Transcript Factors Predicting HIV-related Knowledge Among Urban Health Workers In Malawi Sri Yona,1 So Hyun Park,1 Jane L.

Factors Predicting HIV-related Knowledge Among Urban Health Workers In Malawi
Sri Yona,1 So Hyun Park,1 Jane L. Chimango,,2 Angela F. Chimwaza, 2, Chrissie. P. N. Kaponda,2 Kathleen F. Norr,1 James L. Norr1
1. University of Illinois at Chicago 2. Kamuzu College of Nursing, University of Malawi
Advancing Nursing Leadership
BACKGROUND
SETTING AND SAMPLE
• Malawi is predominately rural and agricultural; 52.4% of
population lived below poverty in 2004 (World Bank, 2010)
• This secondary analysis used baseline survey data
for 366 urban health workers in a referral hospital
• The national adult HIV prevalence rate is 11% and 800,000
Malawians are HIV positive (UNAIDS, 2010)
• All hospital workers were eligible, and were
randomly selected from an employee list
• Over 80% of new infections are due to sexual transmission
• Job Type
• Health workers need to know about HIV in order to prevent
infection for themselves and their patients
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51.4% clinical and technical workers
(MD, clinical officer, dentist, RN)
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36.3% clinical support workers
(auxiliary nurse, patient attendant, community worker)
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Africa
Malawi
RESULTS
Means and Correlations
• Health workers had the highest knowledge scores for HIV
transmission (81% correct). Knowledge of sexual prevention
strategies was lowest (65% correct)
• Correlations between HIV-related knowledge scores were relatively
low. The highest correlation was between HIV transmission and STI
knowledge (r = .29, p<.001)
Table 1. Means and Correlations among HIV-related Knowledge
12.3% were non-clinical support workers
(administrators, clerks, guards, laundry workers ).
Education: 53% had primary school or less
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Marital Status: 75% currently married
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Age: 62% were over age 35
METHODS
AND IMPLICATIONS
• More effective HIV-related education for health workers is needed,
especially for lower level workers
• Because different aspects of HIV-related knowledge are not highly
related, it is important to educate health workers regarding all
aspects of HIV prevention
• Reducing stigmatizing attitudes toward PLWH may also contribute
to improved HIV-related knowledge
• Future health worker training should include sexual prevention
strategy knowledge and stigma reduction
• Demographic Characteristics
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DISCUSSION
HIV/AIDS Services
Nurse Sterilizing Equipment
Analyses
• Mean scores for each knowledge index and correlations among the
four aspects of HIV-related knowledge were examined
PURPOSE
• To identify health workers’ level of knowledge about:
 HIV sexual transmission prevention strategies
 HIV transmission
 Sexually Transmitted Infections (STIs)
 Universal precautions (UP)
• To identify the demographic and attitudinal factors that predict
each of the four aspects of HIV-related knowledge
• Multiple linear regressions were used to determine the impact of
demographic and attitudinal variables on each of the four HIV-related
knowledge measures
Dependent Variables: HIV-related knowledge
1. Preventing sexual transmission: 1 item, scored as proportion mentioned
of 3 strategies (abstaining, being faithful, using condoms), range 0-1
2. HIV transmission: 6 items (e.g., a person can get HIV from a mosquito
bite), scored as proportion correct, range 0-1
* p <.05, ** p <.01
Multiple Linear Regression
• Clinicians/technicians had significantly higher scores than lower
level workers for all four areas of HIV-related knowledge. This was
the only predictor related to all four areas of knowledge
• Blaming PLWHs was significantly related to lower knowledge of
HIV transmission and STI knowledge
Table 2. Demographic and Attitudinal Factors Predicting HIV-Related
Knowledge (multiple regression)
3. STI knowledge: 2 items (who needs to be treated, can have STI without
knowing it), scored as proportion correct, range 0-1
ACKNOWLEDGEMENTS
4. UP knowledge: 22 items, 4 knowledge indices (gloves,15-items; hand
washing, 3-items; sharp, 2-items; and cleaning, 2-items); scored as
proportion correct, range 0-1
• National Institute of Health, National Institute of Nursing Research
(R01 NR08058, K. Norr PI)
Explanatory factors
• John Fogarty International Centre AIDS AITRP at UIC
(D43TW001419) provided Sri Yona with support while doing this
analysis
• Job type and demographic factors
• Attitudinal factors
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Hospital Facility
Consulting About a Client
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Condom attitudes: 10 items, scored % positive
Blames a person living with HIV (PLWH) for getting infected: 1 item, no=1, don’t
know=2, yes=3, range 1-3
Accepts contact with PLWH: Mean score, 2 items (cook a meal, be in public places),
no=1, not sure=2, yes=3, range 1-3
* p <.05, ** p <.01