October 17, 2018

Ms. Milavel D. Nazario, Ed.D

President
Zamboanga State College of Marine Sciences and Technology
Fort Pilar, Zamboanga City

Thru:

Mr. Jaime G. Jalon, Ph. D

Vice President, Academic Affairs
Zamboanga State College of Marine Sciences and Technology
Fort Pilar, Zamboanga City

Dear Sir,

Greetings of Peace!

In partial fulfillment of our requirements in our subject, Nursing 516 - Practicum in Nursing
Supervision, we, the graduate students, taking up Masters in Nursing (MN) at Ateneo de Zamboanga
University, would like to ask for your permission to conduct an action research paper entitled,
“Awareness among Senior High School Students on Human Immunodeficiency Virus (HIV) at
Zamboanga State College of Marine Sciences and Technology”. This study aims to determine the
awareness of the respondents towards HIV, since the current trend in HIV infection continues to
rise in number especially to young age.
A survey questionnaires will be provided which are vital and insightful for the actualization of
the paper. Also, might be possible to be a part of the focus group discussion. The step by step
procedure in the study, is primarily intended for researches purposes only. Since this study is
very sensitive and crucial, an informed consent will be asked from the parents and an assent will
be asked from the respondent. The researchers rest assured that all data gathered from you will
be kept in the highest level of confidentiality.
In lieu of this, we would like to ask from your good office, to allow us to gather information, conduct
study, and do the implementation of our paper in your institution. We believe that you are with us in
our enthusiasm in our quest for better knowledge and understanding of the subject matter. Through
your support, we, the undersigned, would be able to finish this paper which then can be beneficial to
our community especially to the health sector to be of better service. We hope for your positive
response on this humble matter.

Thank you very much!

Sincerely yours,

Chazandra Joy H. Pis-an, RN Gay Mary F. Cruz, RN

MN Student MN Student

Noted by:

MS. JOSEPHINE JUDITH P. ALFORTE, RN, MN

Research Adviser

Approved by:

MA. LORNA B. PABER, RN, MAN

Dean, College of Nursing
Ateneo de Zamboanga University
 ASSENT FORM FOR THE RESPONDENTS

TITLE OF RESEARCH: The Awareness toward Human Immunodeficiency Virus (HIV)

among Senior High School Students

INVESTIGATOR: Chazandra Joy H. Pis-an, RN

Gay Mary F. Cruz, RN

The investigators named above are doing a research study.

We are asking you to be in a research study. Research is a way to test new ideas regarding your
awareness on HIV in terms of knowledge, how it can be acquired and how it can be prevented.
Research helps us learn new things as well. Whether or not to be in this research is your choice.
You can say Yes or No. Whatever you decide is OK. We will still take good care of you.
You are being asked to be in the study because the investigators target respondents from the
Senior High School Student. The researchers need to know more about the awareness of the
Senior High School Student regarding HIV, how it can be acquired and how it can be prevented.
If you agree to be in this study, you will
 Have to answer questionnaires concerning HIV infection in terms of:
o Knowledge
o Mode of Transmission
o Prevention

In this study, no tissue and blood sample will be taken from you. There is also no payment
involved. Only your knowledge, thoughts and perception regarding HIV will be needed in the
study. Since the study is very sensitive and crucial, the researchers rest assured that all data
gathered from you will be kept in the highest level of confidentiality.
After visit, someone from the study will ask your parents for an approval that you will be part of
the study through signing a consent form. You will be given a copy of informed consent to be
addressed to your beloved parent.
People may have good things happen to them because they are in a research study. After doing
surveys, the researchers will coordinate with the DOH to provide you a seminar or campaign
towards awareness of HIV on its infection, how to acquire the infection and how to prevent the
infection. It will give you a bigger picture of understanding and wide range on knowledge on
HIV infection after giving the talks. Thus, you could also share your knowledge to the
community and be an instrument of change.
If in case, the respondents will have psychological effect during this study, the researchers will
willingly assist or refer the students to a psychological support.
You do not have to be in the study if you do not want to. The research team would accept if you
don’t want to be part of the study. It is best that you participate in the study voluntarily. Even if
you say yes now, you can change your mind later. It is up to you. It is fine with the team, if you
don’t want to do this. In case, you feel sick or afraid that something is wrong with you during the
survey, tell an adult at once. You do not have to answer any questions that are asked of you.
After participating in the study, the researchers will provide you a simple token as a sign of
appreciation. The team will be highly overwhelmed for being part of their study.
If you have any questions or doubts about this study, you or your parents can call the primary
investigators Ms. Chazandra Joy H. Pis-an, RN (09360535661) or Ms. Gay Mary F. Cruz, RN
(09757171785)

Before deciding if you want to be in the study, ask any questions you have. You can also ask
questions during the time you are in the study.

If you sign your name below, it means that you agree to take part in this research study.

Your Name (Printed) Age

Your Signature Date

Signature of Person Obtaining Consent Date

Signature of Witness Date

 ASSENT FORM FOR THE RESPONDENTS

TITLE OF RESEARCH: The Awareness toward Human Immunodeficiency Virus (HIV)

among Senior High School Students

INVESTIGATOR: Chazandra Joy H. Pis-an, RN

Gay Mary F. Cruz, RN

The investigators named above are doing a research study.

We are asking you to be in a research study. Research is a way to test new ideas regarding your
awareness on HIV in terms of knowledge, how it can be acquired and how it can be prevented.
Research helps us learn new things as well. Whether or not to be in this research is your choice.
You can say Yes or No. Whatever you decide is OK. We will still take good care of you.
You are being asked to be in the study because the investigators target respondents from the
Senior High School Student. The researchers need to know more about the awareness of the
Senior High School Student regarding HIV, how it can be acquired and how it can be prevented.
Also, what are your thoughts on HIV infection.
If you agree to be in this study, you will
 Have to answer one main question with a follow up questions by expressing your own
thoughts verbally concerning HIV infection in terms of:
o Knowledge
o Mode of Transmission
o Prevention

In this study, no tissue and blood sample will be taken from you. There is also no payment
involved. Only your knowledge, thoughts and perception regarding HIV will be needed in the
study. Since the study is very sensitive and crucial, the researchers rest assured that all data
gathered from you will be kept in the highest level of confidentiality.
After visit, someone from the study will ask your parents for an approval that you will be part of
the study through signing a consent form. You will be given a copy of informed consent to be
addressed to your beloved parent.
People may have good things happen to them because they are in a research study. After doing
surveys, the researchers will coordinate with the DOH to provide you a seminar or campaign
towards awareness of HIV on its infection, how to acquire the infection and how to prevent the
infection. It will give you a bigger picture of understanding and wide range on knowledge on
HIV infection after giving the talks. Thus, you could also share your knowledge to the
community and be an instrument of change.
If in case, the respondents will have psychological effect during this study, the researchers will
willingly assist or refer the students to a psychological support.
You do not have to be in the study if you do not want to. The research team would accept if you
don’t want to be part of the study. It is best that you participate in the study voluntarily. Even if
you say yes now, you can change your mind later. It is up to you. It is fine with the team, if you
don’t want to do this. In case, you feel sick or afraid that something is wrong with you during the
survey, tell an adult at once. You do not have to answer any questions that are asked of you.
After participating in the study, the researchers will provide you a simple token as a sign of
appreciation. The team will be highly overwhelmed for being part of their study.
If you have any questions or doubts about this study, you or your parents can call the primary
investigators Ms. Chazandra Joy H. Pis-an, RN (09360535661) or Ms. Gay Mary F. Cruz, RN
(09757171785)

Before deciding if you want to be in the study, ask any questions you have. You can also ask
questions during the time you are in the study.

If you sign your name below, it means that you agree to take part in this research study.

Your Name (Printed) Age

Your Signature Date

Signature of Person Obtaining Consent Date

Signature of Witness Date

 LETTER OF INFORMED CONSENT TO THE PARENTS

DATE: _______________

Dear Parents,

Good Day!
We are graduating students of Ateneo de Zamboanga University, taking up Masters in
Nursing. As a requirement in our subject Nursing 516 - Practicum in Nursing Supervision, are
currently conducting a survey on awareness of Senior High School Students toward
Human Immunodeficiency Virus (HIV). P r es e n t l y, w e a r e d o i n g a study entitled,
“The Awareness of Senior High School Students towards HIV ”. This study aims to determine
the awareness of the respondents towards HIV, since the current trend in HIV infection continues
to rise in number especially to young age.
The respondents will be given a copy of informed consent to be addressed to you, beloved
parent. In this regard, we are asking for your permission and approval so we can include
you/your child in this study by signing this letter of consent.
A survey questionnaires will be provided which are vital and insightful for the actualization of
the paper. Also, might be possible to be a part of the focus group discussion. The step by step
procedure in the study, is primarily intended for researches purposes only. Since this study is
very sensitive and crucial, the researchers rest assured that all data gathered from you will be
kept in the highest level of confidentiality.
Your positive response in this request will be a valuable contribution for the success of the study
and is highly appreciated.
Thank you very much for your cooperation.

Sincerely yours,

Chazandra Joy H. Pis-an, RN Gay Mary F. Cruz, RN

RESEARCHER RESEARCHER
 If you have any questions or doubts about this study, you or your parents can call the
primary investigators Ms. Chazandra Joy H. Pis-an, RN (09360535661) or Ms. Gay Mary F.
Cruz, RN (09757171785)

CONSENT SLIP
_________ I agree that I/my child voluntarily participate in the research study.
_________ I will not allow myself/my child to participate in the research study.

___________________ _____________________
Parent/ Guardian Respondent
Signature over printed name Signature over printed name

Date: _____________
October 17, 2018

Fr. Karel S. San Juan, SJ

President
Ateneo de Zamboanga University
La Purisima, Zamboanga City

Thru:

Mr. Rey S. Reyes

Senior High School Principal
Ateneo de Zamboanga University
La Purisima, Zamboanga City

Dear Sir,

Greetings of Peace!

In partial fulfillment of our requirements in our subject, Nursing 516 - Practicum in Nursing
Supervision, we, the graduate students, taking up Masters in Nursing (MN) at Ateneo de
Zamboanga University. As part of our final requirement in our subject Nursing 516- Practicum in
Nursing Supervision, we are required to accomplish an action research paper. In connection to
this, we wish to conduct a study entitled, “Awareness among Senior High School Students on
Human Immunodeficiency Virus (HIV) at Zamboanga State College of Marine Sciences and
Technology”. This study aims to determine the awareness of the respondents towards HIV, since
the current trend in HIV infection continues to rise in number especially to young age.
In lieu of this, we would like to ask from your good office, to allow us to validate our
questionnaire in your school. Rest assured that the result of the study will be confidential and be
used only for the purpose of the study. Through your support, we, the undersigned, would be able
to finish this paper which then can be beneficial to our community especially to the health sector
to be of better service. We hope for your positive response on this humble matter.

Thank you very much!

Sincerely yours,

Chazandra Joy H. Pis-an, RN Gay Mary F. Cruz, RN

MN Student MN Student
Noted by:

MS. JOSEPHINE JUDITH P. ALFORTE, RN, MN

Research Adviser

Approved by:

MA. LORNA B. PABER, RN, MAN

Dean, College of Nursing
Ateneo de Zamboanga University
 GROUP DISCUSSION FOR STUDENTS

Dear Respondents,

We are graduating students of Ateneo de Zamboanga University, taking up Masters in

Nursing. As a requirement in our subject Nursing 516 - Practicum in Nursing Supervision, are
currently conducting a survey on awareness of Senior High School Students toward
Human Immunodeficiency Virus (HIV). P r es e n t l y, w e a r e d o i n g a study entitled,
“The Awareness of Senior High School Students towards HIV ”. This study aims to determine
the awareness of the respondents towards HIV, since the current trend in HIV infection continues
to rise in number especially to young age.
Since the study is a sensitive topic an assent will be provided by the researchers before
answering the questionnaire. Students who are below 18 years old, an informed consent will be
given to the parents for an approval that their child will be to be part of the study.

There is no right or wrong answers as long as you did it honestly. Rest assured that all your
answers to this questionnaire will be treated with outmost confidentiality. The study will be
solely for research purpose only. The questionnaire will be analyzed comprehensively and
constructively.

Thank you for your kind consideration in participating in the study. Your responses will highly
contribute to our research study.

Sincerely yours,

Ms. Chazandra Joy H. Pis-an, RN

RESEARCHER

Ms. Gay Mary F. Cruz, RN

RESEARCHER
I. SOCIO-DEMOGRAPHIC FACTORS:
Name (optional): ___________________________ Date: ____________
Age: ____
Sex: ____
Grade: _______________
Religion: ________________

INSTRUCTION: Kindly place a check mark in the spaces provided for. Please don’t
hesitate to rate according to your current knowledge. You will have 20
minutes to answer to questionnaire. Confidentiality in this study is fully &
strictly observed.

Weight
TOTALLY AWARE 4
MODERATELY AWARE 3
FAIRLY AGREE 2
SLIGHTLY AWARE 1

Totally Moderately Fairly Slightly

CRITERIA: Aware Aware Aware Aware
4 3 2 1
A. KNOWLEDGE ON HIV
1. HIV infection attacks the immune system of
the infected person.
2. A person is weak, when infected with HIV.
3. There is a difference between Human
Immunodeficiency Virus and Acquired
Immunodeficiency Syndrome.
4. If HIV is not treated, the person will die.
5. Males are more susceptible in having HIV
infection thank females.
6. There is a cure for HIV
B. MODE OF TRANSMISSION ON HIV
1. HIV can be transmitted through using used
needles and syringes (such as needle pricks,
drug users).
2. HIV can be transmitted through infected
blood products.
3. HIV can be transmitted from pregnant mother
to fetus (such as vaginal delivery,
breastfeeding).
4. HIV can be transmitted through unprotected
sex with a person who is infected with HIV.
5. HIV can be transmitted through having many
 sex partners.
6. HIV cannot be transmitted through kissing
with an HIV infected person.
7. HIV cannot be transmitted through hugging
with an HIV infected person.
8. HIV cannot be transmitted through shaking of
Hands with an HIV infected person.
9. HIV cannot be transmitted through sharing
same utensils used by a HIV infected person.
10. HIV cannot be transmitted through talking
with an HIV infected person.
11. HIV cannot be transmitted through breathing
the same air, cough, sneeze
12. HIV cannot be transmitted through swimming
in a pool with an HIV infected person.
13. HIV cannot be transmitted through using
toilet seats.
14. HIV cannot be transmitted through mosquito
bites.
15. HIV cannot be transmitted through tears (such
as comforting someone who is crying).
16. HIV cannot be transmitted through sweat
(such as contact through sports).
17. HIV can be transmitted when a person has a
history of Gonorrhea, Syphilis, Chlamydia.
C. PREVENTION ON HIV
1. HIV can be prevented through using
sterilized/disposable syringes.
2. HIV can be prevented through not having
sexual contact. (Abstinence)
3. HIV can be prevented through the use of
condom.
4. HIV can be prevented through having only
one sexual partners.
5. HIV can be prevented through screening of
blood for transmission
6. HIV can be prevented through seminars
and/or campaigns being conducted by the
government and/or other organizations.
7. Topic on HIV should be included in sexuality
education in school curriculum.
GROUP DISCUSSION
Main Question: What are your thoughts about HIV?

Follow up Questions:

1. What do you think are the modes of transmission of this disease?

2. What do you think are the ways on how a person can acquire HIV?

3. What do you think are the ways of prevention in getting HIV?