No abstract

Background Late HIV diagnosis remains one of the challenges in combating the epidemic. Primary care providers play an important role in screening for HIV infection. Our study aims to evaluate the relationship between knowledge and barriers to HIV testing and screening outcomes. The impact of an education program for primary care providers, towards improving HIV testing and late diagnosis rates, is also assessed. Methods A self-administered questionnaire that was developed within the framework of the European project OptTEST was used to examine HIV knowledge and barriers to HIV testing scores before and after being involved in an HIV education program. A quasi-experimental design with pre- and post-intervention measures was performed to investigate its impact. We performed multivariable logistic regression analysis to assess the relationship between variables for the HIV testing offer. Results A total of 20 primary care centers and 454 primary care staff were included. Baseline OptTEST results showed that more knowledgeable staff offered an HIV test more frequently (OR 1.07; CI 95% 1.01–1.13; p = 0.027) and had lower barrier scores (OR 0.89; CI 95% 0.77–0.95; p = 0.005). Nurses had lower scores in knowledge-related items (OR 0.28; CI 95% 0.17–0.46; p<0.001), but higher scores in barrier-related items than physicians (OR 3.28; CI 95% 2.01–5.46; p<0.001). Specific centers with more knowledgeable staff members had a significant association with a greater level of new HIV diagnosis rates (OR 1.61; CI 95% 1.04–2.49; p = 0.032). After the intervention, we found that 12 out of 14 individual questions showed improved scores. In the 6 months after the training program, we similarly found a higher HIV testing rate (OR 1.19; CI 1.02–1.42; p = 0.036). Conclusions This study highlights the association between knowledge and barriers to HIV testing, including HIV testing rates. It shows that it is possible to modify knowledge and reduce perceived barriers through educational programs, subsequently improving HIV screening outcomes.

Título: Evaluación de una intervención dirigida a reducir el impacto del estigma en las personas con VIH capacitándolas para afrontarlo. Resumen: Este estudio tuvo como objetivo evaluar un programa de intervención dirigido a disminuir el impacto del estigma en las personas con VIH y a capacitarlas para afrontarlo. Se utilizó un diseño cuasiexperimental, con grupo control no equivalente, y prueba previa y posterior. Participaron 221 personas con VIH, 164 recibieron la intervención y 56 formaron parte de los grupos de control no equivalente. Las variables dependientes fueron la percepción de estigma -declarado e internalizado-, la autoestima, la percepción de autoeficacia, las estrategias de afrontamiento del estigma -control primario, secundario y de evitación-y, la calidad de vida. Se realizaron análisis de las varianzas (MANOVAS y ANOVAS) para comprobar las diferencias en el pre-test y en las puntuaciones diferenciales en ambos grupos, y análisis de la covarianza (MANCOVAS y ANCOVAS) para evaluar la eficacia del programa. Los resultados mostraron una reducción del estigma percibido y de las estrategias de evitación y, un incremento en la autoeficacia percibida para afrontar el estigma, en la disposición al uso de estrategias de aproximación y en la autoestima y la calidad de vida. Estos resultados indican que es posible capacitar a las personas con VIH para afrontar el estigma. Palabras clave: Estigma; VIH; afrontamiento; calidad de vida; evaluación intervención.Title: Assessment of an intervention to reduce the impact of stigma on people with HIV, enabling them to cope with it Abstract: The goal of this study was to assess an intervention program to reduce the impact of stigma on people with HIV and to enable them to cope with it. A quasi-experimental design, with non-equivalent control group and pre-and posttest was used. Participants were 221 people with HIV, of whom 164 received the intervention and 56 made up the nonequivalent control groups. The dependent variables were perception of stigma-enacted and internalized-, self-esteem, perception of selfefficacy, strategies used to cope with stigma-primary control, secondary control, and avoidance-and quality of life. Analysis of variance (MANO-VAS and ANOVAS) was conducted to determine pretest differences and differential scores in both groups, and analysis of covariance (MAN-COVAS and ANCOVAS) was performed to assess the efficacy of the program. The results showed reduction of perceived stigma and avoidance strategies and an increase in perceived self-efficacy to cope with stigma, disposition to use approach strategies, self-esteem, and quality of life. These results indicate that it is possible to train people with HIV to cope with stigma.

No abstract