Perceptions toward HIV, HIV screening, and the use of antiretroviral medications: a survey of maternity-based health care providers in Zambia.
Mother-to-child transmission of HIV (MTCT) is a major contributor to Zambia's HIV burden. Based on our experience in Zambia, we felt that provider perceptions, knowledge base, and practice patterns toward HIV-positive mothers may pose as significant obstacles to preventing MTCT. Two hundred and twenty-five health care providers throughout Zambia were surveyed in 2002. Providers reported widespread stigma associated with HIV. Physicians (OR = 1.9), providers with research affiliations (OR = 2.3), and those located in Lusaka (OR = 9.0) were more likely to offer HIV testing. Only 30% routinely prescribed antiretroviral treatment (ART) to reduce MTCT. Practitioners from district facilities, those from Lusaka, and those employed at research facilities were more likely to prescribe ART routinely (OR = 2.8, 10.1 and 3.4 respectively). Among those never prescribing ART, most cited a lack of availability (83%). Our results highlight the need for further provider education, critical appraisal of the current system for HIV testing, and widespread distribution of ART.
Chi
Benjamin H
BH
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA. Bchi@cidrz.org
Chansa
Kayula
K
Gardner
Michael O
MO
Sangi-Haghpeykar
Haleh
H
Goldenberg
Robert L
RL
Sinkala
Moses
M
Muchimba
Maureen
M
Stringer
Jeffrey S A
JS
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000635:transmission*; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening; D008430:Maternal-Child Health Centers; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy; D011795:Surveys and Questionnaires; D015024:Zambia / Q000453:epidemiology