|Year : 2016 | Volume
| Issue : 2 | Page : 65-67
Knowledge of nurses in caring for pregnant women with HIV/AIDS infection
Program Officer, JHPIEGO, Gwalior, Madhya Pradesh, India
|Date of Web Publication||9-Jun-2020|
Source of Support: None, Conflict of Interest: None
HIV is one of the most threatening acquired infections which can be transmitted from mother to baby. Women of reproductive age comprise more than half of the 33 million people currently living with HIV around the world. Amongst 0.48% of the antenatal mothers attending antenatal clinics it is estimated that 20,000 children are infected by HIV/AIDS contributing to 30% of vertical transmission. In India, stigma and discrimination towards HIV patients hinders them from seeking the best health care services. This descriptive study was done to assess the knowledge of staff nurses in caring for HIV infected pregnant women. Staff nurses working in a Government Hospital, Visakhapatnam were selected through purposive sampling. Questionnaire was administered and data was analyzed using descriptive and inferential statistics. The results showed that 16.67 % had inadequate knowledge, 60 % had moderately adequate knowledge, and 23.33% had adequate knowledge. This study highlighted the need for the knowledge of the nurses as they are the key persons in antenatal clinics providing awareness and Counselling for HIV mothers in order to increase the effective use of Antiretroviral therapy to prevent parent to child transmission.
Keywords: HIV, knowledge, staff nurse, antiretroviral therapy, prevention of parent to child transmission
|How to cite this article:|
Dondapati N. Knowledge of nurses in caring for pregnant women with HIV/AIDS infection. Indian J Cont Nsg Edn 2016;17:65-7
| Introduction|| |
Acquired immunodeficiency syndrome (AIDS) is a term which applies to the most advanced stages of HIV infection. It is defined by the occurrence of any of more than 20 opportunistic infections or HIV related cancers. HIV can be transmitted through unprotected sexual intercourse (vaginal or anal), oral sex with an infected person, transfusion of contaminated blood, and the sharing of contaminated needles, syringes or other sharp instruments. It may also be transmitted between a mother and her infant during pregnancy, childbirth and breastfeeding (World Health Organization [WHO], 2016).
There were approximately 36.7 million people living with HIV at the end of 2015 (WHO, 2016). India has the third largest HIV epidemic in the world. In 2013, HIV prevalence in India was estimated as 0.3%. This figure is small compared to most other middle-income countries but because of India’s huge population (1.3 billion) this equates to 2.1 million people living with HIV(Avert, 2015).
Women of reproductive age comprise more than half of the 33 million people currently living with HIV around the world. In India about 7,90,00 women live with HIV infection (HIV AIDS Asia Pacific Research Statistical Data Information Resource AIDS Data Hub, 2015). The transmission of HIV from a HIV-positive mother to her child during pregnancy, labour, delivery or breastfeeding is called mother-to-child transmission. In the absence of any intervention, transmission rates range from 15% to 45%. This rate can be reduced to below 5% with effective interventions during the periods of pregnancy, labour, delivery and breastfeeding. These interventions primarily involve antiretroviral treatment for the mother and a short course of antiretroviral drugs for the baby (WHO, 2015).
A HIV positive woman about to give birth can dramatically reduce the likelihood of transmitting the virus to her newborn by delivering in a hospital or a primary care setting where she and her infant can receive even a single dose of the antiretroviral drug Nevirapine. The risk of mother-to- child transmission of HIV can be reduced to less than 5% through a combination of preventive measures, including antiretroviral therapy (ART) for the expectant mother and her new-born child, hygienic delivery conditions and safe infant feeding practices (United Nations International Children’s Emergency Fund [UNICEF], 2013).
The challenges in identifying and reaching pregnant women in need of prevention of parent to child transmission (PPTCT) services are immense in India, especially in the northern part of India. In India there are great efforts to establish PPTCT services but many pregnant women in rural areas do not have the means to reach such services (UNICEF, 2013). The role of ART as well as other strategies for the prevention of PPTCT is very important. If antepartum therapy has not been given to the mother, intrapartum therapy & prophylaxis to the infant should be provided. If neither antepartum nor intrapartum therapy has been administered, it is recommended that the infant receives Zidovudine for the first 6 weeks of life (Masci, 2016).
The average HIV prevalence among women attending antenatal clinics in India is 0.48%. Among these women, it is estimated that 20,000 children are infected by HIV/AIDS (Biswas et al, 2016). The number of clients attending the hospital with HIV is increasing especially to the antenatal clinics. The investigator noticed that many women at various stages of pregnancy were identified to be HIV positive and that there is a necessity for prevention of parent to child transmission of HIV. About 138 are receiving ART therapy annually in the PPTCT & ART centers in the hospital where the investigator is working.
In India, people with HIV frequently encounter discrimination while seeking and receiving healthcare services. The knowledge and attitude of healthcare professionals influences the willingness and ability of people with HIV to access care.
The objectives of the study were to
- assess the knowledge of staff nurses regarding the HIV infection
- find association of knowledge of staff nurses on HIV infection with selected demographic variables
| Methods|| |
A descriptive research design was adopted for this study. The population for the study included staff nurses working in a Governement hospital and the sampling technique used was purposive sampling where the investigator selected 30 staff nurses.
| Instruments|| |
A demographic proforma was used to collect staff demographics such as age, gender, education, marital status, experience, and in service education on HIV. A structured questionnaire was developed by the investigator to assess the knowledge of staff nurses regarding HIV Infection, HIV in pregnancy, ART Therapy and PPTCT. The questionnaire had four parts consisting of following:
- Part-I: It had 10 questions regarding knowledge on HIV & AIDS
- Part-II: It included 10 questions regarding knowledge on HIV in pregnancy
- Part-Ill: It consisted of 10 questions regarding knowledge on ART in HIV mothers
- Part-TV: It had 12 questions on knowledge on PPTCT
The total score of 42 was converted to percentage, less than 60% was categorized as inadequate, 61-80% as moderately adequate, and more than 80% as adequate knowledge. Each question if answered correctly was given a score of one. The tool was reviewed for validity and reliability. Written permission was obtained from the superintendent of the hospital. The staff nurses who participated in study were requested to complete the knowledge questionnaire after clear instructions on how to fill the questionnaire. Thirty staff nurses participated in the study and out of the total only 6 (20%) had attended in-service education on HIV / AIDS. The data was analysed using both descriptive and inferential statistics. Pilot study was conducted at KGH, Visakhapatnam and the feasibility and practicality of the tool was checked.
The study revealed that majority of the staff nurses (60%) had moderately adequate knowledge on HIV infection in pregnant mothers. There is no significant association between demographic variables and knowledge on HIV/AIDS infection.
Similarly in a study conducted by Agarwal, Saoji and Kasturwar (2013) on knowledge of nurses on HIV/AIDS in Nagpur it was identified that 36.5% of nurses had very good knowledge regarding HIV. Around 29.5% and 26% study subjects had adequate and low levels of knowledge respectively, and in 8% of study subjects the knowledge was found to be very low. In a study done in China by Chen, Han, and Holzemer (2004) on Knowledge of nurses on HIV Infection and AIDS it was identified that all nurses had heard of AIDS, but 7.4% did not know what causes AIDS. Most knew that a blood test can detect the HIV virus (98.9%) and that HIV can be transmitted (97.1 %), but nurses were not very sure how HIV/AIDS can be transmitted. In the present study majority of nurses had moderately adequate knowledge although many of them (80%) had not attended any inservice education. In a recent study done in Nigeria where the HIV prevalence is high (Mohammed, Kever, Martins, Afolabi, & Bulama, 2016) it was found that nurses (65.7%) inspite of having access to multiple sources of information had low knowledge regarding PPTCT of HIV. It is alarming to find out from this study as well as from other studies that irrespective of the global emphasis given to caring for HIV / AIDS patients and the extensive information available on the topic, nurses had inadequate knowledge regarding care of patients andmothers with HIV/AIDS.
| Conclusion|| |
Thus the study concludes that the staff nurses who are key persons in the healthcare settings need to update their knowledge on HIV, ART regimen and PPTCT since they are the ones who can influence the mothers screened for HIV and thereby encourage them to initiate the Antiretroviral therapy at the earliest in order to prevent PPTCT.
Conflicts of Interest: The author has declared no conflicts of interest.
| References|| |
Biswas, D., Borkakoty, B., Mahanta, J., Walia, K., Saikia, L., Akoijam, B. S., … & Zomawia, E. (2011). Seroprevalence and risk factors of herpes simplex virus type-2 infection among pregnant women in Northeast India. BioMedCentralInfectious Diseases
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Chen, W. T., Han, M., & Holzemer, W. L. (2013). Nurses’ knowledge, attitudes, and practice related to HIV transmission in northeastern China. AIDS Patient Care andSTDs
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Masci, J. R. (2016). Outpatient management of HIV infection.
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Mohammed, E, F., Kever, R. T., Martins, S. D., Afolabi, O., & Bulama, K. (2016). Knowledge, attitudes and practices of nurses’ on prevention of mother-to-child transmission (PMTCT) of human immuno-deficiency virus (HIV) in State Specialist Hospital, Maiduguri, Borno State. International Journal of Nursing and Midwifery, 8(2)
, 12 - 17. Retrieved from file:///C:/Documents% 20and%20 Settings/cmc/My%20Documents/ Downloads /HIV%20AIDS%2 0Nurses% 20knowledge%20(3).pdf