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HIV status, knowledge, attitudes and behaviour of persons with and without disability in South Africa: evidence from a national population-based survey.

ABSTRACT: Introduction:People with disabilities have been identified as a key risk population for HIV. The aim of this study was to investigate HIV status, knowledge, attitudes, behaviours and its correlates in persons with and without disabilities in South Africa. Methods:Cross-sectional data of 26404 participants 15 years and older from the "2012 South African national HIV prevalence, incidence and behaviour survey" were analysed. Results:1348(5.3%) had a disability. Persons with a disability were older (median age 52 years, IQR=24; versus 36 years, IQR=29), more often men, had a lower education and lower income and more likely living in a rural area than persons without disability. The prevalence of HIV infection was 16.7% in persons with disability, 23.0% in persons with visual/hearing or speech disability, 31.6% in persons with hearing disability and 16.2% in persons without disability. Antiretroviral (ARV) exposure in the HIV positive population was 41.3% among persons with disability and 30% in persons without disability. In multivariable logistic regression analysis, persons with disability had a lower odds to know an HIV testing site (Odds Ratio=OR: 0.46, Confidence Interval=CI: 0.22, 0.98) and a higher odds to have had two or more sexual partners in the past 12 months (OR 2.74, CI: 1.44, 5.21), had casual or transactional sex (OR: 6.25, CI: 2.57, 15.21) and psychological distress (OR: 2.10, CI: 1.50, 2.95) than persons without disability. In multivariable logistic regression analysis in both groups (with and without disability), psychological distress (OR: 2.90, CI: 1.53, 5.47, and OR: 1.90, CI: 1.20, 3.01, respectively) and high HIV stigma (OR: 0.31, CI: 0.25, 0.67, and OR: 0.57, CI: 0.34, 0.96, respectively) were associated with increased prevalence of HIV infection. Conclusion:The study found a high prevalence of HIV infection in persons with disabilities, in particular in those with hearing impairment. In some areas, persons with disability showed lower knowledge and higher risk behaviours than persons without disabilities. There is a need to strengthen HIV information and communication strategies geared towards targeting people with all types of disabilities.

SUBMITTER: Pengpid S

PROVIDER: S-EPMC6815518 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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HIV status, knowledge, attitudes and behaviour of persons with and without disability in South Africa: evidence from a national population-based survey.

Pengpid Supa S Peltzer Karl K

The Pan African medical journal 20190819

<h4>Introduction</h4>People with disabilities have been identified as a key risk population for HIV. The aim of this study was to investigate HIV status, knowledge, attitudes, behaviours and its correlates in persons with and without disabilities in South Africa.<h4>Methods</h4>Cross-sectional data of 26404 participants 15 years and older from the "2012 South African national HIV prevalence, incidence and behaviour survey" were analysed.<h4>Results</h4>1348(5.3%) had a disability. Persons with a ...[more]

PMID: 31692863

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Project description:The use of predictive genetic testing, particularly for risk profiling in non-communicable diseases (NCDs), has the potential to benefit public health by decreasing the disease burden and alleviating the pressure on healthcare. It is thus important to assess knowledge and uptake among stakeholders. This study aimed to assess end users' (community, medical practitioners and medical students) knowledge and attitudes regarding the use and support of genomic medicine. A descriptive cross-sectional survey was conducted in Kwazulu-Natal (KZN) among 3 groups of stakeholders (n = 170): medical practitioners from both private and public healthcare, medical students from UKZN and community members represented by teachers. Three structured questionnaires using a Likert scale were administered. Responses were stratified by practice type, and a scoring scale was developed. Principal component analysis (PCA) was used to reduce data on all constructs that made up each variable. All three groups showed adequate knowledge and a positive attitude towards use, apart from medical students who were not as keen to support future use in their own practice. Although medical practitioners supported the use of this technology, with necessary guidelines, expertise and affordability, only 18% from private practice reported having used it. PCA reduced data to fewer parsimonious constructs for all 3 groups: common threads included an awareness that genetic testing may improve health and disease outcomes; guidelines for use; and the provision of education to increase awareness, training to bolster expertise and confidence to use these services. Participants in this study attributed a lack of uptake to limited expertise and professional support, and a lack of legislative guidelines. We recommend updating continuing professional development for medical practitioners and promoting community education concomitantly. Provision of guidelines and increased accessibility to resources are important.

Project description:BackgroundIn South Africa malaria is endemic in Mpumalanga, Limpopo and the north-eastern areas of KwaZulu-Natal provinces. South Africa has set targets to eliminate malaria by 2018 and research into complementary vector control tools such as the Sterile Insect Technique (SIT) is ongoing. It is important to understand community perceptions regarding malaria transmission and control interventions to enable development of community awareness campaign messages appropriate to the needs of the community. We aimed to assess knowledge, attitudes, and practices regarding malaria transmission to inform a public awareness campaign for SIT in Jozini Local Municipality, Mamfene in KwaZulu-Natal province.MethodsWe conducted a cross-sectional survey in three communities in Mamfene, KwaZulu-Natal during 2015. A structured field piloted questionnaire was administered to 400 randomly selected heads of households. Descriptive statistics were used to summarize data.ResultsOf the 400 participants interviewed, 99% had heard about malaria and correctly associated it with mosquito bites. The sources of malaria information were the local health facility (53%), radio (16%) and community meetings (7%). Approximately 63% of the participants were able to identify three or four symptoms of malaria. The majority (76%) were confident that indoor residual spraying (IRS) kills mosquitoes and prevents infection. Bed nets were used by 2% of the participants. SIT knowledge was poor (9%), however 63% of the participants were supportive of mosquito releases for research purposes. The remaining 37% raised concerns and fears, including fear of the unknown and lack of information on the SIT.ConclusionAppropriate knowledge, positive attitude and acceptable treatment-seeking behaviour for malaria were demonstrated by members of the community. Community involvement will be crucial in achieving success of the SIT and future studies should further investigate concerns raised by the community. The existing communication channels used by the malaria control program can be used; however additional channels should be investigated.

Project description:Uganda is among the first to use the Washington Group Short Set of Questions on Disability to identify persons with disabilities in its Demographic and Health Survey. In this paper, we review the HIV Knowledge, Attitudes and Behaviour component of the 2011 Ugandan Demographic and Health Survey, analysing a series of questions comparing those with and without disabilities in relation to HIV/AIDS knowledge, attitudes and practices. We found comparable levels of knowledge on HIV/AIDS for those with and those without disabilities in relation to HIV transmission during delivery (93.89%, 93.26%) and through breastfeeding (89.91%, 90.63%), which may reflect increased attention to reaching the community of persons with disabilities. However, several gaps in the knowledge base of persons with disabilities stood out, including misconceptions of risk of HIV infection through mosquito bites and caring for a relative with HIV in own household (34.39%, 29.86%; p<0.001; 91.53%, 89.00%; p = 0.001, respectively). The issue is not just access to appropriate information but also equitable access to HIV/AIDS services and support. Here we found that persons with multiple disabilities were less likely than individuals without disabilities to return to receive results from their most recent HIV test (0.60[0.41-0.87], p<0.05). HIV testing means little if people do not return for follow-up to know their HIV status and, if necessary, to be connected to available services and supports. Additional findings of note were that persons with disabilities reported having a first sexual encounter at a slightly younger age than peers without disabilities; and persons with disabilities also reported having a sexually transmitted disease (STD) within the last 12 months at significantly higher rates than peers without disabilities (1.38[1.18-1.63], p<0.01), despite reporting comparable knowledge of the need for safer sex practices. This analysis is among the first to use HIV/AIDS-related questions from Demographic Health Surveys to provide information about persons with disabilities in Uganda in comparison to those without disabilities. These findings present a more complex and nuanced understanding of persons with disabilities and HIV/AIDS. If persons with disabilities are becoming sexually active earlier, are more likely to have an STD within the preceding 12 month period and are less likely to receive HIV test results, it is important to understand why. Recommendations are also made for the inclusion of disability measures in Uganda's AIDS Indicator Survey to provide cyclical and systematic data on disability and HIV/AIDS, including HIV prevalence amongst persons with disabilities.

Project description:BackgroundHospital pharmacists are important in antibiotic stewardship programs (ASP), a global strategy to combat antibiotic resistance (ABR). South African public hospitals have limited ASP implementation. This study describes Limpopo Provincial Hospital pharmacists' knowledge, attitudes, and practice toward ASP implementation.MethodA questionnaire to explore pharmacists' knowledge, attitudes and practices regarding ASP implementation comprised 43 questions hosted online. A link was sent by invitation e-mail to eligible respondents in November 2021. Five questions on respondents' demographics, 15 questions on ASP knowledge, 10 Likert scale questions on attitude, and 13 on ASP practices were included. Mean (standard deviation (SD)) knowledge and attitude scores and a median (interquartile range (IQR)) practice score was calculated. Associations between categorical variables were assessed using chi-square/Fisher's exact analysis (p < 0.05), with Cramér's V as effect size.ResultsThe survey yielded 35 responses (13.1%). Twenty (57.1%) respondents were female. Seventeen (48.6%) respondents were between the ages of 31 and 40 years. The mean knowledge score of respondents was 9.8 (2.6) (N = 34), with knowledge gaps on One Health and socioeconomic determinates of ABR. Ten (29.6%) respondents thought One Health discouraged multi-sector collaboration, and nineteen (55.9%) respondents thought ASP was the only strategic response to ABR. Sixteen (47.1%) respondents did not know that poor access to clean water accelerates ABR and seventeen (50.0%) did not know that poverty could be a determinant for antibiotic use. The mean respondent attitude score was 8.0 (1.7) (N = 28). Twenty-seven (96.4%) respondents agreed that ASP was necessary and agreed to participate in ASP respectively. All 28 (100.0%) respondents agreed to lead an ASP. The median (IQR) respondents' practice score was - 2.0 (IQR: -6.0-5.8) (N = 16). Respondents were inconsistently (never, sometimes, every time) participating in multi-disciplinary forums (6/16, 37.5%) and expressed a desire for training (11/13, 84.6%) on ASP through in-service (7/27, 25.9%). Respondents thought ASP training should include medical officers (12/29, 41.4%) and nurses (9/29, 31.8%). Knowledge score was associated with gender (p = 0.048; V = 0.416) and attitude score (p = 0.013; V = 0.556).ConclusionOur study found pharmacists had good knowledge and a positive attitude toward ASP implementation but poor ASP practices. A multi-disciplinary in-service training could address identified knowledge and practice gaps.

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Dataset Information

HIV status, knowledge, attitudes and behaviour of persons with and without disability in South Africa: evidence from a national population-based survey.

Publications

HIV status, knowledge, attitudes and behaviour of persons with and without disability in South Africa: evidence from a national population-based survey.

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