KNOWLEDGE, ATTITUDE AND USE OF HIV COUNSELLING AND TESTING SERVICES BY FEMALE NURSES IN IBADAN METROPOLIS, NIGERIA

Abstract

The impact of HIV/AIDS on the health sector including the health professionals is alarming. HIV Counselling and Testing (HCT) is one of the cornerstones of HIV prevention efforts. Although nurses nurses have important roles to play in promoting the adoption of HCT services among their clients, there is dearth of information on the uptake of this service by the nurses. This study was therefore designed to access knowledge, attitude and use of HCT services by nurses in Ibadan metropolis, Nigeria. The study was a cross sectional survey. A two-stage random sampling technique was used to select 13 facilities from 87 government owned healthcare facilities; 1 tertiary, 4 secondary and 8 primary facilities. A total of 391 registered nurses were randomly selected from the selected health facilities; 277 nurses from the 6 Departments in tertiary, 88 from the secondary and 26 nurses in primary health facilities respectively. Data were collected using a validated questionnaire which included a 14-point knowledge and 12- point attitude scales and use of HCT. Knowledge scores >7 was categorised as good while attitude scores of >6 was rated as positive. Data were analysed using descriptive statistics, Chi-square and logistic regression with level of significance set at 5%. Respondents' age was 34.7±0.1 years, 60.1% were married and 37.3% were staff nurses. Respondents' knowledge score was 7.5±2.2 with 67.3% having poor knowledge of HCT. The attitude score was 7.5±1.9 and 74.7% of them had positive attitude towards use of HCT. Approximately 77% of the respondents had utilised HCT services. Among 300 (76.7%) who had ever been tested for HCT, 42.9% did so during routine antenatal care attendance while 57.1% did so voluntarily in HCT centres. The reasons adduced for getting tested included curiosity (66.1%) and antenatal requirements (18.2%). Majority (76.3%) received pre- and post-test counselling while 23.7% did not. Out of 91 respondents who had never received HCT service 68.7% reported willingness to do so in future. A condition given by 78.8% of respondents with intention to get tested for HIV in future was assurance of confidentiality of result. Reasons given by 76 respondents for unwillingness to utilise HCT services included; not regarding the test as a priority (40.8%), perceived non-vulnerability (28.9%) and fear of a positive result (13.2%). Significantly, more respondents aged 20-29 years (67.3%) used HCT compared to other age groups. Also more respondents aged 20-29 years (76.2%) had positive attitude to the use of HCT compared to other age groups. Similarly, significantly more staff nurses (68.5%) used HCT services than other cadres of nurses. Nurses in secondary health facilities were 2.4 times more likely to have good knowledge of HCT compared to those in tertiary (OR=2.44, CI = 1.34-4.4). Nurses had both inadequate knowledge and low uptake of HIV Counselling and Testing. Health education strategies such as sensitization and training are recommended for improving nurses' knowledge and promoting the utilisation of HIV Counselling and Testing services among them.