Effect of Knowledge of Patients' HIV Positive Status on the Attitude of Health Workers in Zambia

Abstract

Background: Zambia, Southern Africa, has one of the world's most devastating HIV and AIDS epidemics. More than one in every seven adults in the country is living with HIV1 and this disease is the leading cause for patient work load in all health institutions putting a strain on the depleted work force. Fear of contracting HIV from such patients is real and likely to impact negatively on the attitude of patients if they knew the HIV status of the patient to be positive. This study was undertaken to investigate the influence of knowing the HIV status of a patient to be positive on the various decisions of healthcare providers regarding provision of health care to such patients.
Study design: This was a cross-sectional study conducted between 2001 and 2005 in Zambia among health workers during the costing of basic health care package among selected health centres.
Outcome Measures: Information was obtained by questionnaire and scored on Likerts' scale regarding whether a patient with known HIV positive test result should be: nursed in isolation ward, staff and health professionals should be notified , beds of such patients should be specially marked, relatives should be informed (with and without consent), relatives to be the ones to nurse such a patient, the terminally ill one should be denied resuscitation, staff would refuse to handle a patient, they would encourage a patient to use herbs and prayers rather than HAART, medical treatment was ever refused, admission was ever refused and surgeon ever refused operating on patient with positive HIVtest.
Results: Atotal 180 health workers comprising 120 (66.7%) nurses, 25(13.9%) physicians, 22 (12.2%) laboratory technicians and 13 (7.2%) environmental health technicians were studied. Most of interviewees felt that such patients should not be discriminated against. Over 80% felt that health staff should be availed this sero-status while 50% felt that relatives should be informed of the status even without consent and that the relatives nurse these patients .Half thought that resuscitation should not be done for terminally ill such patients and a third said they will offer prayers instead of HAART while half said they will recommend herbs. A third of physician reported having refused to operate on such patient. Conclusion: While most health-care professionals surveyed reported being in compliance with their ethical obligations the findings are a sources of concern. It would be useful to repeat this study now that HAART and post-exposure prophylaxis have been rolled out in Zambia. 

Keywords: Attitude, Health workers, Patient’s HIV status