title: Attitudes, Knowledge, and Correlates of Self-Efficacy for the Provision of Safer Conception Counseling Among Ugandan HIV Providers.
abstract: High rates of childbearing desires (59%) and serodiscordant partnerships (50%) among people living with HIV (PHLA) in Uganda highlight the need for safer conception counseling (SCC). Provider attitudes about counseling PLHA on the use of safer conception methods (SCM) have been explored in qualitative studies, but published quantitative investigations are scarce. Data from 57 Ugandan providers were collected to examine providers' attitudes about childbearing among PLHA and engagement in discussions about childbearing, as well as their knowledge, interest, self-efficacy, and intentions to provide SCC. Correlates of self-efficacy for the provision of SCC were explored to inform the development of training programs. Providers reported a general awareness of most SCM, especially timed unprotected intercourse (TUI); but just over half felt they knew enough to counsel clients in the future and all wanted more training. Childbearing was discussed with less than a third of reproductive aged patients and was mostly initiated by patients. Most providers saw value in providing SCC and believed that most aspects of SCM would be acceptable to their clients, but numerous barriers were endorsed. Self-efficacy was greatest among providers who had had more childbearing conversations, greater SCM awareness, perceived fewer barriers and greater intentions to counsel on TUI. Providers evidence fewer stigmatizing attitudes than in the past. However, those who endorsed more stigmatizing attitudes evidenced a trend for reporting lower self-efficacy for providing SCC. Training will need to simultaneously focus on increasing providers' SCC knowledge and skills while instilling a more realistic appraisal of the risks of assisting couples to employ SCM versus doing nothing.
authors.affiliation: 1 Health Services and Outcomes Research, Children's Mercy Hospitals and Clinics , Kansas City, Missouri.|2 Schools of Medicine and Pharmacy, University of Missouri - Kansas City , Missouri.
authors.forename: Kathy
authors.initials: K
authors.lastname: Goggin
authors.affiliation: 3 Department of Family Medicine, University of Kansas Medical Center , Kansas City, Missouri.
authors.forename: Sarah
authors.initials: S
authors.lastname: Finocchario-Kessler
authors.affiliation: 1 Health Services and Outcomes Research, Children's Mercy Hospitals and Clinics , Kansas City, Missouri.|4 School of Medicine, University of Missouri - Kansas City , Missouri.
authors.forename: Vincent
authors.initials: V
authors.lastname: Staggs
authors.affiliation: 5 RAND Corporation , Santa Monica, California.
authors.forename: Mahlet Atakilt
authors.initials: MA
authors.lastname: Woldetsadik
authors.affiliation: 6 Department of Disease Control and Environmental Health, School of Public Health, Makerere University , Kampala, Uganda .
authors.forename: Rhoda K
authors.initials: RK
authors.lastname: Wanyenze
authors.affiliation: 7 Mulago Hospital Department of Obstetrics and Gynaecology , Kampala, Uganda .|8 College of Health Sciences, Makerere University , Kampala, Uganda .
authors.forename: Jolly
authors.initials: J
authors.lastname: Beyeza-Kashesya
authors.affiliation: 9 University of California , Los Angeles Center for Culture and Health, Los Angeles, California.
authors.forename: Deborah
authors.initials: D
authors.lastname: Mindry
authors.affiliation: 10 The AIDS Support Organization , Kampala, Uganda .
authors.forename: Sarah
authors.initials: S
authors.lastname: Khanakwa
authors.affiliation: 5 RAND Corporation , Santa Monica, California.
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Wagner
mesh_terms: D001291:Attitude of Health Personnel; D044383:Black People / Q000523:psychology; D003267:Contraception / Q000523:psychology*; D003376:Counseling; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D005298:Fertility; D005306:Fertilization; D015658:HIV Infections / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D033182:Intention; D008297:Male; D020377:Self Efficacy; D012747:Sexual Partners / Q000523:psychology; D011795:Surveys and Questionnaires; D014454:Uganda