Factors Affecting HIV/AIDS Prevention Behavior in Adolescents

at SMA Negeri 10 Depok in 2022

Fairus Zahrah, Ony Linda and Cornelis Novianus

Public Health Study Program Faculty of Health Sciences, University of Muhammadiyah Prof. Dr. HAMKA

JL. Limau, South Jakarta, Indonesia

Keywords: Knowledge, HIV/AIDS Prevention Behavior, Adolescents.

Abstract: HIV/AIDS prevention behavior is an effort that can be done by adolescents to avoid HIV/AIDS disease. This

study aims factors related to HIV/AIDS prevention behavior in adolescents. Methodology used quantitative

with a cross-sectional. The population in this study was 629 students, samples taken using the Stratified

Sampling sampling technique 294 students with data collection using questionnaires distributed via gform to

respondents in June 2022. Data analysis with univariate, bivariate and multivariate. The results show that

most of the teenagers who had positive HIV/AIDS prevention behaviors were 216 people (73.5%), positive

attitudes of 155 people (52.7%), 168 individuals (57.1%) played a positive peer role in their lives, the part of

parents, who portrayed 221 people (75.2%), and low media exposure of 191 people (65%). In this study,

attitudes (p<0.001), peer roles (p<0.001), parental roles (p<0.001) were obtained, and media exposure

(p<0.001) related to HIV/AIDS prevention behavior. The knowledge (p=0.235) is not related to HIV/AIDS

prevention behavior. The role of parents who play a role is at 3,343 times greater risk of having hiv/aids

prevention behaviors that are positive rather than respondents who have a less parental role. Advice given is

to maintain attitudes.

1 INTRODUCTION

Teenagers are the next generation of the nation. The

development and decline of the country cannot be

separated from the role of the younger generation.

Adolescents are talented people who have great

potential to play a major role in the development of

the country, but sometimes most teenagers have many

problems that reduce their quality of life.

Adolescence is a period of change that is

recognized by changes in physical, emotional, and

psychological conditions. The period of adolescence

is the period in which the workings of the

reproductive organs in adolescents begin to function

very well, which can be called the puberty period. In

the period of adolescence, there are drastic changes in

physical organs (organobiological) and these changes

are not balanced with psychological changes (psycho-

emotional). The occurrence of this big change usually

confuses the teenagers who experience it. Because

puberty is an important part of adolescence, the

emergence of unhealthy sexual impulses can lead to

irresponsible sexual behavior that requires special

attention (Lisnawati & Lestari, 2015).

Behavior according to Priyoto (2015) is an

activity carried out by humans, spontaneously or not.

The definition of behavior in general is an action

taken by all things that live in the world, and based on

the American Encyclopedia, behavior is the behavior

or response of a living thing in the place where it

lives. The Indonesian Ministry of Health defines

behavior as a person's response to something that

makes him do something, consciously or

unconsciously, with a certain frequency, duration,

and purpose. Behavior is easily monitored through

human actions.

Preventive behavior that is carried out on

students is important. Prevention of HIV/AIDS

cannot be separated from adolescents who should

have understood the procedures to avoid HIV/AIDS,

treatment with the aim of avoiding a disease is a form

of behavior that reflects health. Prevention efforts are

a strategic component of eradicating HIV/AIDS in

adolescents (Ministry of Health, RI, 2014). STDs,

such as HIV/AIDS, are more likely to exchange

sexual friends and can be caused by a lack of condom

use among adolescents (Umaroh et al., 2016).

HIV/AIDS is the most dangerous and deadly sexually

Zahrah, F., Linda, O. and Novianus, C.

Factors Affecting HIV/AIDS Prevention Behavior in Adolescents at SMA Negeri 10 Depok in 2022.

DOI: 10.5220/0011643100003608

In Proceedings of the 4th International Conference on Social Determinants of Health (ICSDH 2022), pages 5-12

ISBN: 978-989-758-621-7; ISSN: 2975-8297

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

transmitted disease known to occur most frequently

during adolescence (Kemenkes RI, 2017). This

makes sexual problems, HIV/AIDS and drugs the

main health problems for adolescents in the field of

reproductive health.

HIV/AIDS is a problem in the health sector with

its spread classified as active across regional borders,

causing community problems in this country as well

as in all other countries. This disease affects the

body's organs that regulate antibodies in a person,

lowering the patient's immune system and making

him very vulnerable to various diseases (Kemenkes

RI, 2014).

WHO said in 2016, globally 40% of all cases of

HIV/AIDS occurred in young people aged 15-24

years, with 36.7 million people having HIV (WHO,

2016). It is at this age that young people around the

world are at risk for HIV/AIDS. Therefore, it is

important to carry out an activity to prevent the

occurrence of HIV/AIDS.

The majority of people living with HIV

worldwide live in Africa (25.7 million people),

followed by Southeast Asia with 3.8 million people

and the Americas with 3.5 million people. The lowest

level is the Western Pacific with a population of 1.9

million. The large number of infected humans in the

Southeast Asian region must first be carefully

informed about the spread and transmission of the

virus in Indonesia (UNAIDS, 2019).

Data on cases of HIV/AIDS in Indonesia

continues to grow from year to year. In 2019, cases of

HIV/AIDS that occurred in the 15-24 year age group

in Indonesia were 18.3%. In the last 11 years, the total

number of infected people in this country reached

50,282 in 2019. According to WHO data in 2019, it

was recorded that 78% of the Asia Pacific had new

HIV infections. The highest AIDS incidence rate for

the past 11 years is 12,214 cases in 2013. The five

regions with the highest total number of infections are

Papua, East Java, Central Java, DKI Jakarta, West

Java, with the majority in 2017 occurring in these five

areas. The trend of this disease was highest from 2017

to 2019 and remained the same, especially in the Java

region (Directorate General of P2P, 2019).

The trend of this disease in the Depok area

fluctuated during 2017-2020, it can be seen in Figure

1.1 In 2017-2020, cases of HIV/AIDS that occurred

in Depok City in the 15-24 year age group in

Indonesia were 372 cases in 2017.

2018, 247 cases in 2019, and 220 cases in 2020.

(P3M Section of Depok City Health Office, 2020).

Based on research conducted by Nugrahawati

(2018), it shows that as many as 31 (52.5%)

respondents have positive preventive behavior and 28

(47.5%) respondents have negative preventive

behavior. SMAN 10 Depok is a place to gain

knowledge located in Curug Village, Bojongsari

District. SMA Negeri 10 Depok was established in

2014. SMA Negeri 10 Depok has 629 students. Based

on a preliminary study conducted on 30 students at

SMA Negeri 10 Depok, it was found that 3 students

tried to wear tattoos according to him not to cause this

disease, as many as 17 students avoided someone who

had this disease and had bad speculations to sufferers,

as many as 1 student has ever had sexual intercourse,

as many as 14 students avoid and do not make friends

with sufferers, and as many as 15 students avoid

contact with sufferers worried about being at risk.

From the data obtained, the authors were motivated to

conduct research related to "Factors Influencing

HIV/AIDS Prevention Behavior in Adolescents at

SMA Negeri 10 Depok in 2022".

2 METHOD

The method is based on an analytic observational

design with a cross sectional study where data

collection for the independent variable and the

dependent variable occurs simultaneously. This study

aims to determine HIV/AIDS prevention behavior so

that awareness is realized in preventing risky

behavior in adolescents. Quantitative research aims to

test the theory and show the relationship between

variables and provide statistical descriptions. In

addition, the advantages of cross sectional according

toYani (2019)can explain the relationship between

studied health phenomena and accompanying factors

(especially persistent traits).

The research was conducted at SMA Negeri 10

Depok. The research was conducted from October

2021 to August 2022. The population in this study

were all students of SMA Negeri 10 Depok who were

registered at the SMA, totaling 629 people, consisting

of 315 class X and 314 class XI. Class XII is not made

into the population because with the consideration

that class XII will carry out the final school exam.

According toGaraika and Darmanah

(2019)population is a large area consisting of objects

with differences determined by the researcher for

research purposes. The total population is 629

students.

The sample of this research is some teenagers in

SMA Negeri 10 Depok. The sample is part of the

entire population (Garaika & Darmanah, 2019).

Samples were obtained as many as 294 students. The

list of sample names was obtained by asking the

attendance list for each class to the administration of

SMA Negeri 10 Depok. The sampling technique used

ICSDH 2022 - The International Conference on Social Determinants of Health

in this study is simple random sampling, which is a

simple random selection by doing a

lottery(Notoatmodjo, 2016).

3 RESULT

Table 1: Distribution of Frequency Based on Variables.

Variable Category

Frequency

n %

HIV/AIDS

Prevention

Behavio

Negative 78 26.5

Positive 216 73.5

Knowledge

Not good 128 43.5

Well 166 56.5

Attitude

Negative 139 47.3

Positive 155 52.7

Peer Role

Not good 126 42.9

Well 168 57.1

The role of

parents

No role 73 24.8

play a role 221 75.2

Media

Exposure

Low 191 65.0

Tall 103 35.0

Table 2: Bivariate Analysis Factos Associated with

Preventive Behavior.

Variable

Preventive Behavior

Odds Ratio

(95% CI)

Negative Positive

N % N %

Knowledge

Not good

29 22.7 99 77.3 0.911

***

(0.795-1.044)

Well 49 29.6 117 70.5 1

Attitude

Negative

56 40.3 83 59.7 1,437

(1,236-

1,671)

Positive 22 14.6 133 85.8 1

Peer Role

Not good

52 41.3 74 58.7 1,439*

(1,226-1,689)

Well 26 15.5 142 84.5 1

The role of parents

No role

34 46.6 39 53.4 1,499*

(1,198-1,876)

play a role 44 19.9 177 80.1 1

Media Exposure

Low 67 35.1 124 64.9 1.376*

(1,216-1.557)

Tall 11 10.7 92 89.3 1

Note: *Pvalue <0.001; *** Pvalue >0.05

Table 1 shows that most of the respondents have

positive preventive behavior as many as 216 people

(73.5%), good knowledge as many as 166 people

(56.5%), positive attitudes as many as 155 people

(52.7%), role good peers as many as 168 people

(57.1%), the role of parents as many as 221 people

(75.2%), and low media exposure as many as 191

people (65%). Based on table 2. It shows that there is

a relationship (P-value 0.001) with HIV/AIDS

prevention behavior on the attitude variable (P-value

0.000), the role of peers (P-value 0.000), the role of

parents (P-value 0.000), media exposure (P-value

0.000). Meanwhile, those who showed no

relationship (P-value 0.05) with HIV/AIDS

prevention behavior on the knowledge variable (P-

value 0.235). Based on table 3. It shows that the

variable of the role of parents who play a risky role is

3.343 times greater for having a positive HIV/AIDS

prevention behavior than respondents who have a role

of parents who have less role.

Table 3: Multivariate Analysis Factors associated with

Preventive Behavior.

Variable Odds Ratio (95% CI)

Attitute 2.945** (1.602 – 5.414)

The Role of Peers 2.201** (1.184 – 4.095

The Role of

Parents

3.343* (1,778-6,288)

Media Exposure 3.103** (1.422 – 6.769)

Note: *Pvalue <0.001;** Pvalue <0.05

4 DISCUSSION

Research conducted on adolescents at SMA Negeri

10 Depok showed that there were as many as 78

respondents (26.5%) adolescents at SMA Negeri 10

Depok had negative HIV/AIDS prevention behavior,

while adolescents who had positive preventive

behavior were 216 respondents (73 ,5%). Adolescents

who always apply a clean and healthy lifestyle

(PHBS) have the most positive HIV/AIDS prevention

behaviors as many as 291 people (99.0%).

Adolescents who have positive preventive

behavior are more than those who have negative

preventive behavior. This happens because most of

the teenagers already have good knowledge about the

symptoms of HIV/AIDS, the attitude is not to ignore

positive HIV/AIDS problems, the role of peers by

reminding each other not to have sexual relations

before marriage is good, and the role of other people.

Parents who always remember teenagers not to use

injecting drugs and not to get married under the age

of 20 cause these teenagers to have positive

HIV/AIDS prevention behavior.

Factors Affecting HIV/AIDS Prevention Behavior in Adolescents at SMA Negeri 10 Depok in 2022

This study is in line with the research conducted

by Tampi et al. (2013) showed that as many as 84

respondents (70%) had good preventive behavior in

SMA Manado

International School. According to

research by Kotajin et al. (2020), SMA Negeri 1

Halmahera Utara North Maluku had 173 students

(65.3%) who exhibited good preventative behavior.

Research conducted by Nugrahawati (2018) shows

that 31 people (52.5%) at SMA Negeri 2 Sleman have

positive preventive behavior. This study is not in line

with the research conducted by Lestari et al. (2021)

which shows that respondents who are in RW 15,

Kecapi Sub-District, Harjamukti Sub-district,

Cirebon City mostly have negative preventive

behavior towards HIV/AIDS prevention,

Teenagers in high school are very at risk of

getting HIV/AIDS, if they have negative preventive

behavior. Such as having promiscuity, having sex

outside of marriage, using injection drugs, etc.

Knowledge variable is suspected as one of the factors

related to HIV/AIDS prevention behavior in

adolescents at SMA Negeri 10 Depok. The results of

the univariate analysis showed that 128 respondents

(43.5%) had poor knowledge while 166 respondents

(56.5%) had good knowledge. The results of bivariate

analysis with Chi-Square test showed that there was

no significant relationship between knowledge and

HIV/AIDS prevention behavior (0.235). The results

of the multivariate analysis showed that knowledge

was included in the candidate model (P value 0.184).

Adolescents who have good knowledge already know

AIDS is a collection of symptoms caused by

decreased immunity due to HIV infection, as many as

271 people (92.2%) have positive HIV/AIDS

preventive behaviors.

This study is consistent by Angela et al (2019)

shows the results of statistical tests using the Chi-

Square test obtained a P value of 1,000 so that there

is no significant relationship between knowledge and

student prevention behavior in HIV/AIDS

prevention. Research conducted byErshad

(2014)shows that there is no relationship between

knowledge and HIV/AIDS prevention behavior as

evidenced by the P value = 0.174. Research

conducted byPlantika (2019)shows that there is no

significant relationship between adolescent

knowledge about HIV/AIDS and HIV/AIDS

prevention in adolescents at SMK X Ungaran with a

P value of 0.196 > 0.05. This research is not in line

with research conducted byAisyah and Fitria,

(2019)shows the results of statistical tests using the

Chi-Square test obtained p = 0.000 <a = 0.05 and Ho

is rejected, which means that there is a relationship

between knowledge and efforts to prevent HIV/AIDS

in adolescents at SMA Negeri 1 Montasik, Aceh

Besar District.

This study explains that respondents who have

poor knowledge are not necessarily at risk of having

negative HIV/AIDS prevention behavior. So the

researchers argue that in this case it is not a significant

risk factor, there may be other factors that have a

more significant relationship.

Attitude is a variable to show the respondent's

statement about the subjective behavior that he/she

does either openly or privately in the prevention of

HIV/AIDS. Attitude variable is considered as one of

the factors related to HIV/AIDS prevention behavior

in adolescents at SMA Negeri 10 Depok. Univariate

results showed that 155 people (52.7%) had a positive

attitude and 139 people (47.3%) had a negative

attitude. The results of bivariate analysis with Chi-

Square test showed that there was a significant

relationship between attitudes and HIV/AIDS

prevention behavior with Pvalue (0.000). The results

of the calculation of the Prevalence Ratio (PR) show

that respondents who have a negative attitude are

1.437 times more likely to have negative preventive

behavior than respondents who have a positive

attitude (95% CI 1.236-1.671).

Adolescents who have a disapproving attitude

will be closed (ignorant) to the discussion of

HIV/AIDS issues, namely the most have positive

HIV/AIDS prevention behavior up to 185 individuals

(62.9%). This study supports research done by

Angela et al. (2019), which demonstrates that there is

a relationship between attitudes towards HIV/AIDS

and HIV/AIDS prevention efforts with a p-value of

0.000. Research conducted byAisyah & Fitria

(2019)showed attitude was significantly related to

HIV/AIDS prevention behavior with P value = 0,000.

Research conducted byTulung et al. (2014)shows that

there is a significant relationship between attitudes

and prevention of HIV/AIDS with P value = 0.014.

This research is not in line with the research

conducted byErshad (2014)shows that there is no

relationship between respondents' attitudes and

HIV/AIDS prevention behavior in adolescents in

Kudus Regency can be concluded with (p value =

1.476). This means that attitudes do not have a

significant relationship with HIV/AIDS prevention

measures.

This study explains that respondents who have a

negative attitude are at risk of having negative

HIV/AIDS prevention behavior. So the researcher

argues that in this case it is also a significant risk

factor, because if someone has a negative attitude, he

will carry out negative preventive behavior.

The role of peers is a variable to indicate whether

the respondent has a good peer role relationship at

school, the role of peers is considered as one of the

factors associated with HIV/AIDS prevention

behavior in adolescents at SMA Negeri 10 Depok.

The results of univariate analysis showed that 168

ICSDH 2022 - The International Conference on Social Determinants of Health

people (57.1%) had good peer roles, while 126 people

(42.9%) had poor peer roles. The results of bivariate

analysis with Chi-Square test showed a significant

relationship between the role of peers and HIV/AIDS

prevention behavior with Pvalue (0.000). The results

of the calculation of the Prevalence Ratio (PR) show

that respondents who have poor peer roles have a high

chance of 1, 439 times more likely to have negative

preventive behavior than respondents who had good

peer roles (95% CI 1.226-1.689). The results of the

multivariate analysis showed that the role of peers

was included in the candidate model (P value 0.000).

The role of peers by prohibiting sexual

intercourse before marriage because of the risk of

contracting HIV/AIDS. The highest number of people

who have HIV/AIDS prevention behavior is positive

as many as 275 people (93.5%). This research is in

line with that conducted byMunthe (2016)showing

the role of peers on behavior in the prevention of

HIV/AIDS obtained a P value of 0.029. Therefore,

based on the results of this study there is the influence

of peers on behavior. The same thing in another study

conducted by Manafe et al. (2014) shows a p value of

0.000, therefore p value < 0.05, then H5 is accepted

or there is a relationship between the role of peers and

the prevention of HIV/AIDS infection. Research

conducted bySari (2021)shows that there is a

relationship between peers and HIV/AIDS prevention

behavior in adolescents at SMAN X Pariaman in

2021 with a P value of 0.010.

This study explains that respondents who have a

less favorable peer role are at risk of having negative

HIV/AIDS prevention behavior. So the researcher

argues that in this case it is also a significant risk

factor, because if someone has a bad peer role, he or

she will carry out negative preventive behavior.

The role of parents is a variable to show the

respondent's statement about the role of parents

towards him, the variable of the role of parents is

considered to have a relationship with HIV/AIDS

prevention behavior in adolescents at SMA Negeri 10

Depok. The results of the univariate analysis showed

that there were 221 people (75.2%) who had a

parental role, while 73 people (24.8%) had a non-

parental role. The results of bivariate analysis with

Chi-Square test showed a significant relationship

between the role of parents and HIV/AIDS prevention

behavior with Pvalue (0.000). The results of the

calculation of the Prevalence Ratio (PR) show that

respondents who have the role of parents who do not

play a role have a high chance of 1, 499 times greater

to have negative preventive behavior than

respondents who have a parental role that plays a role

(95% CI 1.198-1.876). The results of the multivariate

analysis showed that the role of parents was included

in the candidate model (P value 0.000).

Parents play a role by always directing to get

married over the age of 20 years, which is the most

positive HIV/AIDS prevention behavior as many as

280 people (95.2%). This study is in line with that

conducted bySari (2021)shows the results of P-value

0.030 where the role of parents has an influence on

behavior in the prevention of HIV/AIDS. Research

conducted bySintia (2017)shows that there is a

significant relationship between the role of parents

with HIV/AIDS prevention behavior with P value =

0.013. This study is not in line with the research

conducted by Endah Yulianingsih (2015) which

showed that the results of the statistical test obtained

p value of 0.092 > 0.05, so it can be concluded that

there is no relationship between the role of parents

and the risk of contracting HIV/AIDS.

This study explains that respondents who have a

parental role who do not play a role are at risk of

having negative HIV/AIDS prevention behavior. So

the researcher argues that in this case it is also a

significant risk factor, because if someone has a

parental role that does not play a role, he will carry

out negative preventive behavior.

Media exposure is a variable to show respondents'

statements about how often they are exposed to

media, media exposure variables are considered to

have a relationship with HIV/AIDS prevention

behavior in adolescents at SMA Negeri 10 Depok.

The results of the univariate analysis showed that

there were 191 people (65%) with low media

exposure, while as many as 103 people (35%) with

high media exposure. The results of bivariate analysis

with Chi-Square test showed a significant

relationship between media exposure and HIV/AIDS

prevention behavior with Pvalue (0.000). The results

of the Prevalence Ratio (PR) calculation show that

respondents who have low media exposure have a

1.376 times greater chance of having negative

preventive behavior than respondents who have high

media exposure (95% CI 1.216-1.557).

Adolescents have low media exposure due to not

keeping leaflets/sheets of paper related to HIV/AIDS,

which is the most negative HIV/AIDS prevention

behavior as many as 258 people (87.8%). This

research is in line with that conducted byManafe et al.

(2014)there is a relationship between information

media and HIV/AIDS prevention in students at SMA

Negeri 4 Manado with a Pvalue of 0.006. Another

study conducted by Endah Yulianingsih (2015)

showed that the results of the statistical test obtained

p value of 0.009 <α 0.05, it can be concluded that

there is a significant relationship between exposure to

information media and the risk of contracting

HIV/AIDS. This research is not in line with the

research conducted bySari (2021)shows that there is

no relationship between media exposure and

Factors Affecting HIV/AIDS Prevention Behavior in Adolescents at SMA Negeri 10 Depok in 2022

HIV/AIDS prevention behavior in adolescents at

SMA NX Pariaman in 2021 with a P value = 0.609.

This study explains that respondents who have

low media exposure are at risk of having negative

HIV/AIDS prevention behavior. So the researcher

argues that in this case it is also a significant risk

factor, because if someone has low media exposure,

he or she will carry out negative preventive behavior.

This study uses multiple logistic regression to see the

most dominant variable with HIV/AIDS prevention

behavior. The dominant variable is obtained from the

largest Odds Ratio (OR) value. The results obtained

for the dominant variable, The role of parents who

play a role is at 3,343 times greater risk of having

hiv/aids prevention behaviors that are positive rather

than respondents who have a less parental role..There

is a significant relationship between the role of

parents and adolescent behavior towards HIV/AIDS

prevention at SMAN X Pariaman in 2021, with a p-

value of 0.030 and an OR of 2.753.(Sari, 2021).

5 CONCLUSION

1. Most of the respondents are morehave positive

preventive behaviour, good knowledge, positive,

good peer roles 168 people (57.1%), 221 people

(75.2%), and 191 people (65%) believe that

parents play a significant influence in their

children's lives. Based on the results of the

bivariate test on 294 adolescents studied, which

showed a relationship (P-value 0.05) with

HIV/AIDS prevention behavior on the variables:

attitude (P-value 0.000), the role of peers (P-value

0.000), the role of parents (P-value 0.000) ), media

exposure (Pvalue 0.000).

2. Based on the results of the bivariate test on 294

adolescents studied, which showed no

relationship (P-value 0.05) with HIV/AIDS

prevention behavior on the knowledge variable

(P-value 0.235).

3. Based on the results of the multivariate test on 294

adolescents studied, which showed the dominant

variable, The role of parents who play a role is at

3,343 times greater risk of having hiv/aids

prevention behaviors that are positive rather than

respondents who have a less parental role.

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