Factors predicting HIV- related knowledge among urban health workers in Malawi

Background: Health workers need HIV knowledge to prevent infection and improve care. This study identified demographic and attitudinal predictors of HIV transmission and universal precautions (UP) knowledge among health workers in Malawi. Methods:This secondary analysis used baseline survey data of 352 urban health workers in a referral hospital in Malawi to examine knowledge of HIV transmission (6 items) and UP (22 items). Demographic factors included age, food security, education, and job level. Attitudes included condom use attitude (10 items α=.77); Blame (if persons living with HIV (PLWH) should be blamed, 1 item: range 1-3, 3=blamed, 2=don't know; 1=not blamed); and Contact Acceptance (2 items, PLWH allowed: in public places, to cook family meal, 3=permitted, 2=don't know; 1=not permitted). Using linear regression we examined the impacts of demographic factors and attitudes on transmission and UP knowledge. Results: Health workers had higher knowledge of HIV transmission (87.6% correct) than UP (78.5 % correct). HIV transmission and UP were not correlated (r =.04). The regression analysis explained 35.1% of the variation in transmission knowledge, and Blame (negative) and Contact were the only significant predictors (F=16.535; p<.001). The regression analysis explained 33.5% of the variation in UP knowledge, and higher education and job levels were the only significant predictors (F=19.338; p<.001). Conclusion: HIV transmission knowledge related to less stigmatizing attitudes toward PLWH, while UP knowledge related to higher job level and education. Future health worker training should be made available for less educated workers and should include UP knowledge and stigma reduction.