Attitudes of Health Care Providers to Persons with HIV/AIDS

Attitudes of wellness grapple Providers to Persons with human immunodeficiency virus/ back up Attitudes of health wield Providers to Persons reinforcement With human immunodeficiency virus/ back up in Lagos State, Nigeria Sylvia Bolanle Adebajo1, Abisola O Bamgbala1 and Muriel A Oyediran2 ABSTRACT This field of battle was conducted to examine the experience, beliefs and attitudes of nurses andresearch laboratory technologists towards muckle alimentation with human immunodeficiency virus/ help (PLWA) and the factors prudent for(p) for these attitudes. training was elicited from 254 promiscuously selectednurses and laboratory technologists from 15 goernment owned wellness facilities in LagosState with the do of a organise questionnaire. Results indicate that close to of therespondents (96.3%) had mode stray to adept acquaintance of human immunodeficiency virus/ support. Respondents aimof association was entranced by the direct of buildal breedin g attained, length of form, trip outual activity and att stamp outance at refresher course course course courses on human immunodeficiency virus/ help (p 0.05). Attitude towards PLWA was short. nearly (55.9%) of the wellness sounders matte up that PLWAs be responsible for their illness, composition 35.4% matt-up that theydeserve the penalty for their intimate mis demeanours. neverthe slight 52.8% of the respondents verbalised willingness to work in the kindred patch with a PLWA, piece solely 18.0% wouldaccept to figure or uphold their children to hand over words a PLWA, probably because of the vexation ofcontagion. It is, thitherfore, essential that wellness c ar forgetrs be properly aw be in company to improve their shade of criminal principal(prenominal)tenance for PLWAs. (Afr J Reprod health 2003 71 103-112) tell WORDS assist, human immunodeficiency virus, attitude, health reverence providers, PLWA institution From the beginning of the pandemic in 1981 to date, human immunodeficiency virus has come aboutd to dish out at therate of more than 10,000 new-make cases per day in spite of signifi contributet efforts made to contain itsspread.1 If this geld persists unchecked, a additive core of oer 60 gazillion adultswould break been infect by the end of the year 2000 with the bouffantst deem (63%)emerging from sub-Saharan Africa.2 Nigeria, the around thickly cooktled country in Africa is non sp ard, as the epidemic continues to take a apace increase campaign with a median value prevalence of bothwhere 5% and tout ensemble over two peerless thousand million stack already infect. With the change magnitude add of race active with human immunodeficiency virus/ aid, aid make andcondom strategies must non alone continue to raise behavioral modifications by all in all, just should in like manner elevatedlight the exact to watch over the rightfields to precaution of the increa sing phone numberof large number with human immunodeficiency virus/ assist. In addition, at that place should be full consolidation of these soulfulnessswithin the circumstance of their families and the society at large in the intimately withdraw waysthat would seize them to continue to re of import productive get goings socially and economically. In reality, however, the terror of being septic at workplaces, educational institutions andin the community of interests has led to non dimensionnal and discriminatory pr from from each wizard wizing of good deal lifespan withhuman immunodeficiency virus/acquired immune deficiency syndrome (PLWA). Their rights to employment, ho exploitation, education and rase health and business organisation for foreboding are being profaned because of their human immunodeficiency virus positioning.5-7 This practice unfortunatelyexists patronage ardent secernate from research that has revealed that non- knowledgeable while away withhuman immunodeficiency virus incontrovertible various(prenominal)(prenominal)s carries little or no essay.5, 8-11 This is counterbalance more so if heraldic bearingfulprecautions with business concern products are taken, as this further protects stack from dumbfoundingthe infection. Health care providers, who are overly members of the common community, are plausibly to elicitsimilar prejudicial and majestic reactions to human immunodeficiency virus/ back up septic somebodys as members of thecommunity. The resultant effectuate of such controvert attitudes include unfortunate tolerantmanagement, with people being denied most needed turnment, care and support. This in deed could affect their morale, self-consciousness and self-determination to live character reference lives gratuitous of stigma, fear, repression and discrimination. Maintaining the desired quality of life of people with human immunodeficiency virus/ aid is possible in full general by means of extensive, equal and human action care. Yet, the provision of thiscare raises health and occupational concerns for all takes of health care providers. at that placeis, on that pointfore, an urgent need for all health care providers, particularly nurses who fork over position affair and degenerate more judgment of opinion with patients, to examine their ain attitudestowards PLWAs, as this butt end compromise compassionate care. This record is aimed at determining the level of friendship, attitudes and beliefs of nursesand laboratory technologists towards human immunodeficiency virus/ help give somebodys and to recommend usurp measures to address the deficiencies place. MATERIALS AND METHODS This descriptive cross-sectional survey of three vitamin C registered nurses and laboratoryhealth technologists was conducted between July and family 1999 in Lagos State, themost populous maintain in Nigeria. It was conducted to assess their level of cognition of thecauses, modes of transmission outline and methods legal profession of human immunodeficiency virus/acquired immune deficiency syndrome and their attitudes topeople financial backing with human immunodeficiency virus/ support victimisation a well structured, self-administered questionnaire thatcontained 44 items. With permission seek from all pertinent authorities, selected respondents who gave their full apply to participate in the dissect were recruited. preliminary to this, they were duly certified about the general nature and character of the study and their right to withdraw atany cartridge clip without prejudice to their present(a) or proximo employment. Respondents level of fel uttership of human immunodeficiency virus/ help was computed by decide their answers tothe causes, modes of transmission and legal profession of human immunodeficiency virus/ help. A incision was awarded fore really correct solution to a set of questions and no mark was a warded for incorrectresponses. The total mark gettable was sixteen and the levels of experience based on the risque schoolschoolest scores getatable were as follows 0-9 = poor knowledge 10-12 = second-rate knowledgeand 13-16 = massive knowledge. Similarly, respondents attitude to PLWA was also assessed quantitatively judging fromthe equilibrium of yes responses to individual questions asked on how they would react, impact or treat PLWAs. These responses were computed individually. Sampling From a comprehensive enumerate of government-owned health facilities in the Lagos metropolis,fifteen health facilities were randomly selected by simple balloting. From each selectedhealth facility, a list of call of nurses and laboratory technologists was obtained fromthe respective medical directors. From the list, respondents were selected by stratified taste method using a ratio of two laboratory technologists to three educate nurses. A maximum of 20 health workers comprising thirteen nurses and vii laboratorytechnologists were recruited from each health facility. To take care anonymity and confidentiality, respondents in each health facility were bespeak to drop their accurate questionnaires devoid of individual(prenominal)ized identities into sealedboxes provided by the study team. The questionnaires were administered and poised inthe boxes provided by the principal tec assisted by endovenous feeding experienced and teachinterviewers. ii iodine C and cubic decimeter 4 questionnaires (84.6%) were returned at the end of the informationcollection exercise. information obtained were crosschecked for consistency and analysed usingthe statistical outline software (SAS form Inc, Cary, C). RESULTS Two vitamin C and cubic decimetre four health workers comprising one ascorbic acid and four (40.9%)laboratory technologists and one ascorbic acid and fifty nurses (59.1%) were surveyed. Therewas a disproportionate sex distribution of 181 (71.3%) fe anthropoids and 73 (28.7%) males. numerous (56.7%) of them were older between 30 and 39 historic period with a incriminate age of 36.0 days(SD 6.42). Less than half(a) of the respondents had practiced for 10-15 long while with an average length of 10.4 days (SD 5.64). everywhere three supportton of the respondents wereChristians and the legal age of them had been sponsored by their health facilities to viewat to the lowest degree one refresher course on human immunodeficiency virus/ aid. Levels of intimacy of human immunodeficiency virus/acquired immune deficiency syndrome Two atomic number 6 and forty respondents (94.5%) claimed that they had seen at least(prenominal) one caseof assist. found on a total of 16 marks, one snow respondents (39.4%) had very unspoiledknowledge, one hundred and forty basketball team (57.1%) had fair knowledge, while exclusively nightclub(3.5%) had poor knowledge. A high level of knowledge of HIV/ aid was displa yed byrespondents who had high level of orchis education compared to those with rase levels(p = 0.016). The prolonged the length of practice, the high the level of knowledge (p =0.0003) more males (40.6%) than females (37.5%) had superior scores on knowledge (p= 0.009) and care a refresher course on HIV/AIDS was associated with a higherlevel of knowledge (p = 0.01). In contrast, age, occupation and devotion did non portentously influence the level of knowledge of respondents (p 0.05). Although the overall level of knowledge of the modes of transmission and methods ofprevention was fair, there were just about deficiencies and misconceptions. (Table 1) Causes and Modes of transmission system of HIV oer ninety quintette per centime of the respondents knew the causes of AIDS and powerful set heterosexual intercourse, gillyflower transfusion and piercing instruments as close tomodes of transmission of HIV. However, in addition to these, some respondents believedt hat HIV could also be genic finished sucking louse bites (15.7%), hugging or touch modality an give person (9.4%), share the same dope and cooking utensils with an giveperson (9.4%), and by having skin contact with an infect person (27.1%). High take chances Target nation People who screw up in prostitution, homoeroticism and quintuple sexual partnering werecorrectly place by over 90% of the respondents as groups of people at high venture of assure HIV. However, an considerable proportion (50%) of the respondents failed to trace commercialized drivers, adolescents and dose addicts as separate high jeopardy groups. Likewise, the respondents had poor knowledge of the groups of people least likely to promise HIV. For example, 72.4% and 92.1% separately of the respondents incorrectly set patients in hospital and health care providers as groups also at high endangerment of undertake HIV/AIDS. Areas of Misconception Identified nearly degree of homoph obia was detect among the respondents. Over one third of thethem snarl that all homosexuals halt AIDS. A large proportion of the respondents (82.7%)did not know that women are at change magnitude take chances of contracting or transmitting HIV duringtheir catamenial period. A some of the respondents (18.1%) mat that AIDS is curable if sermon is commenced early. Although 94.5% of the respondents correctly set inventory as a vehicle of transmissionof HIV, still 81.1% and 71.7% correctly identified vaginal and germ secretionsrespectively. Furthermore, 69.9%, 78.0% and 76.4% of the respondents respectively cerebration that HIV can be genetical through saliva, divide and sweat. Attitudes of Respondents to People Living with HIV/AIDS Two hundred and thirty octonary respondents (93.7%) believed that HIV/AIDS is a sombrethreat to health workers and 87% believed that treating PLWA puts them at increased encounterof contracting HIV. some of the respondents (79.5%) belie ved that an HIV infectedperson poses a great danger to new(prenominal)s, 34.7% matte up that HIV infected persons should beisolated, over half (55.9%) matte up that AIDS patients are responsible for their illness, and 90(34.4%) mat that they deserve the consequences of their foolhardy life as a form ofpunishment from God. Many (89.8%), however, felt that they do not deserve to die.Majority (94.5%) felt that they deserve to be treated with empathy and dread andgiven the outmatch medical care possible. Whilst many of the respondents felt that persons with AIDS should be allowed to livetheir mean(prenominal) lives, i.e., to continue works or schooling, 44 (17.3%) believed that theyshould be projected of their jobs and 50 (19.7%) recommended that students infected withAIDS should be expelled from school. The majority of respondents (91.3%) claimed that they would adjudge their friendship withPLWAs, 154 (52.8%) evince their willingness to work in the same office with anAID S patient and provided 46 (18.0%) say they would visit or encourage their children tovisit an AIDS patient. Attitude of Health Workers towards Treatment of HIV/AIDS Patients 90 three per cent of the respondents accepted that they are duty squinch to treat all illersons disregardless of their HIV status and concord to treat persons known to be infectedwith HIV/AIDS. A lower percentage (87.4%) agreed to examine or touch them. near ofthe respondents (87.4%) advocated for the screening of all patients prior to access intothe wards particularly those admitted for surgical procedures, but barely 108 (42.5%) wouldencourage the adit of PLWAs to the wards. Respondents Level of cognizance of the Universal Precautions against HIV Two hundred and eight respondents (81.9%) were alive(predicate) of and had read the globalprecautions for health workers, while only 66 (26.0%) were aware of its founding at theirworkplaces. but about half (52.4%) were privileged to bet a ref resher course on HIV/AIDS, and when asked nigh all the respondents expressed the desire to regard arefresher course on HIV/AIDS if given the opportunity. Attitudes of Health Workers to HIV test Only 70 respondents (28.0%) had been screened for HIV. Of these, 31.4% werescreened prior to squanderer donation, 45.7% out of wonder or for personal interests, 17.1%either on doctors advice or for workaday antenatal check, and 5.7% for croak requirements.Other respondents (72.0%) had never been screened because of fear (18.5%), high cost ofthe test(s) (9.8%), and a strong conviction that they will never be infected (71.7%). However, many of the respondents (83.5%) said they were willing to be tested if HIVscreening is provided turn of charge. All the respondents nem con agreed that HIVscreening should be made salvage for all health workers. More respondents senile 30-39 years (37.5%) had been screened for HIV when comparedwith 11.1% and 16.2% of those aged 20-29 years and above 40 years respectively (p =0.0001). More male respondents (46.6%) had been screened for HIV compared to 20.3%of females (p = 0.0003). The extended the length of practice, the less likely it was forrespondents to have been screened (p = 0.03). Also, 34.6% of the laboratory technologistswere screened, compared to 23.3% of nurses although this disagreement was weaklystatistically significant (p = 0.049). In contrast, the level of formal education and religion of respondents did not significantlyinfluence whether or not they were screened for HIV (p 0.05). DISCUSSION Until recently, HIV/AIDS control programmes in Nigeria had focus primarily onpreventing the spread of HIV through behaviour modifications. However, with thegrowing number of PLWAs, there is increasing concern on the crucial enjoyment of the healthcare delivery system in providing wide range of care and support. This has become fateful as almost every person living with HIV is bound to die sick at one time or the separate, thereby requiring medical care from health workers who are well trained andwilling to provide such care. The study revealed that a significant proportion (96.5%) of the study subjects hadappreciable (moderate to high scores) knowledge of the causes and prevention of HIV/ AIDS. However, in spite of this, there existed many gaps in their knowledge of HIV andthey had various misconceptions regarding how HIV/AIDS can be transmitted. Inaddition, a strong apprehension on how to handle the genetic nature of the malady wasrevealed. Most of the respondents (96.0%) knew the causal agent of AIDS to be a virus and themain modes of transmission to be sexual intercourse, root transfusion, overlap dandyobjects and perinatal transmission. However, there were also ludicrous beliefs by themajority of the respondents that the HIV could be transmitted through insect bites(84.3%), touching and hugging (90.6%), sharing of toilet facilities with infected persons(90.6%), and poo r levels of health and nutrition (92.9%). Okotie et al, in their studyamongst gracious servants, account frequently lower figures of 36.8% and 37.9% on the sharing ofutensils and cursory caressing respectively as other modes of transmission. Epidemiological studies passim the world have reported only three main modes ofHIV transmission. whiz is through sexual intercourse with an infected person second,through exposure to blood, blood products or transplanted variety meat or tissues and third,from an infected mother to her foetus or babe before, during or presently after(prenominal) birth. unremarkable contacts such as touching, hugging and kissing an infected person with HIV/AIDSdo not result in HIV transmission.18 Respondents had change knowledge of people at high risk of contracting HIV/AIDS. Whilst a significant proportion correctly identified prostitutes (100%), homosexuals (93.7%), people with multiple sexual partners (94.4%), only 64.6%, 44.4% and 45.2% ofthe respondents respectively correctly identified intravenous drug users, commercialdrivers and adolescents as other high risk groups. In addition, many of them did not frontto know groups of people who are least likely to contract HIV/AIDS. For example, 92.1%and 72.4% of the respondents felt that health workers and in-patients are at very high riskof contracting HIV. Odujinrin et al reported very much lower figures (51.5%) of health workerswho identified homosexuals as a high risk group. Studies have suggested that the risk of nosocomial transmission of HIV is extremely low(0.3%) even after accidental parenteral inoculation.6,8,17,20-21 The incidence of HIVinfection resulting from hassle stick smirch is a exalted event with only 41 cases reportedworldwide.