Study Design and Study Population
A cross-sectional study was conducted among final-year pharmacy students at Taibah University in Saudi Arabia. The survey was not based on any formal sampling method. Instead, all pharmacy students in their final academic year were invited to participate in an online survey. A link to the questionnaire was shared with the participants via WhatsApp groups for pharmacy students.
During the first semester of the academic year 2022–2023, approximately 170 pharmacy students were in their final year of study. The required target size was determined using the Raosoft sample size calculator [25]. To achieve a 50% response rate, a 95% confidence interval, a 5% margin of error, and a design effect of 1.0, a minimum sample size of 119 was calculated. Taibah University’s College of Pharmacy offers a 5-year bachelor’s programme that spans 15 semesters. In the 4th year of the programme, students learn about managing and treating HIV/AIDS patients in pharmacy practice through the course ‘Infectious Diseases Applied Pharmacotherapy’.
Survey Instrument and Data Collection
With some modifications, a validated self-administered anonymous questionnaire, previously used for the same purpose among Malaysian pharmacy students [17], was adopted to survey the students in this study. The survey was conducted in English using the Google Forms platform and consisted of four sections designed to gather information on students’ demographics, knowledge, attitudes and risk perceptions about HIV/AIDS. The first section collected data on age and gender. The second section comprised 15 questions in a ‘yes’, ‘no’ or ‘I don't know’ format designed to evaluate the student’s knowledge of HIV/AIDS. The third section consisted of five items in a ‘strongly disagree’, ‘disagree’, ‘neutral’, ‘agree’ or ‘strongly agree’ format, aimed at evaluating the student’s overall attitude towards HIV/AIDS. The fourth section had five items presented in a ‘strongly disagree’, ‘disagree’, ‘neutral’, ‘agree’ or ‘strongly agree’ format, which aimed to assess participants' perception of the risk associated with HIV/AIDS.
In the knowledge section, a score of 1 is assigned for each correct response (indicated by ‘yes’), while a score of 0 is given for incorrect answers (indicated by ‘no’ and ‘I do not know’). The student’s overall knowledge score was then categorised using Bloom’s cut-off point from 1968 [26], with a score of 12 to 15 considered good and a score of 9 to 11.9 was moderate, and less than nine was poor.
The attitude and risk perception sections consisted of five items, with a total score of 25. Scores were calculated based on the student’s responses to each statement regarding attitude or risk perception, with a rating of one indicating ‘strongly disagree’ and a rating of five indicating ‘strongly agree’. The total score ranged from 5 to 25, with a high score indicating positive attitudes or high-risk perception [26]. For attitude or risk perception items phrased negatively, scores were re-coded, with five indicating ‘strongly disagree’ and one indicating ‘strongly agree’.
Validity and Reliability of the Study Questionnaire
The questionnaire used in the study underwent a thorough review by three experienced researchers who specialise in the field of infectious diseases. A team of researchers, including two clinical pharmacists and one academic pharmacist, assessed each item’s relevance using a Likert scale that ranged from 1 to 5, with 1 indicating unimportance and five denoting high importance. Any items that were deemed irrelevant by all three researchers were excluded, while those considered relevant or highly relevant were preserved. If there were any ambiguous items, the researchers resolved them through discussion and reached an agreement.
Before conducting the official survey, six pharmacy students were randomly selected to test the questionnaire for clarity and comprehension. However, these students were not included in the final study. The questionnaire was found to be clear, and no changes were necessary. To ensure score stability, the test-retest method was employed. Nine pharmacy students were asked to answer the questions twice, with a short interval of 30 minutes to 1 hour between rounds. Previous studies have shown that acceptable coefficients were set a priori at >80% [27, 28]. Cronbach’s alpha statistics were utilised to evaluate the internal consistency of the study tool, with a range of 0.6 to 0.8 considered acceptable [29].
Statistical Analysis
Before conducting any analysis, we ensured that the collected data was thoroughly checked for completeness and cleanliness. SPSS version 27 was used to analyse the data. For descriptive analysis, we employed measures such as frequency, percentage, mean and standard deviation, while for categorical analysis, we used Pearson’s Chi-Square (χ2) test. We considered a p-value of less than .05 to be statistically significant when comparing the association between variables.
Ethical Approval and Consent to Participate
The students participated in the study voluntarily, without being offered any incentives. The ethical research committee at the College of Pharmacy, Taibah University, granted ethical clearance with the identification number (COPTU-REC-52-20220110). The study was conducted in accordance with the declaration of Helsinki. Prior to enrolling in the study, all participants provided written informed consent and received a briefing on the study’s purpose. Only those who gave their consent were included in the study.