Background: Approximately 2.4 million people presently living in India have HIV/AIDS. Nurses have a vital role in the prevention and treatment of HIV/AIDS; therefore, education of nurses is imperative to manage HIV/AIDS in India. Very little information is available about nurses' knowledge in India. Purpose: The purpose of this study was to examine the effectiveness of a train-the-trainer (TTT) program in improving nurses' knowledge and assessing attitude about HIV/AIDS among nurses employed in three private hospitals in Coimbatore, India. Methodology: The study used a one group pretest, post-test design, and time series at 12-months post-test. The Lead Trainers (LT) were selected from PSG College of Nursing who trained 47 Primary Trainers (PT) for three days. At the next level, the 47 PT trained 848 Secondary Trainers (ST) for two days. A 12-months follow-up post-test was conducted among 471 ST.

Results: The results of the current study revealed that cognitive, transmission, and overall knowledge of HIV/AIDS improved significantly from pre-test to post-test for the original sample of 848 subjects. At the 12-months post-test, the scores decreased significantly from the immediate post-test but were still significantly higher than the pre-test scores for the remaining 471 participants; paired t-test at p<0.001. Nurses from the current study showed a moderately positive attitude about HIV/AIDS patients at 12-months post- test. Nurses' educational qualification had an association in the ANOVA and a predictive relationship in the regression with cognitive, transmission, overall knowledge, and empathy items of attitude of HIV/AIDS in the current study. Discussion: This research once again demonstrated that the TTT program educated a large number of nurses and significantly improved their knowledge of HIV/AIDS in a short time. This study also improved the gap in the knowledge that had not been covered in the nursing curriculum. Education of the nurses, specifically BSN-prepared nurses, had a significantly stronger relationship with knowledge and attitude. However, results also showed that continuing education about HIV/AIDS is important for the nurses in India.