The role of HIV knowledge on HIV‐related behaviours: a hierarchical analysis of adults in Trinidad

Stigma and Dissatisfaction of Health Care Personnel in HIV Response in Iran: A Qualitative Study

Background and Aims:

With regard to the disease pandemics of HIV/AIDS, it is clear that there is need for prevention, treatment, care, and support of HIV positive patients in the health care system. In order to achieve these goals, job satisfaction should be a priority for health care staff. This study examined the problems of health care personnel and the behavior of patients undergoing HIV/AIDS counseling at Imam Khomeini Hospital in Tehran, Iran.

Methods:

Interviews were conducted individually with 5 health care personnel who participated in this study. Participants had 30 to 45 minutes each per session at the clinic, during which they were able to discuss the problems they faced in their careers. All conversations were officially recorded.

Results:

The most common problems mentioned by these health care workers included the lack of safety and standardization of work conditions, the lack of appropriate equipment, limited space, high numbers of patients, low staffing levels and financial and morale problems compounded by the lack of support by hospital authorities.

Conclusion:

The authorities need to allocate more funds to provide facilities and appropriate working conditions for health care staff in order to increase job satisfaction and enable staff to provide the best services and care to HIV positive patients.

Perception of Patients With HIV/AIDS From Stigma and Discrimination

Background:

Stigma and discrimination among patients with HIV/AIDS cause various problems for the patients and their health systems.

Objectives:

The purpose of this study was to explain the perceived experiences of the patients from stigma and discrimination and their roles on health-seeking services among patients.

Patients and Methods:

This was a qualitative research using content analysis approach and semi-structured interviews, conducted on patients living with HIV/ADS, during 2013 - 2014 in Iran. Sampling started purposefully and continued in a snowball.

Results:

The experiences of patients with HIV/AIDS from stigma and discrimination led to exploring three main themes and nine subthemes. The main themes were multidimensional stigma, rejection, and insult and discrimination in receiving health services.

Conclusions:

Stigma and discrimination play an important role in patients' lives and hinder them from accessing the treatment. The patients' responses to this event by secrecy strategy can be an important factor in the disease prevalence.

Foundations of life-long sexual health literacy

Purpose

– Sexual education in adolescence may represent the only formal sexual information individuals ever receive. It is unclear whether this early educational experience is sufficient to promote lifelong sexual health literacy. The purpose of this paper is to examine the influence of the timing and source of sexual knowledge on current safe sex knowledge and risky sexual behaviours among middle-aged and older adults in the USA.

Design/methodology/approach

– Participants (n=410, mean age=53.9, 50.7 per cent female) reported whether and when they received sexual knowledge from various sources. They were asked about their current safe sex knowledge and their lifetime sexual risk behaviours.

Findings

– Most of the participants (61.5 per cent) received formal sexual education in adolescence and 20.2 per cent reported formal sexual education post-adolescence. Across the life span, friends were the most common source of sexual information. The sample scored in the upper mid-range on the scale indexing safe sex knowledge (M=6.69, SD=1.64, range=0-8). Participants reported engaging in an average of approximately four (out of 16) risky sexual behaviours across their lifetime. Those with formal sex education in adolescence scored significantly higher on safe sex knowledge. However, they also engaged in more risky sex behaviours.

Originality/value

– This study is among the first to situate the normative, formal sexual education experience of adolescence within a life span context that not only accounts for time, but also multiple sources of influence. It would appear that there are more things to learn about the long-term influence of sexual education programmes during the formative years by studying adult sexual health and knowledge.

Facility and home based HIV Counseling and Testing: a comparative analysis of uptake of services by rural communities in southwestern Uganda

Background

In Uganda, public human immunodeficiency virus (HIV) Voluntary Counseling and Testing (VCT) services are mainly provided through the facility based model, although the home based approach is being promoted as a strategy for improving access to VCT. However the uptake of VCT varies according to service delivery model and is influenced by a number of factors. The aim of this study therefore, was to compare predictors for uptake of facility and home based VCT in a rural context.

Methods

A longitudinal study with cross-sectional investigative phases was conducted at two sites (Rugando and Kabingo) in southwestern Uganda between November 2007 (baseline) and March 2008 (follow up). During the baseline visit, facility based VCT was offered at the main health centre in Rugando while home based VCT was offered at the household level in Kabingo and a mixed survey questionnaire administered to the respondents. The results presented in this paper are derived from only the baseline data.

Results

Nine hundred ninety four (994) respondents were interviewed, of whom 500 received facility based VCT in Rugando and 494 home based VCT in Kabingo during the baseline visit. The respondents had a mean age of 32.2 years (SD 10.9) and were mainly female (68 percent). Clients who received facility based VCT were less likely to be residents of the more rural households (adjusted Odds Ratio (aOR) = 0.14, 95% CI 0.07, 0.22). The clients who received home based VCT were less likely to report having an STI symptom (aOR = 0.63, 95% CI 0.46, 0.86), and more likely to be worried about discrimination if they contracted AIDS (aOR = 1.78, 95% CI 1.22, 2.61).

Conclusion

The uptake of VCT provided through either the facility or home based models is influenced by client characteristics such as proximity to service delivery points, HIV related symptoms, and fear of discrimination in rural Uganda. Interventions that seek to improve uptake of VCT should provide potential clients with both facility and home based VCT options within a given setting. The clients are then able to select a model for VCT that best fits their characteristics. This is likely to have positive implications for both service coverage and uptake by different sub-groups within particular communities.

HIV testing practices among women living in public housing in Puerto Rico

OBJECTIVE

The objective of our study was to examine HIV testing practices among a large sample of women living in public housing in Puerto Rico and the relationships among HIV testing, sociodemographic variables, and HIV-related behaviors.

METHODS

A total of 1138 women were surveyed between April and August 2006 using a self-administered survey instrument.

RESULTS

Eighty-two percent of the women in the sample group reported a history of HIV testing. Hierarchical logistic regression analyses revealed that those adults who were at least 25 years of age and those who perceived some risk of HIV were more likely to report previous HIV testing. Also, those who had attended an HIV/AIDS education workshop or discussion and those who reported knowing persons living with HIV/AIDS were more likely to report previous testing.

CONCLUSIONS

A large percentage of the women in our study have been tested for HIV; it is imperative, however, that appropriate HIV education and prevention messages be given to them when they receive their results. Client-initiated HIV testing to learn HIV status provided through counseling and testing remains critical to the effectiveness of HIV prevention. It is unwise to underestimate the importance of being tested. One of the first steps in self-protection from HIV is to be informed of one's HIV status, which allows one to make appropriate and responsible sexual decisions. Future success in decreasing the number of new infections among women will result from targeting women who may be at high risk, although not because of sex work or drug use. Increasing knowledge of HIV serostatus and the implications of these results, especially among those who are infected, can serve as a gateway to sustained behavioral risk reduction intervention, as well as to care and treatment. Considering the fact that both the actual and estimated numbers of HIV/AIDS cases among women in Puerto Rico continue to increase, it is clear that effective, targeted, and aggressive strategies are urgently needed to prevent both primary and secondary HIV transmission.

HIV testing practices in Jamaica

OBJECTIVES

Prevention programmes often promote HIV testing as one possible strategy for combating the spread of the disease. The objectives of the present study were to examine levels of HIV testing practices in a large sample of Jamaicans and the relationships among HIV testing, sociodemographic variables and HIV-related behaviours.

METHODS

A total of 1800 persons, aged 15-49 years, were surveyed between May and August 2004 using a household-level, interviewer-administered questionnaire. The questionnaire included HIV-related knowledge, attitudinal and behavioural items. For the present analyses, data from 1558 sexually experienced persons were examined.

RESULTS

Approximately 38% of the sexually experienced sample reported a history of HIV testing. Hierarchical logistic regression analyses revealed that adults, females, persons with post-high school education and married persons were more likely to report previous HIV testing. Also, those who had attended an HIV/AIDS education workshop or discussion and those who reported knowing persons living with HIV/AIDS were more likely to report previous testing. However, HIV testing was not associated with condom use or with the number of sexual partners.

CONCLUSIONS

The lack of significant findings establishing a relationship between testing and risky sexual behaviours should not negate the importance of HIV testing. Being informed regarding personal HIV serostatus is one of the first steps in self-protection. Effective messages and programmes promoting HIV testing need to be developed and implemented in Jamaica, in order to educate people about how to assess their level of risk with respect to contracting HIV infection.

Prevalence and Correlates of HIV Testing: An Analysis of University Students in Jamaica

BACKGROUND

Prevention programs often promote HIV testing as one possible strategy of combating the spread of the disease.

OBJECTIVE

To examine levels of HIV testing practices among a large sample of university students and the relationship among HIV testing, sociodemographic variables, and HIV-related behaviors.

METHODS

A total of 1252 students were surveyed between June 2001 and February 2002 using a 193-item questionnaire measuring a variety of HIV-related knowledge and attitudinal and behavioral items.

RESULTS

Hierarchical logistic regression analyses revealed that youths, married persons, persons who had attended an HIV education forum, and those who knew someone with HIV/AIDS were more likely to report a previous HIV test. However, HIV testing was not associated with condom use or number of sex partners.

CONCLUSION

The lack of significant findings between testing and risky sexual behaviors should not negate the importance of HIV testing. Being informed regarding personal HIV serostatus is one of the first steps in self-protection. Effective messages and programs need to be developed and implemented in Jamaica to promote HIV testing and help persons to adequately assess their level of risk with respect to contracting HIV.