designing targeted college programs and in-service workshops intended to prepare more effective AIDS educators and ensure a supportive and non-discriminatory school environment for students affected by the disease.

Construct

The scales measure two distinct but related psychological constructs essential for effective teaching and professional conduct regarding public health issues in schools.

The first construct, Knowledge, assesses the respondent’s cognitive understanding of the Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). This includes both general medical facts (disease process, diagnosis, treatment) and practical, context-specific knowledge related to the likelihood of transmission in various common scenarios, thereby addressing common misconceptions and fears.

The second construct, Attitudes, measures the respondent’s affective and behavioral orientation toward HIV/AIDS and affected individuals. This includes dimensions such as perceived personal risk, support for anti-discrimination laws, views on confidentiality, comfort levels with teaching the topic, and opinions regarding the inclusion of HIV-positive students and teachers in the regular school environment. The scoring methodology reflects a continuum from unsupportive to highly supportive attitudes.

Validity

The validity of the HIV/AIDS Knowledge and Attitude Scales for Teachers was primarily established through rigorous content validation procedures during development.

Items and/or format were adapted from several established and authoritative instruments, including the National Health Interview Survey (Hardy, 1989), the Nurses’ Attitudes About AIDS Scale (Preston, Young, Koch, & Forti, 1995), and a prior instrument used with preservice elementary education teachers (Ballard, White, & Glascoff, 1990). The scales thus demonstrate strong foundational links to accepted measures in public health and education.

Furthermore, a panel of three experts specializing in HIV/AIDS disease and education reviewed the items and correct answers for relevancy and factual accuracy. This expert review was conducted during the initial development phase and has been maintained at 5-year intervals to ensure the continued accuracy and relevance of the content. A pilot test for content validity was also performed using 10 elementary education majors. Researchers recommend that further testing be conducted to establish construct validity across different groups of education majors, student teachers, and educators from various subject areas and school levels.

Reliability

Reliability for both the knowledge and attitudes scales was established using two psychometric methods, based on data collected by Singer (1991).

First, test-retest reliability was assessed using a sample of 59 elementary education majors. The results yielded strong Pearson product-moment correlations: .87 for the Knowledge Scale and .89 for the Attitudes Scale, indicating high stability over time.

Second, internal consistency reliability was evaluated using a sample of 128 elementary education student teachers. For the Knowledge Scale, the overall reliability, measured using the Kuder-Richardson’s statistic, was .89. The sub-sections demonstrated strong internal consistency as well: .78 for the General Knowledge section and .88 for the Likelihood of Transmission section. For the Attitude Scale, internal reliability was calculated using Cronbach’s alpha coefficient, yielding a high value of .89. Researchers suggest that reliability studies should be replicated and extended to include educators from diverse content areas and across elementary, intermediate, and high school levels.

Factor Analysis

The original source content does not provide specific details regarding a formal factor analysis conducted on the HIV/AIDS Knowledge and Attitudes Scales for Teachers.

Instrument

Test Type: Psychometric Scale (Knowledge and Attitude Assessment)

Format: The instrument consists of two scales: the Knowledge Scale (35 items) utilizing True/False and 6-point Likelihood scales, and the Attitudes Scale (25 items) utilizing a 5-point Likert-type scale (Strongly Agree to Strongly Disagree).

Language Available: English (Original development language).

Population Group: Educators and related school professionals, including preservice education students, in-service teachers, and school counselors.

Age Group: Adult

Population Details: The scales are applicable to professionals working across all school levels: elementary, intermediate, and high school. Initial validation studies focused on elementary education majors and preservice/in-service school counselors.

Test Methodology: Self-report questionnaire. The Knowledge Scale requires approximately 20 minutes to complete, and the Attitudes Scale requires approximately 10 to 15 minutes, resulting in a total administration time of roughly 30 to 35 minutes.

Keywords

Psychological scale, public health, education, AIDS, professional development, school policy, psychometrics, knowledge assessment.

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: [email protected] (Patricia Barthalow Koch)

Correspondence Address: Patricia Barthalow Koch, Department of Biobehavioral Health, The Pennsylvania State University, 304B Health and Human Development Building East, University Park, PA 16802.

Permissions & Fee and Test Year

Test Year: Circa 1991 (Based on initial validation research by Singer).

Permissions and Fee: Information regarding current usage permissions and associated fees is not provided in the source material. Correspondence should be addressed to the primary author for current access policies.

Reference’s

Ballard, D., White, D., & Glascoff, M. (1990). HIV/AIDS education for preservice elementary teachers. Journal of School Health, 60, 262– 269.

Boscarino, J. A., & DiClemente, R. J. (1996). AIDS knowledge, teaching comfort, and support for AIDS education among school teachers: A statewide study. AIDS Education and Prevention, 8, 267–277.

Brucker, B. W., & Hall, W. H. (1996). Teachers’ attitudes toward HIV/AIDS: An American national assessment. Early Child Development and Care, 115, 85–98.

Centers for Disease Control and Prevention. (2007). Cases of HIV infection and AIDS in the United States and dependent areas. HIV/AIDS Surveillance Report, 19, 1–63.

Costin, A. C., Page, B. J., Pietrzak, D. R., Kerr, D. L., & Symons, C. W. (2002). HIV/AIDS knowledge and beliefs among pre-service and in-service school counselors. Professional School Counseling, 6(1), 79–86.

Dawson, L. J., Chunis, M. L., Smith, D. M., & Carboni, A. A. (2001). The role of academic discipline and gender in high school teachers’ AIDS-related knowledge and attitudes. Journal of School Health, 71(1), 3–8.

di Mauro, D. (1989–1990, December/January). Sexuality education 1990: A review of state sexuality and AIDS education curricula. SIECUS Report, 18(2), 1–9.

Hardy, A. M. (1989). AIDS knowledge and attitudes for April-June 1989. Provisional data from the National Health Interview Survey. (Advance Data from Vital and Health Statistics, No. 179.) (DHHS Publication No. PHS 90-1250.) Hyattsville, MD: National Center for Health Statistics.

Kistner, J., Eberstein, I. W., Guadagno, D., Sly, D., Sittig, L., Foster, K., et al. (1997). Children’s AIDS-related knowledge and attitudes: Variations by grade, race, gender, socioeconomic status, and size of community. AIDS Education and Prevention, 9, 285–298.

Landau, S., Pryor, J. B., & Haefli, K. (1995). Pediatric HIV: School-based sequelae and curricular interventions for prevention and social acceptance. School Psychology Review, 24, 213–229.

Preston, D. B., Young, E. W., Koch, P. B., & Forti, E. M. (1995). The Nurses’ Attitudes About AIDS Scale (NAAS): Development and psychometric analysis. AIDS Education and Prevention, 7, 443–454.

Singer, M. D. (1991). Elementary student teachers’ knowledge and attitudes of HIV/AIDS and HIV/AIDS education. Unpublished thesis, Pennsylvania State University, University Park, PA.

Steitz, J. A., & Munn, J. A. (1993). Adolescents and AIDS: Knowledge and attitude. Adolescence, 28(111), 609–619.

Items of the HIV/AIDS Knowledge and Attitudes Scales for Teachers

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

HIV/AIDS Knowledge Scale for Teachers

Please indicate, to the best of your knowledge, if the following statements are true (1) or false (2) by circling a number from the scale for your answer. If you are not sure of the correct answer, circle 3.

1 = True 2 = False 3 = Not Sure

1. AIDS is an infectious disease caused by a bacteria. a

2. AIDS breaks down the body’s immunity by destroying the B cells in the endocrine system.

3. AIDS can damage the brain.

4. It may be more than 5 years before an HIV-infected person develops AIDS.

5. HIV lives and functions in warm, moist environments for days outside of the body.

6. Early symptoms of HIV infection include fatigue, fever, weight loss, and swelling of the lymph nodes.

7. A person who has tested negatively on one HIV antibody blood test could still transmit HIV to a sexual partner.

8. The number of HIV-infected persons will be decreasing during the next two years.

9. Two common disorders found in persons with AIDS are pneumocystis carinii pneumonia and Kaposi’s sarcoma.

10. Latex condoms are not as effective as “lambskin” or natural membrane condoms in preventing the spread of HIV.

11. Drugs can be used to slow down the rate of reproduction of HIV and lengthen the life of an infected person.

12. It is possible to detect HIV antibodies in the bloodstream immediately after becoming infected.

13. There is a vaccine available in Europe that can protect a person from getting AIDS.

14. There have been no cases of AIDS spread by students to their teachers or classmates through usual daily contact.

15. In recent years, adolescents are among the groups with the largest increase of HIV infection.

16. Less than one-half of the states have mandated that AIDS education be included in their schools’ curricula.

17. There is a federal law that protects children with HIV or AIDS from educational discrimination.

18. There is no cure for AIDS at the present time.

    To what degree do you think the following are likely to transmit HIV? Please use the numbers from the scale for your answers.

    1 = Very Likely	2 = Somewhat Likely	3 = Somewhat Unlikely
    4 = Very Unlikely	5 = Definitely Not Possible	6 = Don’t Know

19. Working near someone with AIDS.

20. HIV-infected mother to baby during pregnancy/birth.

21. Kissing someone who has AIDS.

22. Eating in a restaurant where the cook has AIDS.

23. Receiving a blood transfusion.

24. Sharing plates, forks, or glasses with someone who has AIDS.

25. Living with a person who has AIDS (without sexual involvement).

26. Donating blood.

27. Sharing needles for drug use with someone who has AIDS.

    How likely do you think the following situations are in transmitting HIV? Please use the numbers from the scale for your answers.

    1 = Very Likely	2 = Somewhat Likely	3 = Somewhat Unlikely
    4 = Very Unlikely	5 = Definitely Not Possible	6 = Don’t Know

28. Mosquito bites.

29. HIV-infected mother to baby through nursing.

30. Receiving anal intercourse from an HIV-infected person without using a condom.

31. Receiving anal intercourse from an HIV-infected person with using a condom.

32. Having sexual intercourse with an HIV-infected person without using a condom.

33. Having sexual intercourse with an HIV-infected person with using a condom.

34. Performing oral sex on an HIV-infected man without using a condom.

35. Performing oral sex on an HIV-infected woman using a dental dam.

HIV/AIDS Attitudes Scale for Teachers

The following statements reflect attitudes about HIV and AIDS. Circle the number that best describes your reactions to each statement.

1 = Strongly Agree 2 = Agree 3 = Uncertain 4 = Disagree 5 = Strongly Disagree

1. I believe I have enough information about HIV/AIDS to protect myself in my social life.a

2. I worry about possible casual contact with a person with AIDS.

3. Activities that spread HIV, such as some forms of sexual behavior, should be illegal.

4. I feel uncomfortable when coming in contact with gay men because of the risk that they may have AIDS.

5. I believe I have enough information about HIV/AIDS to protect myself in my future work setting.

6. Persons with AIDS are responsible for getting their illness.

7. Civil rights laws should be enacted/enforced to protect people with AIDS from job and housing discrimination.

8. Male homosexuality is obscene and vulgar.

9. HIV antibody blood test results should be confidential to avoid discrimination against people with positive results.

10. I feel that more time should be spent teaching future teachers about HIV/AIDS in their college courses.

11. I feel disgusted when I consider the state of sinfulness of male homosexuality.

12. I would quit my job before I would work with someone who has AIDS.

13. People should not blame the homosexual community for the spread of AIDS in the U.S.

14. AIDS is a punishment for immoral behavior.

15. I feel secure that I have reduced all risks of personally contracting HIV.

16. I think all children should be tested for HIV before entering school.

17. I believe it is the regular elementary classroom teacher’s responsibility to teach AIDS education.

18. In my opinion, parents of all students in the class should be notified if there is a student with HIV or AIDS in the class.

19. I feel that all school personnel who have direct contact with a student with HIV or AIDS should be notified.

20. I think that students with HIV or AIDS should be allowed to fully participate in the day-to-day activities of the regular classroom.

21. I would support including AIDS education in the curriculum in a school where I was teaching.

22. A teacher with HIV or AIDS should be allowed to continue teaching.

23. It scares me to think that I may have a student with HIV or AIDS in my classroom.

24. I believe that teachers should have the right to refuse to have students with HIV or AIDS in their classroom.

25. I feel that I could comfortably answer students’ questions about HIV/AIDS.

a The appropriate scale of numbers follows each item in the scale.