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Title: ETHICAL PERCEPTION AND PRACTICES TOWARDS HIV TESTING AND DISCLOSURE AMONG HEALTH CARE WORKERS IN SOU

Authors: Adebimpe Wasiu Olalekan

Topic: Clinical Research

Abstract:

Introduction Ethical issues often arise in matters relating to HIV counseling, testing and disclosure (CTD). The objective of this study was to assess perception and practice of health care workers in southwestern Nigeria towards ethical issues relating to HIV testing and disclosure.

Methods: Descriptive cross sectional study of perception and practice towards ethical issues related to CTD among 320 secondary level health care workers selected using multi staged sampling method. Research instruments were semi structured interviewer administered questionnaires. Data was analyzed using the SPSS software version 17.0

Result: Mean age of respondents was 38.5(+4.3) years, 84(26.2%) were female while eighty three (25.9%) were involved in rendering comprehensive HIV care services. Forty seven (56.6%) of these routinely obtained a written inform consent, 12(14.4%) does post test counseling as a group. One hundred and twenty eight (40.0%) said clients have readymade access to their folders or hospital cards.

Measures usually adopted to ensure that all clients get tested including rescheduling a counseling session and use of incentives. Only 6(7.2%) of respondents doing CT have disclosed HIV status without clients consent, 240(75.0%) said they have right to know HIV status of clients before they perform some procedures on them. 43(13.4%) have refused doing a procedure for a client before because client was HIV positive,  while 241(75.3%) believed that clients have the right to say no to HIV testing. About 61.9% had positive attitude while 38.1% had poor perception to ethical issues relating to HIV CTD. Respondents who have had training on counseling and testing were thrice more likely to have a good perception towards ethical issues in CTD than those who were not trained (OR=2.9, CI=0.2-0.9, p=0.004)

Conclusion: Good perception but poor practice towards ethical issues in CTD were reported. Improving general awareness and training for all health workers could bridge this gap.

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    COMMENT - 1

  • IFFAT AHMED (Viewer) 31st Jan 2015 - 12:39 PM
    How do you propose to improve the general awareness of health care workers?
    And why do you think the health care workers have good perceptions about HIV but dont practice what they feel ?
    Thank you.
    • OLALEKAN WASIU ADEBIMPE (Author) 9th Feb 2015 - 4:44 PM
      This research does not say anywhere that heath care workers studied does not translate perception into practice. That was not the focus of the study. Evidence based outcome of this study found out that trainings (NGOs etc), on the job capacity buildings and improved supervisory roles among higher subordinates are among the strategies that could assist health care workers towards good ethical practices. This is a significant finding that emanated from this study, which was also commended by many other reviewers.

  • COMMENT - 2

  • Michael Sello Seahloli (Viewer) 2nd Feb 2015 - 1:11 AM
    Congratulations!! Adebimpe. Your article is important to the health workers and it is interesting to read that at this day and age there are still health workers who need training to understand how patients to be handle and especially vulnerable group. Continual medical education is important to help the health workers to able to perform their duties properly. Your article has highlighter the importance of training and the need. The policies are always changing and improved to protect both client and the health worker. Training is the only way to bridge this gab and I agree with your conduction. Health care intuitions should also apply the data privacy policies and train staff on it. Looking at the structure of the article, it was structured well however the referenced used were old. The latest reference in this article was in 2010 which is 4 to 5 years ago. Perhaps you should have added recent article to support you findings. Lastly I have noted that Table 1 was not labelled was not numbered like other table presented. Number one is missing.
    • OLALEKAN WASIU ADEBIMPE (Author) 9th Feb 2015 - 4:46 PM
      Thanks for your comments. I have substituted all the 4 old references that I found that were old. I don’t think references within 7-8 years are old. Table I is Socio-demographic characteristics of respondents. The numerical number 01 is missing and that’s omission error. Its now inserted. Thanks.

  • COMMENT - 3

  • Stephen joseph atta mensah (Viewer) 5th Feb 2015 - 2:49 AM
    Thanks Adebimpe for the article. It is very good to assess the impact of quality training on the performance of health workers in all areas. Your article has confirmed that continuous in-service trainings are critical to the quality of services delivered by the health workers. Health workers offering HIV CTD need proper trainings and refresher trainings also for them to render quality service to clients.
    Routine supportive supervision and monitoring are also very key to ensure high quality of service rendered to clients.
    • OLALEKAN WASIU ADEBIMPE (Author) 9th Feb 2015 - 4:47 PM
      Thanks for your comments

  • COMMENT - 4

  • Stephen joseph atta mensah (Viewer) 5th Feb 2015 - 2:50 AM
    Thanks Adebimpe for the article. It is very good to assess the impact of quality training on the performance of health workers in all areas. Your article has confirmed that continuous in-service trainings are critical to the quality of services delivered by the health workers. Health workers offering HIV CTD need proper trainings and refresher trainings also for them to render quality service to clients.
    Routine supportive supervision and monitoring are also very key to ensure high quality of service rendered to clients
    • OLALEKAN WASIU ADEBIMPE (Author) 9th Feb 2015 - 4:48 PM
      Thanks once again

  • COMMENT - 5

  • JULIUS FRU CHE (Viewer) 6th Feb 2015 - 3:20 AM
    Hello Adebimpe.
    Your article is very revealing. I however wish to know if the design was of the study to target institutions which had benefited from the training of the NGO was a way of evaluating the training being conducted by the NGO.
    • OLALEKAN WASIU ADEBIMPE (Author) 9th Feb 2015 - 4:52 PM
      Thanks. though there was a purposiveness in using health care workers with technical knowhow due to the Southwestern Nigeria based NGO with proven wide records of training among health care workers as stated in the manuscript, this research does not specifically target the NGO trained health care workers. In Nigeria, most training are NGO driven, and some of the NGO trained health care workers might have been selected to take part in the study simply because their facilities were randomly chosen to take part in the study. Its coincidence and this cannot be used to evaluate quality of the training given to Nigerian health care workers by the NGOs

  • COMMENT - 6

  • NZASI MUNDABI (Viewer) 7th Feb 2015 - 1:42 PM
    There was no statistically significant association between readiness to disclose HIV status and believing that health care workers have the right to know the status of clients before given them treatment?
    • OLALEKAN WASIU ADEBIMPE (Author) 9th Feb 2015 - 4:56 PM
      I don't understand your question or your focus here, since this your incomplete sentence was not any part of the study. our study did binary logistics regression mainly to showcase the importance of 'training'