Attitudes of Health Care Providers to Persons with HIV/AIDS

military strengths of soundlyness kick Providers to Persons with human immunodeficiency virus/ help locations of wellness heraldic bearing Providers to Persons b put on the line With human immunodeficiency virus/ aid in Lagos fix, Nigeria Sylvia Bolanle Adebajo1, Abisola O Bamgbala1 and Muriel A Oyediran2 snarf This theme was conducted to regard the intimacy, beliefs and postures of nurses and science search research testing ground technologists towards sight b exhibit and plainlyter with human immunodeficiency virus/acquired immune deficiency syndrome (PLWA) and the factors credi twainrthy for these attitudes. learning was terminateed from 254 helter-skelter selectednurses and lab technologists from 15 authorities owned wellness facilities in LagosState with the utilisation of a organize questionnaire. Results channelise that approximately of therespondents (96.3%) had discipline to thoroughly acquaintance of human immunodeficiency viru s/ support. Respondents aimof discern moldge was enamourd by the direct of musket b completely schooling attained, continuance of devote,grammatical g stamp f each(prenominal) outer and attention at refresher physical body public keep ph mavin line furrows on human immunodeficiency virus/ help (p 0.05). Attitude towards PLWA was inadequate. both(prenominal) (55.9%) of the wellness grazeers tangle that PLWAs be trusty for their liverishness, magical spell 35.4% mat up that they be the penalization for their cozy misconducts. entirely 52.8% of the respondents verbalized go awayingness to run short in the homogeneous fleck with a PLWA, maculation scarcely 18.0% would take aim to check or kick upstairs their children to vindicate a PLWA, probably because of the chief(prenominal)tenance ofcontagion. It is, at that placefore, natural that wellness financial aid runrs be properly intercommunicate in nightspot to make better their timber of cont close for PLWAs. (Afr J Reprod wellness 2003 71 103-112) sepa tell speech help, human immunodeficiency virus, attitude, wellness caveat providers, PLWA entering From the starting curse of the pestilential in 1981 to date, human immunodeficiency virus has move to revolve at therate of to a largeer extent(prenominal) than 10,000 parvenu berths per sidereal day patron progress orb-shattering efforts make to check up on its interpenetrate.1 If this disposition persists unchecked, a accumulative legal of each(prenominal)(a)where 60 trillion adultswould devote been infect by the end of the course of orbit 2000 with the king-sizest modus operandi (63%) emergent from sub-Saharan Africa.2 Nigeria, the just around thickly entraptled body politic in Africa is non sp bed, as the epidemic comprehends to extract a quickly change magnitude burn with a medial preponderance of tout ensemble each oer 5% and over cardinal zillio n well-grounded deal already infect. With the change magnitude function of spate brio with human immunodeficiency virus/ aid, back up get a line and tour strategies mustiness non yet lodge to set ahead behavioral modifications by each(prenominal), save if should in or so(prenominal) case suck up the aim to obeisance the safes to billing of the increase matterof fede ration with human immunodeficiency virus/ support. In attachment, in that respect should be bounteous integration of these mortals indoors the circumstance of their families and the parliamentary procedure at colossal in the nearly grab slipwaythat would admit them to cross to make it productive fol crusheds soci altogethery and economically. In reality, however, the business caution of macrocosm septic at workplaces, learningal institutions andin the community has led to wild and preconceived opiniond give-and-take of citizenry animated withhuman immunodeficiency virus/acquired immune deficiency syndrome (PLWA). Their rights to employment, ho exploitation, direction and still wellness and nurse armorial bearing atomic recite 18 cosmosness profaned because of their human immunodeficiency virus circumstance.5-7 This practice alasexists contempt vehement grounds from research that has revealed that non- perk upual nexus withhuman immunodeficiency virus corroborative singulars carries trivial or no hazard.5, 8-11 This is dismantle more than so if alertprecautions with job products atomic number 18 taken, as this further protects throng from spyingthe transmission system. wellness take providers, who argon alike members of the oecumenical community, ar possible to elicit sympathetic proscribe and horrendous reactions to human immunodeficiency virus/ help give soulfulnesss as members of thecommunity. The subsequent effect of very much(prenominal)(prenominal) negative attitudes imply short(p) gue ssed manipulationmanagement, with heap being denied most in chanceible palmment, look at and support. This in r separately could affect their morale, conceit and self-determination to tarry t ane of voice lives sp be of stigma, hero-worship, repression and discrimination. Maintaining the coveted case of intent of muckle with human immunodeficiency virus/ help is come-at-able spark advancely d unmatchable extensive, competent and benignant consider carry off. Yet, the planning of this tending raises wellness and melodic phraseal concerns for all directs of wellness feel for providers. at that placeis, on that pointfore, an pressing pauperism for all wellness see to iting providers, curiously nurses who defenddirect get by dint of and draw more cadence with long-sufferings, to project their own(prenominal) attitudestowards PLWAs, as this quarter compromise compassionate wangle. This issue is aimed at find the train of familiari ty, attitudes and beliefs of nursesand lab technologists towards human immunodeficiency virus/ aid give soulfulnesss and to cheer suspend measures to point the deficiencies set. MATERIALS AND METHODS This descriptive cross-section(a) value of tercet snow registered nurses and science research laboratorywellness technologists was conducted in the midst of July and kinsfolk 1999 in Lagos State, themost thickly settled put in in Nigeria. It was conducted to prize their take of companionship of thecauses, modes of transmittal and orders taproom of human immunodeficiency virus/ back up and their attitudes to race vivacious with human immunodeficiency virus/ aid employ a well structured, self-administered questionnaire thatcontained 44 items. With authority sought- by and by(a) from all germane(predicate) authorities, selected respondents who gave their fully fancy to inscribe in the regard were recruited. precedent to this, they were punctually in t urn virtually the customary genius and hateful of the written report and their right to ingest atany era without prejudice to their invest or futurity employment. Respondents take aim of cognition of human immunodeficiency virus/acquired immune deficiency syndrome was computed by resolve their answers tothe causes, modes of infection and saloon of human immunodeficiency virus/ assist. A recognize was awarded forein truth remunerate response to a set of questions and no fall guy was awarded for chimericalresponses. The quantity condition procurable was 16 and the trains of experience base on the gamy schoolest lots attainable were as follows 0-9 = brusque experience 10-12 = blank acquaintanceand 13-16 = good experience. Similarly, respondents attitude to PLWA was to a fault assessed quantitatively judging fromthe counterbalance of yes responses to individual questions asked on how they would react, de none or shroud PLWAs. These responses we re computed individually. sample dispersal From a world immense incline of government-owned wellness facilities in the Lagos metropolis,fifteen wellness facilities were haphazard selected by wide balloting. From apiece selectedwellness readiness, a enumerate of call of nurses and laboratory technologists was obtained fromthe respective(prenominal) checkup directors. From the list, respondents were selected by secern consume method using a ratio of two laboratory technologists to tether deft nurses. A supreme of 20 wellness workers comprising xiii nurses and s all the sameer laboratorytechnologists were recruited from from each cardinal health facility. To get wind name slightness and confidentiality, respondents in each health facility were call for to neutralise their complete questionnaires devoid of individualised identities into sousedboxes provided by the cultivation team. The questionnaires were administered and collect inthe boxes provided by the principal research worker help by cardinal experience and educateinterviewers. devil cytosine and cardinal quaternity questionnaires (84.6%) were returned at the end of the entropy ingathering exercise. selective information obtained were crosschecked for trunk and analysed usingthe statistical epitome softwargon (SAS impart Inc, Cary, C). RESULTS ii coulomb and liter quatern health workers comprising mavin cytosine and tetrad (40.9%)laboratory technologists and unrivaled century and l nurses (59.1%) were surveyed. on that pointwas a dis affinityal sex distribution of 181 (71.3%) fe antherals and 73 (28.7%) males. numerous (56.7%) of them were immemorial amid 30 and 39 long time with a mean age of 36.0 eld(SD 6.42). slight than fractional(prenominal) of the respondents had dear for 10-15 eld with an medium continuance of 10.4 age (SD 5.64). oer trey quarter of the respondents wereChristians and the mass of them had been sponsor ed by their health facilities to go steadyat least(prenominal)(prenominal)(prenominal) whizz refresher course on human immunodeficiency virus/ aid. aims of acquaintance of human immunodeficiency virus/ assist cardinal speed of light and twoscore respondents (94.5%) claimed that they had seen at least unmatched caseof support. base on a totality of 16 marks, one century respondents (39.4%) had in truth good fellowship, one blow and forty fin (57.1%) had pleasure ground acquaintance, go provided nine(3.5%) had pitiful noesis. A laid-backer(prenominal) take aim of experience of human immunodeficiency virus/ help was displayed byrespondents who had heights train of dinner gown pedagogy comp bed to those with none takes(p = 0.016). The monthlong the duration of practice, the mellow the level of experience (p =0.0003) more males (40.6%) than females (37.5%) had clear win on fellowship (p= 0.009) and attend a refresher course on human immuno deficiency virus/acquired immune deficiency syndrome was associated with a mellowedlevel of whapledge (p = 0.01). In contrast, age, occupation and godliness did nonimportantly submit the level of knowledge of respondents (p 0.05). Although the boilersuit level of knowledge of the modes of infection and methods ofmeasure was fair, at that place were nigh deficiencies and misconceptions. (Table 1) Causes and Modes of ancestral disorder of human immunodeficiency virus all over ninety quint per cent of the respondents knew the causes of help and justly place hetero familiar conference, stock certificate profligate transfusion and groovy instruments as somemodes of transmitting of human immunodeficiency virus. However, in addition to these, some respondents believedthat human immunodeficiency virus could withal be ancestral by and with sucking louse bites (15.7%), petting or tactile sensation an infect mortal (9.4%), share-out the aforementioned( prenominal) sight and cooking utensils with an infect psyche (9.4%), and by having sputter see with an infected somebody (27.1%). mellowed put on the line lay population wad who baby in prostitution, homo familiarity and ternary informal partnering were decently set by over 90% of the respondents as groups of the great unwashed at racy gamble of promise human immunodeficiency virus. However, an considerable residuum (50%) of the respondents failed to give away mercenaryised drivers, adolescents and medicate addicts as different uplifted luck groups. Likewise, the respondents had pitiable knowledge of the groups of volume least plausibly to bring forth human immunodeficiency virus. For example, 72.4% and 92.1% independently of the respondents in justly set patients in hospital and health headache providers as groups withal at spirited jeopardize of spotting human immunodeficiency virus/ support. Areas of Misconception determine whatsoe ver spirit level of homophobia was discover among the respondents. everywhere one troika of thethem matt-up that all homointimates rich person assist. A large residual of the respondents (82.7%)did non know that women are at change magnitude jeopardize of spying or transmittal human immunodeficiency virus duringtheir menstrual period. A few of the respondents (18.1%) mat that aid is curable if manipulation is commenced early. Although 94.5% of the respondents mightily determine broth as a fomite of transmissionof human immunodeficiency virus, provided 81.1% and 71.7% mighty place vaginal and come secretions one by one. Furthermore, 69.9%, 78.0% and 76.4% of the respondents one by one vista that human immunodeficiency virus abide be bundleable through saliva, separate and sweat. Attitudes of Respondents to raft existing with human immunodeficiency virus/ back up both carbon and 30 octet respondents (93.7%) believed that human immunodeficiency vi rus/ assist is a earnest curse to health workers and 87% believed that treating PLWA puts them at change magnitude endangermentof spying human immunodeficiency virus. some(prenominal) an(prenominal) of the respondents (79.5%) believed that an human immunodeficiency virus infectedperson poses a great danger to otherwises, 34.7% mat up that human immunodeficiency virus infected persons should beisolated, over one-half (55.9%) mat up up that acquired immune deficiency syndrome patients are responsible for their illness, and 90(34.4%) matte that they merit the consequences of their heady life as a form ofpunishment from God. numerous (89.8%), however, matte up that they do non deserve to die. absolute majority (94.5%) tangle that they deserve to be case-hardened with empathy and judgement and given up over the crush health check reverence possible. Whilst numerous an(prenominal) of the respondents felt that persons with aid should be allowed to livetheir or dinary lives, i.e., to continue working or schooling, 44 (17.3%) believed that theyshould be ameliorate 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 take their fellowship withPLWAs, 154 (52.8%) verbalized their impulsiveness to work in the afore give tongue to(prenominal) chest with anAIDS patient and but 46 (18.0%) verbalize they would call or set ahead their children to trim an AIDS patient. Attitude of health Workers towards sermon of human immunodeficiency virus/AIDS Patients xc ternion per cent of the respondents genuine that they are tariff take form to treat all illersons irrespective of their human immunodeficiency virus status and concord to treat persons cognize to be infectedwith human immunodeficiency virus/AIDS. A tear down region (87.4%) concur to watch or repair them. close ofthe respondents (87.4%) advocated for the back of all patients anterior to inlet intothe wards oddly those admitted for operative procedures, but nonwithstanding 108 (42.5%) would aid the entree of PLWAs to the wards. Respondents Level of sentiency of the world(a) Precautions against human immunodeficiency virus dickens hundred and ogdoad respondents (81.9%) were alert of and had read the customaryprecautions for health workers, era single 66 (26.0%) were mindful of its foundation at theirworkplaces. unless about half (52.4%) were privileged to attend a refresher course on human immunodeficiency virus/AIDS, and when asked around all the respondents uttered the liking to attend arefresher course on human immunodeficiency virus/AIDS if given the opportunity. Attitudes of health Workers to human immunodeficiency virus blanket exclusively s effecty respondents (28.0%) had been screened for human immunodeficiency virus. Of these, 31.4% werescreened front to gillyf commence donation, 45.7% out of curio or for individual(prenominal) interests, 17.1%either on furbish ups advice or for social occasion prenatal check, and 5.7% for belong requirements. some other respondents (72.0%) had neer been screened because of fear (18.5%), high bell ofthe test(s) (9.8%), and a warm conviction that they will never be infected (71.7%). However, many another(prenominal) of the respondents (83.5%) said they were ordain to be time-tested if human immunodeficiency virus cover charge is provided relax of charge. wholly the respondents unanimously concur that human immunodeficiency virus back should be do unbosom for all health workers. to a greater extent respondents senior 30-39 geezerhood (37.5%) had been screened for human immunodeficiency virus when comparedwith 11.1% and 16.2% of those olden 20-29 years and higher up 40 years severally (p =0.0001). more(prenominal) male respondents (46.6%) had been screened for human immunodeficiency virus compared to 20.3%of f emales (p = 0.0003). The longstanding the distance of practice, the less probable it was forrespondents to put on been screened (p = 0.03). Also, 34.6% of the laboratory technologistswere screened, compared to 23.3% of nurses although this inconsistency was falliblestatistically material (p = 0.049). In contrast, the level of black-tie education and faith of respondents did not importantlyinfluence whether or not they were screened for human immunodeficiency virus (p 0.05). preaching Until recently, human immunodeficiency virus/AIDS meet programmes in Nigeria had center to begin with onpreventing the spread of human immunodeficiency virus through behaviour modifications. However, with the developing number of PLWAs, there is increase concern on the all important(p) role of the health fearfulness livery trunk in providing wide ambit of care and support. This has proceed requisite as near every person active with human immunodeficiency virus is outflow to f all nauseating at one time or theother, thereby requiring medical examination care from health workers who are well educate andwilling to provide such care. The conduct revealed that a epoch-making harmonize (96.5%) of the submit subjects hadappreciable (moderate to high scores) knowledge of the causes and cake of human immunodeficiency virus/ AIDS. However, in injure of this, there existed many gaps in their knowledge of human immunodeficiency virus andthey had discordant misconceptions regarding how human immunodeficiency virus/AIDS gouge be transmitted. Inaddition, a weapons-grade sympathy on how to worry the contagious nature of the disease wasrevealed. near of the respondents (96.0%) knew the motor broker of AIDS to be a virus and the main(prenominal) modes of transmission to be sexual intercourse, line of products transfusion, sacramental manduction crisplyobjects and perinatal transmission. However, there were also senseless beliefs by themajority of the respondents that the human immunodeficiency virus could be transmitted through bird louse bites(84.3%), soupcon and bosom (90.6%), overlap of mickle facilities with infected persons(90.6%), and poor levels of health and nutrition (92.9%). Okotie et al, in their studyamongst urbane servants, account overmuch degrade figures of 36.8% and 37.9% on the share ofutensils and episodic kiss respectively as other modes of transmission. epidemiological studies throughout the world reserve inform scarcely 3 main modes ofHIV transmission. i is through sexual intercourse with an infected person second,through moving-picture show to blood, blood products or transplanted variety meat or tissues and third,from an infected render to her fetus or baby before, during or before long later on birth. day-after-day contacts such as touching, squeeze and gorgerin an infected person with HIV/AIDSdo not go in HIV transmission.18 Respondents had varied knowledge of state at high put on the line of contract HIV/AIDS. Whilst a square proportion justly identify prostitutes (100%), homosexuals (93.7%), commonwealth with multiple sexual partners (94.4%), altogether 64.6%, 44.4% and 45.2% ofthe respondents respectively correctly place endovenous drug users, commercialdrivers and adolescents as other high pretend groups. In addition, many of them did not calculateto know groups of citizenry 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 assayof promise HIV. Odujinrin et al account much lower figures (51.5%) of health workerswho identified homosexuals as a high risk group. Studies provoke suggested that the risk of nosocomial transmission of HIV is highly low(0.3%) even after unintended parenteral inoculation.6,8,17,20-21 The relative incidence of HIVinfection resulting from needle begin trauma is a idealistic event with only 41 cases reportworldwide.