166061 Impact of a Peer Group Intervention on Rural Health Workers' HIV Prevention in Malawi

Monday, November 5, 2007: 10:30 AM

Marie L. Talashek, RN EdD , College of Nursing, University of Illinois at Chicago, Chicago, IL
Diana N. Jere, RNM, MScN , College of Nursing, University of Illinois at Chicago, Chicago, IL
Kathleen S. Crittenden , Sociology, University of Illinois at Chicago, Chicago, IL
C. P. N. Kaponda, MRNM PhD , Kamazu College of Nursing, University of Malawi, Llongwe, Malawi
Sitingawawo Kachingwe, MRNM MScN , University of Malawi, Kamuzu College of Nursing, Lilongwe, Malawi
M. M. Mbeba, MRNM PhD , Kamuzu College of Nursing, University of Malawi, Lilongwe, Malawi
James L. Norr, PhD , College of Nursing, University of Illinois at Chicago, Chicago, IL
Kathleen F. Norr, PhD , Department of Women, Children and Family Health Science, University of Illinois at Chicago, College of Nursing, Chicago, IL
           
Background: Health workers (HWs) can play a major role in reducing the negative impacts of the AIDS epidemic in Malawi. This presentation examines the impact of a 10-session peer group intervention on HWs' personal and occupation-related HIV prevention knowledge, attitudes and behaviors.

Methods: A quasi-experimental design tested the intervention in two rural districts randomly assigned to the intervention or control condition. The intervention/control HWs were compared using midterm (M) and final (F) interviews (n=M93/98; F221/196) and observations (n=M106/98; F407/311) at 15 and 30 months post- intervention.

Results: HWs were significantly more hopeful at midterm but not at final. At both times, intervention district HWs had significantly higher HIV knowledge and more positive attitudes, including less stigmatization, more positive attitudes toward condoms and HIV testing, higher self-efficacy for safer sex and discussing HIV, and more discussion of safer sex with partner(s). At final evaluation only, HWs in the intervention district had significantly fewer risky sexual behaviors (5-item index) and were more likely to have had a recent HIV test. Intervention district HWs engaged in more community HIV prevention activities at midterm and final. Observed and reported hand washing increased at both midterm and final. Workers did not report more glove use but had higher observed glove use at both times. Reported and observed HIV teaching increased at both times.

Implications: Providing a peer group intervention for rural HWs' HIV risk promotes both personal and work-related HIV prevention.

Learning Objectives:
1. Recognize the personal and occupational risk of health workers (HW) in rural Malawi. 2. Recognize the necessity of tailoring interventions to the structural and social context of the health care delivery system. 3. Discuss the impact of the peer group intervention on health workers’ personal knowledge, attitudes and behaviors and their use of universal precautions and client teaching about HIV.

Keywords: HIV Interventions, Risk Behavior

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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