The Effectiveness of Health Education in improving HIV/AIDS Knowledge among Low Income People in Pondong Baru Village

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AIDS
(acquired immunodeficiency syndrome) is a symptom of some disease due to the suppression of the immune system by HIV infection 1 . Human immunodeficiency virus (HIV) is a global health problem that has not been addressed until now 2 .
People diagnosed with HIV should be given antiretroviral treatment (ARV) as soon as possible after the diagnosis and periodic monitors use clinical parameters and laboratories, including, measuring the number of viruses (viral load) in the blood via tests, if antiretroviral (ARV) are used it can be used to prevent HIV transmission to others 3 .
Southeast Asia is the secondhighest HIV case after America 2 . The number of HIV infections is increasing in years 4 . Data from The World Health Organization (WHO) 2021 indicates that more than 38,4 million people worldwide diagnosed with HIV and 650.000 people have died from AIDS, but, only 75% of HIV sufferers have accepted the antiretroviral (ARV), so 25% have not received the antiretroviral (ARV) 5 .
Data from The Ministry of Health Data and Information Centre (2020) revealed that the number of HIV cases in Indonesia was high during the last 11 years in 2019, which was 50,282 cases 6  Previous studies claimed that while governments have been trying to lower the HIV/AIDS rate, it is still hampered by acceptance of HIV-related societies 12 . Accepting a society can be influenced by knowledge, proving that public knowledge has poorly to do with HIV/AIDS 13,14 .
Person's level of knowledge is one of the keys to optimum health, and in this context, knowledge about HIV/AIDS is the acquisition of facts and scientific information about symptoms, how if we get contact, bad consequences and HIV/AIDS disease prevention strategies 15 .
Health workers who have a role in informing the public, one of which is midwife, in accordance with The Law 2019 No.4 Article 46, section 1 arranged that a midwife could provide an obstetrics service on female reproductive health 9 . Article 51 of the same laws also stated that a midwife has the right to conduct education, communication, information, and counseling according to the rules 9 .
According to a quick survey of low income people in the Pondong Baru Village, 90% of the people who has minimum wage do not know HIV/AIDS related information. In fact, very few communities have received health education on HIV/AIDS. Furthermore, the level of public education still allows them to receive only information via direct lecture methods. So, researchers feel that health education about HIV/AIDS still needs to be implemented in Pondong Baru Village. Thus, researchers are doing health education in the Pondong Baru Village in partnership with doctors, midwife, and Paser's social services to provide HIV/AIDs information to low income people in this village.  Table.1, a total of 31 respondents' classified individuals based on age groups, education levels, and parity. The most respondents were >40 years of age, coming from primary education, and multipara parity.

Respondents' Knowledge after
Intervention The result was all respondents had upper average knowledge, without under average knowledge.

DISCUSSION
Based on the baseline measurements (before intervention), 54,8% respondents' age >40, 93,5% respondents' had under average knowledge. Understandably, age >40 has a curiosity about something as it enters the productive age, while it also affects one's capture and mindset 16. As it grows older, so will the perception and the mindset, so that the acquired knowledge increases, but as it turns out in this study, 90.3% have less knowledge, so it needs to be increased knowledge.
Knowledge plays a key role in determining intact behavior because it forms trust, providing the basis for decision-making and specifying behavior on specific objects so that knowledge will influence one's behavior 17 . The study is supported by the results of the study Prihantana (2016) that knowledge has a close relationship to the decision he will making as with knowledge a person has a basis for deciding his choices 18 .
The factors that affect knowledge are education, age, employment 9,10 . Increased age has affected how to think and how to capture 11 . The higher the age then the more the capture grows but will decrease in the old age 12 . According to the study, more than 50% of respondents are under the age of >40.
Education is a process of changing attitudes, behavior through individual teaching and good education or group 11,13 . Education influences knowledge, the higher a person receives information the easier it is. With a higher education, a person is more likely to receive information both from others and from the media 19 . According to this study, 74.2% of those who graduated from elementary school and 16.1% of those who did not receive education caused 94.5% had under average knowledge.
Based on Table. 3, all respondents' had upper average knowledge after given health education (after intervention). This result reveal with Notoadmodjo's Theory, change in knowledge especially increase can be demonstrated by changes in individual behavior, family and community as principal objects of enlightment 10 . This theory is supported by studies that the prevention of HIV/AIDS is effective and efficient enough to increase public knowledge, as more and more people are getting information the better one's knowledge 15 .
People who have access to hivrelated information can take precautions, raise awareness about and have access to health insurance, lower risk of HIV infection, transmitting HIV, and, if needed, effectively working on their HIV virus load 16 .
Based on the table. 4, all respondents had high knowledge after receiving health education. One's knowledge can also be influenced and gained through information from TV, radio newspapers and health personnel, for example, by providing health education 19 . Health education is one of the efforts to increase knowledge in communities 20 . Health education can be done in various media, including audiovisual media 21 . Such health education can be done by various methods, including the lecture method, information obtained by the method. It had never been done by local health, when the method of speaking according to studies such as the study done by flora al (2017) was found to be that teaching methods can improve knowledge 20 . So, this health education uses lecture methods with media power point. Selection of these methods and media was adapted to a community in new pondong who was more likely to receive talks from senior health workers in there.
The results of this study on table. 4., suggest that there has been an increase in the scores of knowledge before and after being given health education. Before intervention, the average knowledge score was 0.32. Based on the results of the study it may be known that prior to training, the respondents did not understand HIV and AIDS, the cause, the factor risk and transmitting HIV.
The study is in line with Walriyah (2018) that obtained a knowledge score before intervention was 61.37 and after interventions were 84.54 17 . This proves that health education can increase knowledge in communities 18 . Previous studies also reveal that there is an influence in health education in knowledge of HIV/AIDS, as there is in health education a learning process that can change attitudes from low to better attitudes 22 .
This study and other studies have consistently shown that health education using a lecture could improve respondents' knowledge 21 . The purpose of health education is to achieve changes in the behavior of individuals, families and communities in fostering and maintaining healthy behavior and a healthy environment, and to play an active role in bringing about optimum degrees of health 21 .
The study is supported by the Notoatmodjo Theory that changes in knowledge in particular increase can be explained by changes in individual, family and community behavior as principal objects of health education 10 . Knowledge can be acquired from the senses as well as from the learning and stimulation of health information that either brings a response or a reaction to the learning process 10 .
Knowledge is a solid basis for determining one's actions that is influenced by information from the media as well as by family or friends and health professionals who constantly provide health information 10 . It was one of the efforts to educate nonformal people in order to increase their knowledge particularly about HIV/AIDS 23 .
The limitations of the study is low income people in Pondong Baru Village is the majority had low educational levels and could not read or write, so in the study it needed the help of researchers to read and write answers in the provided questionnaire.
We measure the health education immediately after the last session of interventions, so we cannot determine whether the improvement of knowledge is durable or sustainable. So, for the next study can measure knowledge within a few days following theoretical interventions.

CONCLUSION
This study has found is that health education can turn out to be one way to increase in knowledge of HIV/AIDS in income -based groups low income peopke or those with low levels of education.