HIV Counseling and Testing Uptake, Knowledge and Attitude and Influencing Factors among Student Nurses and Midwives in The Gambia: An Institutional-based Cross-sectional Study

Source:
By:Author(s)

DOI: https://doi.org/10.30564/jmser.v6i1.5308

Abstract:

HIV counseling and testing (HCT) has become paramount in the prevention and control of HIV/AIDS worldwide. However, the uptake of HCT has been very slow globally, especially in sub-Saharan Africa. Student nurses formed the largest group undergoing health care training in the country compared to doctors and other health cadres. According to WHO, they are part of the most vulnerable group to HIV infection, judging by the fact that they interact more with patients/clients than other healthcare professionals. This study aimed to determine the prevalence of HCT uptake, knowledge, and attitude and evaluate influencing factors among student nurses and midwives in public nursing schools. An institutional-based cross-sectional study design was employed to collect data from 305 randomly selected nursing students and midwives using a validated and reliable self-administered questionnaire. Descriptive statistics (percentages, mean and standard deviation) and inferential statistics (chi square, logistics regression, one-way ANOVA and independent samples t-test) were used for data analysis using SPSS version 25.0. A p-value < 0.05 was considered for statistical significance. Out of the 305 students recruited for the study, 60.98% were females, with a mean age of 25.5 years old. About 58.4% of the participants had tested for HIV in the past. About 95.7% acknowledged the importance of HCT in the prevention and control of HIV/AIDS. HCT uptake among student nurses and midwives was influenced by factors ranging from an individual that are interpersonal challenges (such as concerns of friends), perceived susceptibility to the disease, lack of confidentiality, stigma and discrimination from health service providers. Therefore, these barriers can be addressed through an organized targeted health education intervention and advocacy programs across health training institutions in the Gambia and beyond.

References:

[1] Kwapong, G.D., Boateng, D., Agyei-Baffour, P., et al., 2014. Health service barriers to HIV testing and counseling among pregnant women attending Antenatal Clinic; A cross-sectional study. BMC Health Services Research. 14(1), 267. DOI: https://doi.org/10.1186/1472-6963-14-267 [2] Deblonde, J., De Koker, P., Hamers, F.F., et al., 2010. Barriers to HIV testing in Europe: A systematic review. European Journal of Public Health. 20(4), 422-432. DOI: https://doi.org/10.1093/eurpub/ckp231 [3] Peltzer, K., Matseke, G., Mzolo, T., et al., 2009. Determinants of knowledge of HIV status in South Africa: Results from a population-based HIV survey. BMC Public Health. 9, 1-11. DOI: https://doi.org/10.1186/1471-2458-9-174 [4] Reis, C., Heisler, M., Amowitz, L.L., et al., 2005. Discriminatory attitudes and practices by health workers toward patients with HIV/AIDS in Nigeria. PLoS Medicine. 2(8), 0743-0752. DOI: https://doi.org/10.1371/journal.pmed.0020246 [5] Kalyanshetti, S., Nikam, K., 2016. A study of knowledge of HIV/AIDS among nursing students. International Journal of Medical Science and Public Health. 5(6), 1209. DOI: https://doi.org/10.5455/ijmsph.2016.10022016374 [6] Charles, M.P., Kweka, E.J., Mahande, A.M., et al., 2009. Evaluation of uptake and attitude to voluntary counseling and testing among health care professional students in Kilimanjaro region, Tanzania. BMC Public Health. 9, 1-9. DOI: https://doi.org/10.1186/1471-2458-9-128 [7] Patton, G.C., Coffey, C., Sawyer, S.M., et al., 2009. Global patterns of mortality in young people: A systematic analysis of population health data. The Lancet. 374(9693), 881-892. DOI: https://doi.org/10.1016/S0140-6736(09)60741-8 [8] SADC, 2009. Assessment Report on the Status of HIV Testing and Counselling Policies in the SADC Region [Internet]. Available from: https://www.sadc.int/files/4314/1172/0046/Assessment_Report_on_the_Status_ofHIV_Testing_and_Counselling_Policies_inthe_SADC_Region.pdf [9] Journal, S.A., Health, P., Rehanilitation, M., et al., 2014. Acceptability and barriers to uptake of hiv testing and counseling among students of tertiary institutions in Owo Ondo State Nigeria. (1), 1-17. [10] Paul, N., Muewa, M., 2014. Public health in the school of public health [Master’s thesis]. Lexington: Kenyatta University. [11] Obermeyer, C.M., Osborn, M., 2007. The utilization of testing and counseling for HIV: A review of the social and behavioral evidence. American Journal of Public Health. 97(10), 1762-1774. DOI: https://doi.org/10.2105/AJPH.2006.096263 [12] Kalichman, S.C., Simbayi, L.C., 2003. HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa. Sexually Transmitted Infections. 79(6), 442-447. DOI: https://doi.org/10.1136/sti.79.6.442 [13] WHO, 2009. Towards the Universal Access: Scaling Up Priority Hiv/Aids Intervaentions in the Health Sector [Internet]. Available from: https://www.afro.who.int/publications/towards-universal-access-scaling-priority-hivaids-interventions-health-sector [14] Mwangi, R.W., Ngure, P., Thiga, M., et al., 2014. Factors influencing the utilization of voluntary counselling and testing services among university students in Kenya. Global Journal of Health Science. 6(4), 84-93. DOI: https://doi.org/10.5539/gjhs.v6n4p84 [15] Boshamer, C.B., 2015. BKA scale to measure attitudes about H testing: Development and psychometric validation. AEP 1999 O-13. P 10555624. A scale to measure attitudes about HIV-antibody testing: Development and psychometric validation. Journal of Cleaner Production. 86, 311-322. DOI: https://doi.org/10.1016/j.jclepro.2014.08.074 [16] Sambah, F., Elvis, J., Jr, H., et al., 2019. Determinants of HIV testing and counseling utilization among trainee nurses and midwives in central region of Ghana. Clinical Research in Psychology. 2(1), 1-10. [17] Gaskin, C.J., Happell, B., 2014. On exploratory factor analysis: A review of recent evidence, an assessment of current practice, and recommendations for future use. International Journal of Nursing Studies. 51(3), 511-521. DOI: https://doi.org/10.1016/j.ijnurstu.2013.10.005 [18] Bhoobun, S., Jetty, A., Koroma, M.A., et al., 2014. Facilitators and barriers related to voluntary counseling and testing for HIV among young adults in Bo, sierra leone. Journal of Community Health. 39(3), 514-520. DOI: https://doi.org/10.1007/s10900-013-9788-4 [19] Runsewe-Abiodun, T.I., Bondi, F.S., Alabi, A.D., et al., 2016. Infant and young child feeding practices in the east end of Freetown, Sierra Leone. Sierra Leone Journal of Biomedical Research. 8, 4-11. [20] Daniyam, C.A., Agaba, P.A., Agaba, E., 2010. Acceptability of voluntary counselling and testing among medical students in Jos, Nigeria. Journal of Infection in Developing Countries. 4(6), 357-361. [21] Jürgensen, M., Tuba, M., Fylkesnes, K., et al., 2012. The burden of knowing : Balancing benefits and barriers in HIV testing decisions: A qualitative study from Zambia. BMC Health Services Research. 12(2), 10-13. [22] Negin, J., Nemser, B., Cumming, R., et al., 2012. HIV attitudes, awareness and testing among older adults in Africa. AIDS and Behavior. 16, 63-68. DOI: https://doi.org/10.1007/s10461-011-9994-y [23] Tabana, H., Doherty, T., Swanevelder, S., et al., 2012. Knowledge of HIV status prior to a community HIV counseling and testing intervention in a rural district of south Africa : Results of a community based survey. BMC Infectious Diseases. 12, 73. DOI: https://doi.org/10.1186/1471-2334-12-73 [24] Magadi, M.A., 2011. Understanding the gender disparity in HIV infection across countries in sub-Saharan Africa : Evidence from the Demographic and Health Surveys. Sociology of Health & Illness. 33(4), 522-539. DOI: https://doi.org/10.1111/j.1467-9566.2010.01304.x [25] Oppong Asante, K., 2013. HIV/AIDS knowledge and uptake of HIV counselling and testing among undergraduate private university students in Accra, Ghana. Reproductive Health. 10(1), 1-8. DOI: https://doi.org/10.1186/1742-4755-10-17 [26] Grant, E., Logie, D., Masura, M., et al., 2008. Psychological and socio-medical aspects of AIDS / HIV factors facilitating and challenging access and adherence to antiretroviral therapy in a township in the Zambian Copperbelt : A qualitative study. AIDS Care. 20(10), 1155-1160. DOI: https://doi.org/10.1080/09540120701854634 [27] Addis, Z., Yalew, A., Shiferaw, Y., et al., 2013. Knowledge, attitude and practice towards voluntary counseling and testing among university students in North West Ethiopia : A cross sectional study. BMC Public Health. 1-8. [28] Dirar, A., Mengiste, B., Kedir, H., et al., 2013. Factors contributing to voluntary counselling and testing uptake among youth in colleges of Harar, Ethiopia. Science Journal of Public Health. 1(2), 91-96. DOI: https://doi.org/10.11648/j.sjph.20130102.17 [29] Mlay, R., Lugina, H., Becker, S., 2008. AIDS Care : Psychological and Socio-medical Aspects of AIDS/HIV Couple counselling and testing for HIV at antenatal clinics : Views from men, women and counsellors. 20(3), 356-360. DOI: https://doi.org/10.1080/09540120701561304 [30] Norman, L.R., 2006. HIV testing practices in Jamaica. HIV Medicine. 7(4), 231-242. [31] Babalola, S., 2007. Readiness for HIV testing among young people in Northern Nigeria : The roles of social norm and perceived stigma. AIDs and Behavior. 11, 759-769. DOI: https://doi.org/10.1007/s10461-006-9189-0 [32] Gage, A.J., Ali, D., 2010. AIDS care : Psychological and socio-medical Aspects of AIDS/HIV factors associated with self-reported HIV testing among men in Uganda. 17(2), 153-165. DOI: https://doi.org/10.1080/09540120512331325635 [33] Anwar, Y.E., 2006. Determinants Hiv-Vct acceptance in gondar town, northwest Ethiopia : A case control study [Master’s thesis]. Addis Ababa: Addis Ababa University. [34] Tsegay, G., Edris, M., Meseret, S., 2013. Assessment of voluntary counseling and testing service utilization and associated factors among Debre Markos University Students, North West Ethiopia : A cross-sectional survey in 2011. BMC Public Health. 13, 243. [35] Access, O., 2012. Patterns of sexual risk behavior among undergraduate university students in Ethiopia: A cross-sectional study. Annals of Epidemiology and Public Health. 8688, 1-9. [36] Regassa, N., Kedir, S., 2011. Attitudes and practices on HIV preventions among students of higher education institutions in Ethiopia: The case of Addis Ababa University. East African Journal of Public Health. 8(2), 141-154. [37] Njau, B., Covin, C., Lisasi, E., et al., 2019. A systematic review of qualitative evidence on factors enabling and deterring uptake of HIV self-testing in Africa. BMC Public Health. 19, 1289. DOI: https://doi.org/10.1186/s12889-019-7685-1 [38] Fylkesnes, K., Siziya, S., 2004. A randomized trial on acceptability of voluntary HIV counselling and testing. Tropical Medicine & International Health. 9(5), 566-572. [39] Angotti, N., Bula, A., Gaydosh, L., et al., 2009. Increasing the acceptability of HIV counseling and testing with three C’s : Convenience, confidentiality and credibility. Social Science & Medicine. 68(12), 2263-2270. DOI: https://doi.org/10.1016/j.socscimed.2009.02.041 [40] Dapaah, J.M., Senah, K.A., 2016. HIV/AIDS clients, privacy and confidentiality; The case of two health centres in the Ashanti Region of Ghana. BMC Medical Ethics. 17(1), 1-10. DOI: https://doi.org/10.1186/s12910-016-0123-3 [41] Boshamer, C.B., Bruce, K.E., 2002. A scale to measure attitudes about HIV-antibody testing: Development and psychometric validation. AIDs Education and Prevention. 24(3), 193-203. DOI: https://doi.org/10.1023/A:1022991522264 [42] Denison, J.A., O’Reilly, K.R., Schmid, G.P., et al., 2008. HIV voluntary counseling and testing and behavioral risk reduction in developing countries : A meta-analysis, 1990-2005. AIDs and Behavior. 12, 363-373. DOI: https://doi.org/10.1007/s10461-007-9349-x [43] Meiberg, A.E., Bos, A.E.R., Onya, H.E., et al., 2008. Fear of stigmatization as barrier to voluntary hiv counselling and testing in South Africa. East African Journal of Public Health. 5(2), 49-54.