Title : Awareness levels and associated factors regarding HIV/AIDS among youth of red ribbon clubs in colleges of Chandigarh, India: A mixed-methods study
Abstract:
Background: Youth aged 15–29 years account for nearly one-third of new HIV infections globally. India's National AIDS Control Programme established Red Ribbon Clubs (RRCs) in colleges to build HIV/AIDS awareness, reduce stigma, and promote safe practices among students. Despite widespread implementation, evidence on the actual awareness levels achieved among RRC members, and the factors shaping this awareness, remains scarce. This study assessed HIV/AIDS-related awareness, attitudes, and risk behaviours among RRC youth in Chandigarh and explored the factors and lived experiences underlying them.
Methods: A concurrent, cross-sectional mixed-methods study was conducted across six randomly selected RRC-affiliated colleges in Chandigarh (three women's, three co-educational). A structured, pretested questionnaire based on the National Behavioural Surveillance Survey was administered to 400 RRC members aged 18 years or older, selected by simple random sampling, covering socio-demographics, HIV/AIDS knowledge, attitudes, and risk behaviour. Concurrently, 12 in-depth interviews with RRC leaders/in-charges and 6 focus group discussions with members were conducted and analysed thematically using MAXQDA. Quantitative associations were tested using chi-square/Fisher-Freeman-Halton tests (SPSS v29.0), with significance set at p<0.05.
Results: Participants were predominantly female (78.5%) and aged 18–19 years (58%). Awareness of basic transmission routes was high: 96.8% knew HIV/AIDS spreads through sexual contact and shared needles, and 81.5% knew it is preventable. However, critical gaps persisted: only 29% were aware of PPTCT and ICTC services, 56% knew of testing facilities, and 11.2% incorrectly believed mosquito bites transmit HIV. While 80.8% would accept an HIV-positive family member, 46.5% were unwilling to share food with an HIV-positive person, reflecting residual stigma; only 2.5% reported engaging in risk behaviours. Awareness of transmission routes, PPTCT, and stigma-related attitudes was significantly associated with age, gender, area of residence, duration of RRC membership, and socioeconomic class (p<0.05). Qualitatively, leaders described peer influence, workshops, and creative campaigns (rallies, poster-making, cyclothons) as key awareness drivers, while stigma, shyness, and resource limitations emerged as major barriers.
Conclusion: RRC membership was associated with substantial foundational HIV/AIDS awareness, but persistent gaps in service-related knowledge and enduring stigma highlight the need for targeted, peer-led interventions addressing PPTCT/ICTC awareness, myth-busting, and stigma reduction. Strengthening RRC activities through digital engagement, structured feedback mechanisms, and earlier school-level introduction could optimise their contribution to India's youth-focused HIV prevention strategy.
Keywords: HIV/AIDS; Red Ribbon Club; Youth Awareness; Stigma; Mixed-Methods; India
