ABSTRACT
OBJECTIVE: Although Voluntary Counseling and Testing (VCT) has existed for more than 10 years, majority of Kenyans still do not know their HIV status, thus necessitating the introduction of other testing strategies to increase the number of people taking the test. The routine offer of an HIV test to all patients in health-care settings has been proposed to increase access to care. The main objective of this study was to identify factors associated with willingness to accept a routine offer of an HIV test. METHODS: This was a cross sectional study. The Setting was in the Outpatient department at a large Referral Hospital in Western Kenya. A total of 384 adult patients (both males and females) were recruited using systematic random sampling. Information was collected on basic socio demographic characteristics, knowledge about the routine offer of an HIV test, attitudes towards the testing and HIV testing practise. RESULTS: Of the 384 respondents, 64.3% were unaware about the routine offer of HIV testing in Health facilities. Multivariate analysis identified the main predictors of willingness to accept an HIV test offered in hospital as the age (OR 3.7, C.I 0.068-1.075), level of education (OR 3.4, C.I 0.186-62.602), Knowledge about the routine HIV testing (OR 4.6,C.I 2.118-9.847), self-perception of HIV risk (OR 8.4,C.I 3.424-20.496) and attitude towards routine offer of HIV testing (OR 9.2, C.I 0.042-0.284). CONCLUSION: There is a need to come up with tailored training on the routine offer of an HIV test and devising strategies to address the main factors that influence the decision for patients to test as identified above.
Subject(s)
AIDS Serodiagnosis/statistics & numerical data , Counseling/statistics & numerical data , HIV Infections/diagnosis , Health Knowledge, Attitudes, Practice , Motivation , Patient Acceptance of Health Care/psychology , Adolescent , Adult , Cross-Sectional Studies , Female , HIV Infections/prevention & control , Health Surveys , Humans , Interviews as Topic , Kenya , Male , Mass Screening , Middle Aged , Multivariate Analysis , Outpatient Clinics, Hospital , Referral and Consultation , Self Concept , Socioeconomic Factors , Surveys and Questionnaires , Voluntary Programs , Young AdultABSTRACT
OBJECTIVES: To describe the concerns and priorities of key stakeholders in a developing country regarding ethical obligations held by researchers and perceptions of equity or "what is fair" for study participants in an HIV/AIDS clinical drug trial. DESIGN: Qualitative study with focus groups. SETTING: Teaching and referral hospital and rural health centre in Western Kenya. PARTICIPANTS: Potential HIV/AIDS clinical trial participants, clinician researchers, and administrators. RESULTS: Eighty nine individuals participated in a total of 11 focus groups over a four month period. The desire for continued drug therapy, most often life long, following an HIV/AIDS clinical trial was the most common priority expressed in all focus groups. Patients with and without HIV/AIDS also thought subsidizing of drug therapies and education were critical forms of compensation for clinical trial participation. Financial incentives were considered important primarily for purchasing drug therapy as well as obtaining food. Patients noted a concern for the potential mismanagement of any money offered. Clinician researchers and administrators felt strongly that researchers have a moral obligation to participants following a trial to provide continued drug therapy, adverse event monitoring, and primary care. Finally, clinician researchers and administrators stressed the need for thorough informed consent to avoid coercion of study participants. CONCLUSIONS: Kenyan patients, clinician researchers, and administrators believe that it would be unfair to stop antiretroviral therapy following an HIV/AIDS clinical trial and that researchers have a long term obligation to participants.
