title: Determinants of clinician knowledge on aging and HIV/AIDS: a survey of practitioners and policy makers in Kampala District, Uganda.
abstract: OBJECTIVE
  The HIV/AIDS epidemic has evolved with an increasing burden in older adults. We assessed for knowledge about aging and HIV/AIDS, among clinicians in Kampala district, Uganda.
  
  
  METHODS
  A cross-sectional survey of 301 clinicians complemented by 9 key-informant interviews between May and October 2011. Data was analyzed by multivariable logistic regression for potential determinants of clinician knowledge about HIV/AIDS in older adults, estimating their adjusted Odds Ratios (aOR) and 95% confidence intervals (95% CI) using Stata 11.2 software.
  
  
  RESULTS
  Two-hundred and sixty-two questionnaires (87.7%) were returned. Respondents had a median age of 30 years (IQR 27-34) and 57.8% were general medical doctors. The mean knowledge score was 49% (range 8.8%-79.4%). Questions related to co-morbidities in HIV/AIDS (non-AIDS related cancers and systemic diseases) and chronic antiretroviral treatment toxicities (metabolic disorders) accounted for significantly lower scores (mean, 41.7%, 95% CI: 39.3%-44%) compared to HIV/AIDS epidemiology and prevention (mean, 65.7%, 95% CI: 63.7%-67.7%). Determinants of clinician knowledge in the multivariable analysis included (category, aOR, 95% CI): clinician age (30-39 years; 3.28∶1.65-9.75), number of persons with HIV/AIDS seen in the past year (less than 50; 0.34∶0.14-0.86) and clinical profession (clinical nurse practitioner; 0.31∶0.11-0.83). Having diploma level education had a marginal association with lower knowledge about HIV and aging (p = 0.09).
  
  
  CONCLUSIONS
  Our study identified gaps and determinants of knowledge about HIV/AIDS in older adults among clinicians in Kampala district, Uganda. Clinicians in low and middle income countries could benefit from targeted training in chronic care for older adults with HIV/AIDS and long-term complications of antiretroviral treatment.
authors.affiliation: Joint Clinical Research Centre, Kampala, Uganda. eobuku@jcrc.org.ug
authors.forename: Ekwaro A
authors.initials: EA
authors.lastname: Obuku
authors.forename: Sujal M
authors.initials: SM
authors.lastname: Parikh
authors.forename: Victoria
authors.initials: V
authors.lastname: Nankabirwa
authors.forename: Nelson I
authors.initials: NI
authors.lastname: Kakande
authors.forename: David K
authors.initials: DK
authors.lastname: Mafigiri
authors.forename: Harriet
authors.initials: H
authors.lastname: Mayanja-Kizza
authors.forename: Cissy M
authors.initials: CM
authors.lastname: Kityo
authors.forename: Peter N
authors.initials: PN
authors.lastname: Mugyenyi
authors.forename: Robert A
authors.initials: RA
authors.lastname: Salata
mesh_terms: D000288:Administrative Personnel; D000328:Adult; D000367:Age Factors; D000375:Aging; D003430:Cross-Sectional Studies; D004502:Education, Medical, Continuing; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011795:Surveys and Questionnaires; D014454:Uganda; D055815:Young Adult