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Int Health. 2019 Apr 27. pii: ihz016. doi: 10.1093/inthealth/ihz016. [Epub ahead of print]

Health workers' knowledge of safer conception and attitudes toward reproductive rights of HIV-infected couples in Kano, Nigeria.

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Departments of Community Medicine, Bayero University, PMB 3011 Kano, Kano State, Nigeria.
Centre for Infectious Diseases Research, Bayero University, PMB 3011 Kano, Kano State, Nigeria.
Departments of Obstetrics and Gynecology, Bayero University, PMB 3011 Kano, Kano State, Nigeria.
International Research Center of Excellence, Institute of Human Virology, Maina Court, Plot 252, Abuja, Nigeria.
Institute of Human Virology, University of Maryland, 725 W Lombard St, Baltimore, MD 21201, USA.
Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 725, Nashville, TN 37203, USA.



The restriction of reproductive rights of HIV-positive couples in low-resource settings could be related to the attitudes and skills of health workers. We assessed health workers' knowledge of safer conception and their attitudes toward the reproductive rights of HIV-positive couples in a tertiary hospital in Nigeria.


A cross-section of health workers (n=294) was interviewed using structured questionnaires. Knowledge and attitude scores were analyzed. Logistic regression was employed to generate adjusted odds ratios (AORs) for predictors of attitude.


Safer conception methods mentioned by respondents included timed unprotected intercourse with (27.9%) and without antiretroviral pre-exposure prophylaxis (37.4%), in vitro fertilization plus intracytoplasmic sperm injection (26.5%), and sperm washing and intrauterine insemination (24.8%). The majority (94.2%) of health workers acknowledged the reproductive rights of HIV-infected persons, although (64.6%) strongly felt that HIV-infected couples should have fewer children. Health workers reported always/nearly always counseling their patients on HIV transmission risks (64.1%) and safer conception (59.2% and 48.3% for females and males, respectively) (p<0.05). Among health workers, being older (30-39 vs <30 y) (AOR=1.33, 95% CI=1.13-2.47), married (AOR=2.15, 95% CI=1.17-5.58) and having a larger HIV-positive daily caseload (20-49 vs <20) (AOR=1.98, 95% CI=1.07-3.64) predicted positive attitude towards reproductive rights of HIV-affected couples.


Health workers had limited knowledge of safer conception methods, but were supportive of the reproductive rights of HIV-positive couples. Health workers in Nigeria require training to effectively counsel couples on their reproductive rights, risks and options.


HIV/AIDS; Nigeria; PMTCT; health workers; reproductive rights; safer conception knowledge


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