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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.

Author information

1
Departments of Community Medicine, Bayero University, PMB 3011 Kano, Kano State, Nigeria.
2
Centre for Infectious Diseases Research, Bayero University, PMB 3011 Kano, Kano State, Nigeria.
3
Departments of Obstetrics and Gynecology, Bayero University, PMB 3011 Kano, Kano State, Nigeria.
4
International Research Center of Excellence, Institute of Human Virology, Maina Court, Plot 252, Abuja, Nigeria.
5
Institute of Human Virology, University of Maryland, 725 W Lombard St, Baltimore, MD 21201, USA.
6
Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 725, Nashville, TN 37203, USA.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

KEYWORDS:

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

PMID:
31028377
DOI:
10.1093/inthealth/ihz016

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