Changes in Providers' Self-Efficacy and Intentions to Provide Safer Conception Counseling Over 24 Months.
AIDS Behav
; 22(9): 2895-2905, 2018 Sep.
Article
em En
| MEDLINE
| ID: mdl-29464428
ABSTRACT
High rates of fertility desires, childbearing and serodiscordant partnerships among people living with HIV (PLHIV) in Uganda underscore the need to promote use of safer conception methods (SCM). Effective SCM exist but few PLHIV benefit from provider-led safer conception counseling (SCC) and comprehensive national SCC guidelines are still lacking. Providers' self-efficacy, intentions and attitudes for SCC impact provision and should inform development of services, but there are no longitudinal studies that assess these important constructs. This study reports on changes in providers' knowledge, attitudes, motivation and confidence to provide SCC among a 24-month observational cohort of Ugandan HIV providers. Compared to baseline, providers evidenced increased awareness of SCM, perceived greater value in providing SCC, saw all SCM but sperm washing as likely to be acceptable to clients, reported consistently high interest in and peer support for providing SCC, and perceived fewer barriers at the 24-month follow-up. Providers' intentions for providing SCC stayed consistently high for all SCM except manual self-insemination which decreased at 24 months. Self-efficacy for providing SCC increased from baseline with the greatest improvement in providers' confidence in advising serodiscordant couples where the man is HIV-infected. Providers consistently cite the lack of established guidelines, training, and their own reluctance to broach the issue with clients as significant barriers to providing SCC. Despite providers being more interested and open to providing SCC than ever, integration of SCC into standard HIV services has not happened. Concerted efforts are needed to address remaining barriers by establishing national SCC guidelines and implementing quality provider training.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atitude do Pessoal de Saúde
/
Infecções por HIV
/
Cuidado Pré-Concepcional
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Competência Clínica
/
Transmissão de Doença Infecciosa
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Autoeficácia
/
Aconselhamento
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Intenção
Tipo de estudo:
Observational_studies
Limite:
Adult
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Female
/
Humans
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Male
/
Middle aged
/
Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Revista:
AIDS Behav
Assunto da revista:
CIENCIAS DO COMPORTAMENTO
/
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos