Amsterdam 2015
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| Abstract #2333 - Strengthening HIV service provision | ||||
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Session: 44.2: Strengthening HIV service provision (Parallel) on Thursday @ 16.30-18.00 in C202 Chaired by Simon Gregson, Michael Evangeli Authors: Presenting Author: Mrs Tirza de Lange - Health[e]Foundation, Netherlands |
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| Additional Authors: | ||||
| Aim: In Sub-Saharan Africa, initiating and monitoring patients on ART has become a shared responsibility of nurses and doctors. This strategy seems to be effective in improving access to ART in light of the shortage of healthcare workers. However, one of the barriers for access to treatment is discrimination and stigmatization of people living with HIV/AIDS (PLWHA) by healthcare providers. Dignified comprehensive care improves the steps in the cascade from HIV testing, retention in care, starting ART and adhering to ART. Since nurses’ clinical responsibilities for PLWHA are increasing, the objective of this project was to enhance attitudes of nurses towards PLWHA, through a blended e-learning training program on HIV treatment and care. | ||||
| Method / Issue: In 2013 and 2014 a group of 171 nurses from Tanzania, South Africa and Rwanda completed the blended e-learning training program. The training consisted of an onsite kick-off workshop followed by a 12-week distance-based self-study period and a two-day interactive closing workshop. The e-learning training program includes 16 modules with a diversity of topics, focused on improving medical knowledge on HIV to reducing stigma and discrimination. The latter is mainly represented in modules on ‘Human rights and HIV’, ‘Mental Health and HIV’ and ‘Substance Misuse and Addiction’. The individual knowledge gain was assessed via pre- and post-test scores per module. During workshops additional data was collected, using the AIDS attitude scale and focus groups. | ||||
| Results / Comments: The overall increase of knowledge after completion of the training program was 14.5%. The most significant knowledge gain was found in: Adherence, Importance and Support (26%), Palliative Care and HIV (26%), Human Rights and HIV (15%), Mental Health and HIV (13%) and Substance Misuse and Addiction (18%). Compared to baseline, the AIDS attitude scores showed that empathy, as indicated by a more positive attitude towards PLWHA, increased after completion of the training. The nurses expressed more empathy for people who contract AIDS from sexual promiscuity, as well as they realized that living in a country where homosexuality is illegal does not mean homosexual couples have no rights. On a scale from 1 till 6 the average score for empathy was 5.3. The avoidance score, representing a negative attitude towards PLWHA, decreased after the training. The average score for avoidance was 2.2 on a scale from 1 till 6, whereby a lower score represents a less negative attitude. The outcomes of the focus groups confirmed that the nurses became more aware of their own attitude towards PLWHA and learned strategies to prevent discrimination. | ||||
| Discussion: The results confirm that the blended e-learning training program is an effective tool to increase knowledge on HIV treatment and care and enhance positive attitudes amongst healthcare workers towards PLWHA. Knowledge is essential for reducing stigma and discrimination in the healthcare setting and results in improved access to care, closing the gaps in the HIV cascade and retain PLWH within treatment service. | ||||
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