HIV Testing Acceptability Study

Acceptability of Human
Immunodeficiency Virus Counseling
and Testing Among Healthcare
Professionals and Pregnant Women
Consulting at an Urban Tertiary
Government Hospital
Helen V. Madamba, MD
HV MADAMBA and SR BRAVO 2012. Acceptability of Human Immunodeficiency Virus Counseling and Testing Among
Healthcare Professionals and Pregnant Women Consulting at an Urban Tertiary Government Hospital. Unpublished.

General Objective
to determine acceptability of HIV counseling
and testing among healthcare professionals
and pregnant women aged 19 to 45 years old
consulting at an urban government tertiary
hospital.

Specific Objectives
• to describe the demographic characteristics of
the two study groups
• to determine the level of knowledge on HIV/AIDS
among the study population and to identify the
association with demographic characteristics and
HIV background of the two study groups
• to determine presence of stigma towards people
living with HIV among the healthcare
professionals group

Specific Objectives
• to determine attitudes on HIV counseling and
testing among the two study groups
• to correlate risk assessment with the
willingness of high risk groups to undergo HIV
counseling and testing
• to determine whether or not cost is a factor in
offering HIV counseling and testing as part of
routine prenatal care

Methodology

Inclusion criteria for
the healthcare professionals group:
• Healthcare professionals included consultants,
fellows and residents of different departments
in the hospital and nurses assigned at
different areas in the hospital
• There are 96 consultants, 200 fellows and 559
residents at the different departments in the
hospital and approximately 1063 nurses
assigned at different areas in the hospital.

Inclusion criteria for
the pregnant women group:
• Pregnant patients aged 19 to 45 years old
consulting at the outpatient department for
prenatal care.
• The general obstetrics clinic at the outpatient
department caters to 200 patients a day, both
consulting for obstetric and gynecologic
concerns.

Sociodemographic Characteristics of
the Study Population
• A total of 865 questionnaires were completed
by 430 pregnant patients consulting at the
outpatient department and 435 healthcare
professionals (nurses, residents, fellows and
consultants) employed at a tertiary urban
government hospital.

Pregnant Patients
• 77% were from Metro Manila
• 45% were married
• 87% Roman Catholic, 43% and 44% finished
high school and college respectively.
• The mean age 28.2 ± 6.8 years with 48% of the
study population in the 20-29 year age group

Healthcare Professionals
• the mean age was 32.4 ± 7.7 years with 48% also
in the 20-29 year age group
• 29% were male and 71% were female
• 60% were single while 38% were married
• 36% completed college while 64% are post-
graduate
• mean of 5.3 ± 6.1 years in the current job and
77% receiving at least Php 20,000 monthly
income
• Majority (78%) of the study population come
from Metro Manila
• 84% are Roman Catholic.

Background on HIV - HIV Experience
Statements Pregnant
Patients
Healthcare
Professionals
Currently living with HIV 2 (0) 4 (1)
Known someone with HIV 6 (1) 125 (29)
Undergone HIV testing
None 379 (88) 369 (85)
Voluntary 2 (0) 6 (1)
Mandatory 46 (11) 42 (10)
Both 3 (1) 18 (4)
Heard about HIV 399 (92) 429 (99)

HIV Experience of Healthcare
Professionals with HIV Patients
Statement
Attended HIV patient 344 (77)
Received training 146 (34)
Offered HIV counseling
and testing to anyone
155 (36)

Sources of information on HIV/AIDS
Sources
Radio 168 (39)
Doctor 144 (33)
Midwife 36 (8)
Church 62 (14)
Print ads 175 (41)
Flyers 80 (19)
Television 370 (86)
Nurse 70 (16)
Internet 70 (16)

Knowledge on the Mode of
Transmission of HIV
• The healthcare professionals group correctly
identified the two common modes of HIV
transmission more often compared to the
pregnant patients group:
– sexual intercourse 14.8 x (432 [99%] vs 389 [91%])
– blood transfusion 12.6 x (430[99%] vs 375 [87%])

Knowledge on the Mode of
Transmission of HIV
• Pregnant patients group is more aware that
HIV may be transmitted from mother to child
– during pregnancy (417 [96%] versus 318 [74%])
– through breastfeeding (272[63%] versus 206
[48%]).

Factors Associated with Knowledge
on the Mode of Transmission of HIV
• Age, level of education and being a healthcare
professional were some of the factors found
to affect the level of knowledge on the mode
of HIV transmission.
• Being a healthcare professional improved the
level of HIV knowledge by 5.2 times.
• It is notable that the knowledge odds on HIV
increases with increasing level of education.

Positive Attitudes towards People
Living with HIV/AIDS
• level of knowledge on the mode of HIV
transmission
• the level of education
• the number of years employed
NOTE: adjusting for other factors, being a healthcare
professional is not significantly associated with a
positive attitude towards people living with HIV/AIDS
compared to the group of pregnant patients

Prejudice against
People living with HIV/AIDS
• only 30% among the pregnant patients group
allowed them to get married
• only 15% allowed them to have children
• 43% opted to remove young children from
home if one parent is infected with HIV
• 21% would be more sympathetic towards
people who get AIDS from blood transfusion
than those who get it from sex.

Factors Associated with Attitudes
towards People Living with HIV/AIDS
• Knowledge
• Education
• Number of years employed ≥ 5 years

Positive Attitudes Towards HIV
Testing
• Overall, attitudes towards HIV counseling and
testing was more positive in the healthcare
professionals group by as much as 8.3 times
compared to the pregnant patients group (OR
8.3, p value < 0.0001).

Factors Associated with Attitudes
Towards HIV Testing
• Level of knowledge
• Education
• Number of years employed

Stigma Among Healthcare Professionals
Towards People Living with HIV
Statements
Willing to treat HIV patient 292 (67)
Prefer not to treat HIV patients 97 (22)
Ever attended HIV Patients 334 (77)

Willingness to Pay for the HIV test
Questionnaires Pregnant Patients Healthcare
Professionals
OR p
value
n % n %
Agree to a free test
for HIV
364 85 423 97 6.4 <0.000
1
Agree to pay for an
HIV test
169 39 277 64 2.7 <0.000
1

Risk Assessment and willingness to
undergo HIV counseling and testing
Statement Willing to Undergo
HIV Counseling
and Testing
OR p value
n %
History of multiple sex partners
With
Without
16
68
27
18
1.7 0.1161
Symptoms of sexually transmitted
infections
With
Without
2
82
10
20
0.4 0.2688
Use of condoms during sex
With
Without
18
66
26
18
1.6 0.1371
History of Injecting Drugs
With
Without
1
83
13
20
0.6 0.6104

Practice of HIV Counseling and
Testing
Statement Pregnant
Patients
Healthcare
Professional
OR P
value
n % n %
All pregnant
women should have
a mandatory HIV
test.
160 37 203 47 1.5 0.004
8
All pregnant
women should be
offered a test for
HIV with the right
to refuse.
332 77 399 92 3.3 <0.00
01

Conclusion
• There is good level of knowledge on the modes
of transmission of HIV both among the pregnant
patients group and the health care professionals
group
• There still exists significant stigma towards
people living with HIV/AIDS, which needs to be
addressed with programs for stigma reduction to
be able to adequately address issues for the
prevention and management of HIV/AIDS
patients and for the prevention of mother to
child transmission.

HIV Testing Acceptability Study

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