Knowledge and attitudes of nursing students toward patients living with HIV/AIDS (PLHIV): a Turkish perspective

The aim of this study was to assess the knowledge and attitudes towards HIV/AIDS of nursing students in Turkey. HIV/AIDS has become one of the most serious health problems in the world. It is important to understand nursing students' knowledge and attitudes towards people living with HIV (PLHIV) because the educational preparation of nurses has been known to affect the attitudes of the nurse and the effectiveness of the care provided to PLHIV. The study was conducted with 227 nursing students from the School of Health in Antalya, Turkey during the calendar year 2005/2006. Qualitative and quantitative methods were both used to collect data for the study. Analysis of variance, t-test, Mann-Whitney U-test, Kruskal-Wallis and inductive methods were used in data analysis. The majority of nursing students in this study had a moderate level of HIV/AIDS knowledge. Students correctly answered 64.4% of HIV/AIDS-related questions in the questionnaire (Mean 28.99; SD 7.03 out of 45 points). Scores increased parallel with student grade (F=26.925; p=0.000) and age (chi2 (K-W)=35.117; p=0.000). Fear of being infected and feelings of pity and empathy were the feelings most commonly indicated by the students. Students who had previous experience in caring for an AIDS patient and had known someone with HIV/AIDS were willing to care for PLHIV. Results underline the need to strengthen education on all aspects of HIV/AIDS. To improve nursing students willingness to care for PLHIV, particular emphasis should be placed on the training of nursing students as skilled nursing staff with humane attitudes towards PLHIV.     

Discriminatory attitudes toward persons living with HIV/AIDS in Jamaica: a hierarchical analysis of university students

BACKGROUND: As the number of persons living with HIV/AIDS (PLWHAs) continues to increase in Jamaica, concerns of discriminatory attitudes become more important. OBJECTIVE: To examine the attitudes of university students in Jamaica toward PLWHAs, including sympathy and support for PLWHAs in the workplace and in school. METHODS: The authors conducted a survey of 1,252 students between June 2001 and February 2002 using a 193-item questionnaire that measured HIV-related knowledge, attitudes, and behaviors. RESULTS: Less than half of the students who were surveyed reported sympathetic attitudes toward either homosexual males or female prostitutes living with HIV/AIDS (41 percent and 44 percent, respectively), while a majority reported sympathetic attitudes toward heterosexual males and non-prostitute females living with the disease (67 percent and 81 percent). Most students reported that HIV-positive teachers should be allowed to teach, and that HIV-positive children should be allowed to attend school (80 percent and 62 percent). Only a minority (36 percent) reported that HIV-positive nurses should be allowed to work. Students who were more sympathetic toward PLWHAs were more tolerant of PLWHAs in the workplace and in school, while those with inaccurate knowledge concerning HIV transmission risk were less tolerant. CONCLUSION: Levels of discriminatory attitudes are high in Jamaica and warrant the attention of both individual- and societal-level interventions.     

Pediatric primary care provider's knowledge of HIV/AIDS care

To respond to the difficulties that community-based providers face in keeping abreast of the rapid changes in HIV-related care, an intensive pediatric HIV mentoring program (Pediatric HIV Miniresidency [MR]) was developed, linking a regional AIDS Education and Training Center (AETC) with an urban children's hospital HIV outpatient care site. The purpose of this study was to evaluate HIV-related knowledge and perceived skills, abilities, and willingness of community-based primary care pediatric providers and providers completing the MR. A convenience sample of community-based primary pediatric practitioners and those participants in the MR program completed a three-part mailed survey. The survey assessed practice characteristics, knowledge of pediatric HIV clinical care, and perceived skills, ability, and willingness (PSAW) to provide HIV-related care. The main outcome measures were overall knowledge and PSAW scores. One hundred nineteen community-based practitioners (NMRs), 20% of those surveyed, completed the instrument, as did 19 of 20 MR participants. NMRs exhibited low knowledge scores in key areas relating to the identification and evaluation of HIV-exposed children. Fewer than half of these respondents correctly answered questions related to HIV antibody incidence in HIV-exposed newborns and recommended diagnostic testing of such infants. Providers completing the MR scored significantly higher on the knowledge survey (15.2 vs. 8.8, p < 0.001), and had higher PSAW scores (45.8 vs. 33.9, p < 0.001). Although the generalizability of our study is limited by the low response rate, community-based physicians completing the survey demonstrated a lack of knowledge we believe necessary to provide pediatric HIV-related care (as defined by Public Health Service practice guidelines). Physicians completing the MR program had substantial HIV-related knowledge and expressed a willingness to provide care to HIV-exposed/infected children. An effective MR program provides a mechanism for developing a network of dedicated community-based physicians who are willing and capable of providing care to HIV-infected or exposed infants and children.     

Willingness to treat HIV-positive patients at different stages of medical education and experience

The willingness of physicians to provide care to HIV-positive patients has been linked to a number of attitudinal factors, but little is known concerning the impact of premedical, medical, and residency training on these factors. The purpose of this study is to elicit responses to the same series of questions concerning HIV and its treatment from respondents at different stages of training, to detect trends in attitudes and to measure the impact of those attitudes on willingness to provide care for HIV/AIDS patients. Study data come from a cross-sectional survey (n = 249) of respondents across the training continuum, from premedical students to faculty physicians, using a self-administered questionnaire at a single medical school. The response rate was 59.6%. The study showed significant decreases in personal fear and misgivings concerning HIV, coupled with a substantial decrease in the perceived need for testing of non-high-risk individuals, as respondents gained additional education and training. Overall, the intent to treat HIV did not change significantly by training level, but multivariate analyses showed that while the initially strong influence of attitudes toward AIDS and its attendant risks diminishes, comfort relative to being around homosexuals per se continues to exert an impact on the intent to treat. Appropriate use of protective measures when providing care becomes far more common once individuals enter their clinical training years. The impact of medical education through its entire continuum therefore shows a positive impact on attitudes toward HIV, despite the absence of a significant trend in respondents' stated intent to treat. However, negative attitudes toward homosexuals continue to exert a negative influence on intent to treat that endures into the clinical training years.     

HIV/AIDS knowledge, attitudes and beliefs based prediction models for practices in prison inmates, Sindh, Pakistan

This study was conducted on prison inmates in Sindh to determine whether HIV/AIDS related knowledge, attitudes and beliefs can predict their practices which risk HIV infection. A pre-designed questionnaire was administered in this cross-sectional study to collect the data on HIV/AIDS related knowledge, attitudes, beliefs, practices and demographic variables in a systematic sample of 3,395 prison inmates during July 1994. The data on responses of inmates to HIV/AIDS related knowledge, attitudes, and beliefs were analyzed and a clear interpretable factor structure emerged for each set of questions labeled as knowledge, attitude and beliefs. Similarly based on responses of inmates to practice questions, three factors emerged and were labeled as heterosexuality, homosexuality and drugs. The standardized factor scores of inmates for each of these six factors were computed and used in further analyses. Multiple linear regression analyses were carried out separately using heterosexuality, homosexuality and drugs factors score as dependent variables to identify if any of the independent variables (demographic variables, knowledge beliefs and attitude) predict these practice factors. The model for heterosexuality explained 23% of the variance and included HIV/AIDS related knowledge, beliefs, age, ethnicity and marital status and duration of imprisonment (F = 84.33, p < 0.001; R2= 23.0). The predictors in the model for homosexuality together explained 10% of the variance and included significant contribution by belief, martial status, ethnicity, education, age and duration of imprisonment (F = 24.76, p < 0.001; R2= 0.10). The model for drugs had significant contributions from HIV/AIDS related beliefs, marital status and ethnicity (F = 20.10, p < 0.001; R2= 0.03). Implications of prevention program based on these results are considered.     

Association between HIV/AIDS knowledge and stigma towards people living with HIV/AIDS in Botswana

In Botswana, an estimated 350 000 people live with HIV/AIDS. HIV/AIDS testing rates are low, suggesting that many other people remain undiagnosed. Stigma related to HIV/AIDS is prevalent and contributes to low testing rates and under-diagnosis of the virus. Identifying factors that contribute to stigma, such as insufficient or inaccurate knowledge of HIV/AIDS, may be critical in increasing early identification and treatment. This cross-sectional study used nationally representative data from the 2013 Botswana AIDS Impact Survey (BAIS) IV to examine the relationship between HIV/AIDS knowledge and stigmatising attitudes toward people living with HIV/AIDS (PLWHA). The mean (standard error) for stigma towards PLWHA score and HIV/AIDS knowledge score were 0.99 (0.02) and 5.90 (0.03) respectively. HIV/AIDS knowledge score and stigma towards PLWHA score were strongly positively correlated r (4,4045) = 0.415, p < 0.001). After adjusting for potential confounders, HIV/AIDS knowledge score significantly predicted stigma towards PLWHA score [coefficient β (95% CI)] [?0.25 (?0.29, ?0.20), p < 0.001]. These findings imply that programmes and interventions that increase HIV/AIDS knowledge may reduce the pervasive apprehension, blame, and stigmatising attitude held towards PLWHA in Botswana.     

Cultural Determinants of Care and Support for People Living with AIDS in Yoruba Communities of Ibadan and Ilesa,Nigeria

ABSTRACT

This paper examines social and cultural factors influencing care and support for Persons Living with HIV/AIDS (PLWHA) in two selected Yoruba communities of Southwestern Nigeria. The increase in morbidity and mortality associated with HIV/AIDS especially in Nigeria is attributed to poor attention giving to PLWHA. Reasons for this poor attention seem to be relative on culture basis. Among the Yoruba, the cultural conception of HIV/AIDS and the perception of PLWHA by the people, have negative impacts on care and support for PLWHAs. Despite the various attempts to alleviate the burdens of HIV/ AIDS on PLWHAs, the problems continue as a nightmare in that society, and contribute to an increase in the number of people down with HIV/AIDS. To understand the problem, an ethnographic study was conducted in Ilesa and Ibadan where 217 respondents were interviewed through the combination of key-informant, in-depth interviews, focus group discussions and case study analyses. Data revealed that Yoruba conception of HIV/AIDS and the people's perceptions of PLWHAs create barriers against better care for PLWHA. In addition, it was revealed that poverty, illiteracy and inadequate hospital facilities constitute other hindering factors affecting better care and support for PLWHAs.     

Attitude of health care workers to patients and colleagues infected with human immunodeficiency virus

Discrimination against persons living with HIV/AIDS in hospital settings has been documented. This study examined the attitude of health care workers (HCWs) to nurses, doctors and patients infected with HIV. A total of 345 respondents selected by multistage sampling techniques were surveyed, using a semi-structured questionnaire, which explored respondents' attitude to HIV-infected patients and colleagues with HIV/AIDS. HCWs were unwilling to accept that medical procedures be carried out on them by HIVinfected doctors and nurses, with almost 80% refusing surgery or assistance at surgery on them by an HIV-infected doctor or nurse. They were also significantly more unwilling to accept that medical procedures be carried out on them by an infected colleague, compared with their carrying out the same procedure on an HIV-infected patient. Thus, HCWs seemed to believe that the risk of contracting HIV was higher if an infected HCW were to perform medical procedures on them, and fear of contracting HIV seemed to be the driving force for their negative attitudes. Education on occupational risks of HIV, provision of a safe working environment with enforcement of universal precautions, as well as provision of post-exposure prophylaxis are suggested as ways to enable HCWs to change their attitudes.     

Comparing dental students' knowledge of and attitudes toward hepatitis B virus-, hepatitis C virus-, and HIV-infected patients in Taiwan

This study investigated and compared Taiwanese dental students' knowledge of hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV infection, attitudes toward infected patients, and important factors associated with the willingness to treat infected patients. In 2001, a self-administered questionnaire survey was conducted on all 1930 dental students enrolled from seven dental schools in Taiwan, with a response rate of 54.4%. Multiple logistic regression analysis was applied to assess the relationship between multiple factors and willingness to treat. Multivariate analysis was used to compare knowledge levels and the willingness. Of the respondents, 80%, 75%, and 49% were willing to treat HBV-, HCV-, and HIV-infected patients, respectively, and differences among the percentages were statistically significant. Students were less knowledgeable about HCV infection compared to HBV and HIV infection. Factors significantly associated with willingness to treat HBV- or HCV-infected patients were: feeling morally responsible and being able to treat infected patients safely. Those feeling morally responsible (odds ratio [OR] = 33.0, 95% confidence interval [CI] = 15.2, 71.8) and those being able to treat infected patients safely (OR = 4.1, 95% CI = 1.7, 9.9) were more willing to treat HIV patients. Taiwanese dental students were more willing to treat HBV- and HCV-infected patients than to treat HIV-infected patients.     

First year medical students' attitudes and knowledge about AIDS

Medical students attitudes and resulting behaviors about treating HIV-infected patients are critical and will become increasingly so in the years ahead. An anonymous self-administered questionnaire of 135 first year medical students at Boston University School of Medicine conducted in May 1988 queried students' knowledge of HIV transmission; concerns about contracting HIV; ethical and legal responsibilities; attitudes about testing for HIV and treatment of HIV-infected patients; the effect the epidemic poses for their medical careers; changes in personal sexual and drug use practices. Results indicate that students' careers are being affected because they are worried about contracting HIV, that the epidemic will affect their final choice of specialty, and that they believe they should be allowed to refuse to treat AIDS patients during their medical school training. The findings raise serious questions concerning why medical students hold these beliefs and suggest that students' willingness to care for AIDS patients may be a function of their level of knowledge and understanding of HIV infection and the disease AIDS. The results have implications for curriculum reform to address the AIDS crisis.     

A comparison of voluntary counseling and testing uptake between a China CARES county and a county not designated for the china CARES program

A cross-sectional study employing two-stage cluster sampling was conducted between December 2005 and March 2006 to compare adults' knowledge of HIV/AIDS voluntary counseling and testing (VCT) and the attitudes toward and acceptance of VCT between a county in which a comprehensive HIV/AIDS program, China CARES (CC), was available, and a county where it was not. Information on HIV/AIDS knowledge, awareness of VCT, and attitudes was collected. All participants were given a coupon for free VCT after the cross-sectional interview. Uptake of VCT was measured within 2 months of the interview. More participants in the CC county knew someone infected with HIV, had participated in AIDS-related activities, and/or had heard about China CARES. In the control county, education and income levels were higher, there were fewer minorities, and there was a higher proportion of women. VCT uptake was low. Overall, no significant differences in uptake were found between the two counties. Urban residents of the CC county had higher HIV/AIDS knowledge levels than urban residents of the comparison county (p = 0.002). Residents of the CC county were more discriminative against HIV/AIDS and persons living with HIV/AIDS (PLWHA) and had lower perceptions of risk. The differences may be due to the higher proportion of rural residents in the CC county (p < 0.001). The China CARES program may have had a positive effect on urban areas of Guizhou Province in terms of improving HIV/AIDS and VCT knowledge and reducing discrimination, but had little impact in the rural areas. If the China CARES program is to be successful, it must implement a more effective education program and increase the acceptability of testing.     

Knowledge, attitudes and beliefs regarding tuberculosis preventive therapy for HIV-infected persons, Botswana, 1999.

SETTING: Botswana, 1999. OBJECTIVE: To measure knowledge, attitudes and beliefs about tuberculosis (TB) preventive therapy (PT) for persons infected with the human immunodeficiency virus (HIV). DESIGN: A systematic sample of adult clinic attendees, using a standardised questionnaire. RESULTS: A total of 275 patients at 38 clinics in five districts were interviewed. The majority were female (65%) and unmarried (84%). Knowing someone with TB or AIDS was common (78% and 53%, respectively). Respondents perceived a relationship between TB and HIV (80%), and the majority were willing to undergo tuberculin skin testing (92%). Of those, most were willing to undergo evaluation for active TB (98%), and to take PT, although willingness to take PT declined with proposed duration (97% 6 months, 90% 1 year, 81% lifetime, P < 0.01). Previous HIV testing was reported by 13%; those who had not undergone testing reported that they would if doctors could improve the quality (95%) or duration (93%) of life of persons with AIDS. The majority favoured receiving HIV test results on the day they were tested (60%). CONCLUSIONS: Most clinic attendees in Botswana were willing to undergo HIV testing if it were beneficial to do so, such as by receiving PT. Pilot PT projects should be initiated. Voluntary HIV counselling and testing services should consider rapid HIV testing methods.     

Physicians' willingness to participate in the process of lethal injection for capital punishment.

BACKGROUND: It has been found that physicians condone colleague involvement in capital punishment. Physicians' own willingness to participate has not been explored. OBJECTIVE: To examine physicians' willingness to be involved in cases of capital punishment. DESIGN: Survey exploring physicians' willingness to participate in 10 aspects of capital punishment by lethal injection, 8 of which are disallowed by the American Medical Association. SETTING: United States. PARTICIPANTS: 1000 randomly selected practicing physicians. MEASUREMENTS: Questions assessing willingness to be involved in and attitudes toward capital punishment. RESULTS: 41% of respondents indicated that they would perform at least one action disallowed by the American Medical Association; 25% would perform five or more disallowed actions. Perceived duty to society (P < 0.001), approval of the death penalty (P < 0.001), and approval of assisted suicide (P = 0.015) correlated with increased willingness to perform disallowed actions. Only 3% of respondents knew of any guidelines on this issue. CONCLUSIONS: Despite medical society policies, many physicians would be willing to be involved in the execution of adults. The medical profession needs to be better informed about the ethical issues involved in physician participation in capital punishment.     

Effects of internal medicine residency training in AIDS care in Taiwan

Having contact and interacting with HIV/AIDS patients has long been recognized as a means for improving AIDS-related knowledge and attitudes among physicians and hence for increasing their intention to provide AIDS care. To investigate the impact of one-month residency training in an AIDS inpatient unit on internal medicine residents, this quasi-experimental, pre-post, two-group study, conducted from April 2000 to April 2001, used questionnaires. At follow-up, residents who received training in the AIDS unit (experimental group) were significantly more knowledgeable about HIV/AIDS, had more positive attitudes and greater intention to care for HIV-infected patients than residents who did not receive this training (control group). Results suggest that a one-month AIDS residency training intervention can effectively enhance residents' HIV-related knowledge, attitudes and intention to care for patients infected with HIV.     

HIV-Infected African Americans are Willing to Participate in HIV Treatment Trials

Background Despite the high prevalence rates of HIV infection in the African-American community, African Americans remain underrepresented in HIV treatment trials. Objective (1) To develop a questionnaire that measures attitudes and concerns about HIV treatment trials among HIV-infected African Americans at a university-based clinic. (2) To determine actual participation rates and willingness to participate in future HIV treatment trials among HIV-infected African Americans at a university-based clinic. Design Questionnaire development and cross-sectional survey. Setting, Participants, and Measurements In a sample of 200 HIV-infected African-American adults receiving medical care at the Pittsburgh AIDS Center for Treatment (a university-based ambulatory clinic), we assessed research participation rates and willingness to participate in future HIV treatment trials, trust in the medical profession, sociodemographic characteristics, attitudes, and concerns about HIV treatment trials. Main Outcome Measures Research participation rates and willingness to participate in future HIV treatment trials. Results Only 57% of survey respondents had ever been asked to participate in an HIV treatment trial but 86% of those asked said yes. Prior research participation was significantly related to willingness to participate in future HIV treatment trials (P = .001). Contrary to previous studies, neither trust/distrust in the medical profession nor beliefs about the dishonesty of researchers was associated with research participation rates or willingness to participate in future HIV treatment trials. Conclusions Having never been asked to participate in research is a major barrier to the participation of HIV-infected African Americans in HIV treatment trials. African Americans who seek medical care for HIV infection should be asked to participate in HIV treatment trials.     

Reducing discriminatory attitudes toward people living with HIV/AIDS (PLWHA) in Hong Kong: an intervention study using an integrated knowledge-based PLWHA participation and cognitive approach

The present paper describes the development and evaluation of an intervention programme aiming to reduce adolescents' discriminatory attitudes toward people living with HIV/AIDS (PLWHA). The intervention programme integrates components of 'virtual interaction' with PLWHA (watching a documentary), knowledge enhancement and a simple cognitive exercise. To evaluate its effectiveness, the programme was implemented to about 600 form 3-4 (grade 9-10) students of three secondary schools in Hong Kong. Using a structured questionnaire, the level of discriminatory attitudes toward PLWHA, knowledge about HIV/AIDS and perceptions about PLWHA, etc. were measured before and after the implementation of the programme. A notable improvement on the level of acceptance of PLWHA and knowledge about HIV/AIDS was found after the implementation of the programme. Negative perceptions about PLWHA also reduced substantially. For instance, before the programme, over one-third (35.7%) of all respondents believed that the majority of PLWHA were promiscuous; the figure dropped to 15.8% after exposure to the programme (adjusted odds ratio = 0.35, p < 0.001). Further, some gender differences were observed. Female respondents tended to be less discriminatory toward PLWHA and responded more favourably to the programme than their male counterparts.     

HIV knowledge and attitudes among providers in aging: results from a national survey

Within 5 years, half the U.S. HIV-infected population will be over age 50, and providers caring for older adults must deal with this reality. This study assessed attitudes toward people with HIV/AIDS and knowledge of HIV/AIDS among physicians with a geriatrics specialty, and nurses and social workers who specialize in gerontology. A survey mailed in 2008 to a random sample of U.S. providers yielded a 60% response rate. Main outcome measures included: Knowledge of HIV/AIDS, attitudes toward people with HIV/AIDS, and knowledge of issues related to HIV in older adults. General knowledge of HIV/AIDS was good with scores of 89%, 84%, and 81% for physicians, nurses, and social workers, respectively; groups differed significantly (F(2, 483)=18.626, p<0.0005). Attitudes were positive, with a significant main effect of profession on the attitude subscales (F(4, 952)=6.84, p<0.0005). Eighty-three percent of the sample were unaware that dementia due to HIV may be reversible; no significant differences by profession (χ(2)=4.50, p=0.105). The sample had difficulty ranking the four most common risk factors for HIV infection in older adults, with no significant differences among the professions (F(2, 483)=1.22, p=0.296). Only 6% of the sample correctly ranked all four risk factors. Estimates of the percent of U.S. AIDS cases in people over age 50 varied widely; few answered correctly, with no significant differences by professional group (F(2,319)=2.82, p=0.06). These findings highlight the need for further education among providers who specialize in aging.     

Knowledge and attitudes of physicians in private practice towards HIV/AIDS in Mashhad, Iran

Being responsible for providing care for HIV/AIDS in a society, physicians should be knowledgeable and have favourable attitudes. We designed a cross-sectional study to assess knowledge and attitudes towards HIV/AIDS of private practicing physicians in Mashhad, Iran. A total of 346 general practitioners and specialists completed anonymous self-administered questionnaires with response rate of 91.1%. For knowledge questions, the mean proportion of correct responses was 53.5% (±13.2). Misconceptions about HIV transmission were the main areas of insufficient knowledge. Surprisingly only 20% knew how to manage a patient who had experienced sexual contact with an HIV-positive partner. While 84% disagreed that 'HIV-infected individuals deserved to catch infection' owing to high-risk behaviours, 38% sympathized less with people who were infected via extramarital sex. It seems that knowledge and attitudes towards HIV/AIDS among the studied physicians is not favourable and is an area that requires attention to enable effective management of the disease in Iran.