What you don’t know may hurt your patients: examining healthcare students’ reactions toward persons living with HIV (PLHIV)

OBJECTIVE: To examine whether healthcare students reactions towards PLHIV would be significantly different based on their knowledge of resources available for accidental HIV exposure, personal knowledge of someone living with HIV and attendance at HIV relevant sessions. DESIGN AND METHODS: A survey was conducted with 344 health-care students from the Faculty of Medical Sciences of the UWI St. Augustine. Participants’ emotional reactions towards PLHIV, perception of occupational risk for HIV, awareness of availability of post exposure prophylaxis (PEP), personal knowledge of someone with HIV and attendance at HIV relevant sessions in the past year were measured. Independent t-tests were used to analyse the data. RESULTS: Independent t-tests indicated a significant effect of awareness of the availability of post-exposure prophylaxis (PEP) on fear, (p =.02), and prejudicial evaluation (p =.03). Students who were aware of the availability of PEP at their institution had lower mean scores for fear (M = 4.59, SD = 2.44) and prejudicial evaluation (M = 21.47, SD = 6.75) than those who were unaware of the availability of PEP, fear (M = 5.21, SD = 2.40) prejudicial evaluation (M = 23.18, SD = 7.01) CONCLUSION: Healthcare providers should be informed of the resources available in case of accidental HIV exposure and the conditions under which they can be accessed. This knowledge and awareness may contribute to attenuating students’ fears and consequently their reactions toward HIV patients.

PSA, Gleason score and epidemiology of prostate cancer (PC) in Grenada

OBJECTIVE: To assess (1) the incidence and survival rates of PC, (2) the distribution of prostatic-specific antigen (PSA) and Gleason score in Grenada. DESIGN AND METHODS: A PC hospital-based series from the only urologist in the island was assembled. Age-adjusted incidence rates, PSA levels and Gleason scores for Grenada were analyzed and compared with US-Blacks and incidence rates from “International Agency for Research on Cancer (IARC)-contributing” Caribbean registries. RESULTS: 601 new cases of PC diagnosed between 1997-2013 equate to an annual age-adjusted incidence rate of 69.3 per 100,000 in Grenada. This is similar to the Jamaica rate of 77.3, but much inferior to those of US-Blacks 197.7 and Martinique 177.8. The median PSA level in Grenada was 18.0 ng/ml compared to 7.0 among US-Blacks (P<0.05). 47% of Grenadians with PC were in the high risk PSA category (>20ng/ml), compared to only 17% US-Blacks. Lower tract urinary infection and positive digital rectal examination were both significantly associated with high risk PSA and high risk Gleason score (Gleason sum ≥ 8). CONCLUSION: The lower PC incidence in Grenada and Jamaica is likely a reflection of lower prevalence of PSA-testing. Thus, PSA levels fall more substantially in the high risk category.

Predicting HIV testing decisions

OBJECTIVE: To evaluate previous HIV testing history among residents of a community in Trinidad so as to identify predictors of HIV testing decisions. DESIGN AND METHODS: A sample of 186 respondents aged 18- 85 years was surveyed using stratified random sampling. Through interviewer administered questionnaire information was acquired on HIV testing history, awareness of HIV testing and treatment information, fear of HV testing, stigma towards persons living with HIV, and perception of risk. A simultaneous logistic regression was used to model respondents’ decision to have an HIV test. RESULTS: There were 185 respondents (M 92, F 93). Respondents with higher levels of awareness are 1.109 times more likely to have had an HIV test; younger respondents were 0.945 times more likely to have had an HIV test than older respondents. Respondents who reported higher levels of perception of risk were 0.924 times less likely to have had an HIV test. CONCLUSION: Younger persons and persons with higher levels of awareness of HIV testing and treatment information were more likely to decide to be HIV tested while persons reporting higher levels of perception of risk were less likely to be tested. Interventions to build awareness of HIV testing and treatment should be designed to encourage HIV testing among older persons. A routinized approach to HIV testing has potential to shift the focus from HIV prevention to health and well-being and dismantle barriers which prevent people from realising the real risks of HIV infection.