Khan Mohsin Saeed, Unemo Magnus, Zaman Shakila, Lundborg Cecilia Stålsby
Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
J Ayub Med Coll Abbottabad. 2009 Oct-Dec;21(4):1-6.
Human Immunodeficiency Virus (HIV) infection is a global problem of extraordinary dimensions and has so far resulted in nearly 25 million deaths worldwide. Health care providers (HCPs) are considered to play a pivotal role in the provision of preventive and curative services to individuals suffering from HIV/AIDS and sexually transmitted infections. Pakistan, which was previously categorised as having a low-prevalence, high-risk HIV epidemic, is now facing a concentrated HIV epidemic among its most at-risk populations such as injecting drug users. The objective of this study was to assess the knowledge, attitudes and reported practices relating to HIV/AIDS and STIs among private and public sector health care providers providing clinical services in areas where women sell sex.
This was an exploratory quantitative study, where a structured questionnaire was administered in face-to-face interviews with 200 HCPs from the public and private sectors. Knowledge about AIDS and correct diagnosis of STIs were defined as according to the national guidelines of NACP. Pearson's chi-square analysis was performed to test associations between predictors and level of knowledge of STIs in each group separately. Multivariate logistic regression analysis was employed to indicate predicting factors for correct management of STIs.
Forty-five percent of the HCPs had correct knowledge about the transmission and prevention of HIV, whereas 21% had seen a patient with advanced HIV infection, only two HCPs had been trained to manage such cases and 82% were not aware of syndromic management of STIs. Only 10% could cite the 'correct treatment' of gonorrhoea, syphilis and vaginal discharge. The odds of having the 'correct knowledge' of diagnosing gonorrhoea and syphilis were 2.1 (CI 95%, 1.2-3.8) if the HCP was a female medical doctor working in public sector.
Further intensive training is needed to improve the ability of relevant HCPs to correctly diagnose and effectively treat patients infected with HIV and STIs.
人类免疫缺陷病毒(HIV)感染是一个全球性的重大问题,迄今为止已导致全球近2500万人死亡。医疗保健提供者(HCPs)被认为在为感染艾滋病毒/艾滋病和性传播感染的个人提供预防和治疗服务方面发挥着关键作用。巴基斯坦曾被归类为低流行、高风险的艾滋病毒流行国家,现在正面临着在注射吸毒者等最易感染人群中集中爆发的艾滋病毒疫情。本研究的目的是评估在女性从事性交易地区提供临床服务的公共和私营部门医疗保健提供者对艾滋病毒/艾滋病和性传播感染的知识、态度及报告的行为。
这是一项探索性定量研究,通过对来自公共和私营部门的200名医疗保健提供者进行面对面访谈,使用结构化问卷。根据国家艾滋病控制规划(NACP)的指南定义关于艾滋病的知识和性传播感染的正确诊断。分别对每组预测因素与性传播感染知识水平之间的关联进行Pearson卡方分析。采用多变量逻辑回归分析来表明性传播感染正确管理的预测因素。
45%的医疗保健提供者对艾滋病毒的传播和预防有正确的认识,而21%的人见过晚期艾滋病毒感染患者,只有两名医疗保健提供者接受过管理此类病例的培训,82%的人不了解性传播感染的症状管理。只有10%的人能说出淋病、梅毒和白带的“正确治疗方法”。如果医疗保健提供者是在公共部门工作的女医生,对淋病和梅毒进行“正确诊断”的几率为2.1(95%置信区间,1.2 - 3.8)。
需要进一步加强培训,以提高相关医疗保健提供者正确诊断和有效治疗艾滋病毒和性传播感染患者的能力。