Correlation between knowledge of HIV, attitudes and perceptions of HIV and a willingness to test for HIV at a regional hospital in KwaZulu-Natal, South Africa

Background: With millions of South Africans infected with human immunodeficiency virus (HIV) and less than 10of the population aware of their HIV status; HIV counselling and testing (HCT) is the first step in any attempt to reduce the number of new infections. For those who test negative; HCT personalises the risks and reinforces preventative messages whilst for those who are positive; it is the gateway to accessing counselling and care. The Health Belief Model postulates that knowledge and attitude influence behaviour. The aim of this study was to determine whether knowledge of HIV and the attitude of patients referred for HCT correlated with a willingness to test for HIV. Methods: One hundred and seventy two patients referred for HCT were randomly selected over a three month period. Data were collected by a research assistant using the modified standardised World Health Organization (WHO)-Global AIDS Project (GAP) questionnaire.Results: Ninety per cent of the participants demonstrated sound knowledge of HIV; acquired immune deficiency syndrome (AIDS) and HCT. Despite the 90of the participants with sound knowledge only 71.5of the participants tested for HIV. There was no statistically significant difference in knowledge between those who tested and those who did not test for HIV. Twenty five per cent of those who refused to test stated that they had already made up their mind not to test for HIV before the counselling session. Conclusions: Despite excellent knowledge of HIV; a significant number of patients referred for HCT do not test for HIV

Factors that positively influence adherence to antiretroviral therapy by HIV and/or AIDS patients and their caregivers

Background: The importance of dedicated adherence to antiretroviral treatment (ART) in the management of Human Immunodeficiency Virus (HIV) is well documented. Multiple factors may affect adherence and this study explores patients' and their caregivers' perceptions of factors which may positively influence adherence to ART. Method: This study was a descriptive, qualitative study that used both free attitude interviews and focus-group discussions. Nineteen patients attending a busy ART-clinic at a district hospital in KwaZulu-Natal and eight caregivers were purposefully selected. Selection criteria included good adherence to ARTs as evidenced by excellent clinic attendance for more than one year with evidence of clinical, immunological and viral improvement. Interviews were tape recorded, transcribed and thematically analysed. Results: Ten female participants, nine male participants and eight caregivers took part in the study. Participants highlighted three main categories that positively affect their adherence to ART namely: patient, disease and health care provider-related factors. Sub-themes included issues related to acceptance, disclosure to significant others, symptomatic improvement on ARTs and the importance of supportive relationships. Participants greatly valued the health care provider relationship and felt that the main role of the health care provider was to educate and support. Conclusion: This study has shown that the factors which most influenced adherence were patient-related (acceptance, disclosure, determination, and family support), disease-related and treatment-related (symptomatic illness and improvement on ARTs), and healthcare worker-related (relationships, and adherence classes)