title: Knowledge, attitudes and practices of South African healthcare workers regarding the prevention and treatment of influenza among HIV-infected individuals.
abstract: BACKGROUND
  The South African Department of Health (DOH) publishes annual guidelines identifying priority groups, including immunosuppressed individuals and healthcare workers (HCW), for influenza vaccination and treatment. How these guidelines have impacted HCW and their patients, particularly those infected with HIV, remains unknown.
  
  
  METHODS
  We aimed to describe the knowledge, attitudes and practices regarding influenza and the vaccine among South African HCW. Surveys were distributed by two local non-governmental organizations in public health clinics and hospitals in 21 districts/municipalities (5 of 9 provinces).
  
  
  RESULTS
  There were 1164 respondents; median age 41 years; 978/1126 (87%) female; 801/1122 (71%) nurses. One-third (34%) of HCW reported getting influenza vaccine 2013/2014 and most (94%) recommended influenza vaccine to patients infected with HIV. Ability to get vaccine free of charge (aOR 1.69; 95% CI 1.21-2.37) and having received influenza government training (aOR 1.50; 95% CI 1.04-2.15) were significantly associated with self-reported vaccination in 2013/2014. Self-reported 2013/2014 vaccination (aOR 3.76; 95% CI 1.28-11.03) and availability of influenza vaccine during the healthcare visit (aOR 2.56; 95% CI 1.18-5.57) were significantly associated with recommending influenza vaccine to patients infected with HIV/AIDS.
  
  
  CONCLUSIONS
  Only one-third of participants were vaccinated in 2013-2014 but those who were vaccinated were more likely to recommend vaccination to their patients. Free and close access to influenza vaccine were associated with a higher likelihood of getting vaccinated in 2013/2014. HCW who reported getting the influenza vaccine themselves, had vaccine to offer during the patient consult and were familiar with DOH guidelines/trainings were more likely to recommend vaccine to HIV-infected patients.
authors.affiliation: U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.|Battelle Atlanta, Atlanta, Georgia, United States of America.
authors.forename: Jazmin
authors.identifier: http://orcid.org/0000-0003-3484-276X
authors.initials: J
authors.lastname: Duque
authors.affiliation: Beyond Zero, Port Elizabeth, South Africa.
authors.forename: Sisanda
authors.initials: S
authors.lastname: Gaga
authors.affiliation: The Aurum Institute, Johannesburg, South Africa.
authors.forename: David
authors.initials: D
authors.lastname: Clark
authors.affiliation: Beyond Zero, Port Elizabeth, South Africa.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Muller
authors.affiliation: The Aurum Institute, Johannesburg, South Africa.
authors.forename: Bulenani
authors.initials: B
authors.lastname: Kuwane
authors.affiliation: Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.|School of Public Health, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Cohen
authors.affiliation: Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.|School of Public Health, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa.
authors.forename: Sibongile
authors.initials: S
authors.lastname: Walaza
authors.affiliation: U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.|Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.|U.S. Centers for Disease Control and Prevention- South Africa, Pretoria, South Africa.
authors.forename: Stefano
authors.initials: S
authors.lastname: Tempia
authors.affiliation: U.S. Centers for Disease Control and Prevention- South Africa, Pretoria, South Africa.
authors.forename: Puleng
authors.initials: P
authors.lastname: Ramatoboe
authors.affiliation: National Department of Health, South Africa, Pretoria, South Africa.
authors.forename: Tsakani
authors.initials: T
authors.lastname: Furumele
authors.affiliation: U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
authors.affiliation: U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.|U.S. Centers for Disease Control and Prevention- South Africa, Pretoria, South Africa.|United States Public Health Service, Rockville, Maryland, United States of America.
authors.forename: Meredith L
authors.initials: ML
authors.lastname: McMorrow
authors.affiliation: U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.|U.S. Centers for Disease Control and Prevention- South Africa, Pretoria, South Africa.|United States Public Health Service, Rockville, Maryland, United States of America.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Cohen
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007251:Influenza, Human / Q000150:complications / Q000517:prevention & control* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013019:South Africa