Knowledge, Attitude and Practices of Doctors Towards Hiv Testing and Counselling in a Private Tertiary Hospital in Kenya

Abstract

Background: Counselling is one of the core principles in HIV testing service package which may be provided as a part of general healthcare or as a specific specialized service. With involvement of doctors, there is an opportunity to increase uptake of HIV testing services in the private sector. Objective: To establish knowledge, attitude and practices of doctors towards HIV counselling and testing for patients at the private tertiary Hospital in Kenya. Method: This was a cross-sectional study conducted among doctors in private tertiary hospital. Quantitative data was collected by pretested online questionnaires whilst in depth interviews were done with key informants. A consecutive sampling was done to obtain 100 doctors from amongst residents and senior house officers working in the hospital. Data storage and protection was done in Microsoft Access 2013. Data was analysed using statistical software SPSS version 21.0. The quantitative analysis was done using descriptive statistics and the results presented using graphs and figures. Inferential statistics were based on cross tabulations (chi square statistic). The qualitative data was analysed based on patterns or themes identified and related to the study objectives. Results: The doctors interviewed were 57% females, 60% were aged between 31 and 40 years old, 66% had undergraduate qualification and 68% were senior house officers. Most (80%) of the doctors reported offering HIV testing services to their patients though 63% had never attended any training in counseling. Awareness of HIV testing guidelines was low at 16%. The challenges in offering HIV testing services included lack of training (87%) and time (77%) among doctors. There was a high likelihood to offer HIV testing services among doctors who were older than 30 years [OR 3.2 (95% CI 1.2-8.8), p=0.023] and those who had worked for more than 1 year in the hospital; 1 -4 years [OR 3.8 (95% CI 1.2-11.5), p=0.021] and ≥5 years [OR 10.8 (95% CI 2.1-56.3), p=0.005]. Conclusions: A high proportion of doctors in private hospital provided HIV testing services though there was a widespread lack of training and inaccessibility to national guidelines. Most of the testing was guided by the presenting symptoms of patients.