Background
Methods
Study population, setting and design
Sampling procedure
Data collection procedure
Measures
HIV-related knowledge
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The HIV transmission knowledge section included 6 questions. For each item, the responses were coded as 1 (correct answer) or 0 (incorrect answer or unknown). The number of correct responses was summed. A higher score reflected better knowledge. Because the median knowledge score was 4, the respondents with correct answers to at least 4 questions represented the high-score group, and those with correct answers to less than 4 questions represented the low-score group.
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Exposure prevention knowledge was used to measure the emergency response ability of the medical staff after HIV exposure at work. This module contained 10 questions. Respondents with correct responses to at least six of the ten exposure prevention knowledge questions were defined as the high-score group, and those with less than 6 correct responses were defined as the low-score group.
Personal attitudes
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Willingness to treat: Two individual items measured the medical workers’ willingness to take care of PLWHA: (i) general treatment and (ii) high-risk treatment (yes or no).
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Evaluation of occupational exposure protection system: The evaluation of the current security system offered by the government for HIV occupational exposure had one question measured on a three-point scale (1 = not at all to 3 = very satisfied).
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Fear of HIV exposure: The fear of work-related HIV exposure had one question measured on a three-point scale (1 = no fear, 2 = some fear, and 3 = substantial fear).
Discrimination behaviours
Statistical analysis
Results
Sociodemographic and clinical characteristics
Variable | Number | Percent |
---|---|---|
Gender | ||
Male | 266 | 27.4 |
Female | 706 | 72.6 |
Working years | ||
≤2 years | 430 | 44.2 |
3–7 years | 235 | 24.2 |
≥8 years | 307 | 31.6 |
Medical education | ||
Junior college degree or lower | 396 | 40.7 |
Medical degree | 428 | 44.0 |
Higher than medical degree | 148 | 15.2 |
Level of care | ||
Tertiary hospital | 645 | 66.4 |
Secondary hospital or lower | 327 | 33.6 |
Training | ||
Yes | 519 | 53.4 |
No | 453 | 46.6 |
Profession | ||
Doctor | 437 | 45.0 |
Nurse | 432 | 44.4 |
Laboratory technician | 103 | 10.6 |
Department | ||
Internal medicine | 266 | 27.4 |
Surgical department | 355 | 36.5 |
Clinical laboratory department | 66 | 6.8 |
Administrative department | 285 | 29.3 |
HIV-related knowledge
Item | Correct responses N (%) | |
---|---|---|
HIV transmission knowledge | Which is the least risky pattern of exposure to HIV-positive blood? | 818 (84.2) |
Which type of body fluid from PLWHA can cause infection? | 797 (82.0) | |
Which is the most effective measure to prevent HIV infection? | 769 (79.1) | |
What is the current stage of the AIDS epidemic in China? | 752 (77.4) | |
Which sexual behaviour is the most dangerous? | 470 (48.4) | |
What are the epidemic characteristics of HIV/AIDS in China? | 379 (39.0) | |
Exposure prevention knowledge | How should one address needles used by HIV-positive patients? | 879 (90.4) |
Which is not a universal precautionary principle to prevent occupational exposure to HIV? | 807 (83.0) | |
Which is not a measure of HIV occupational exposure? | 741 (76.2) | |
What is the best time for preventive medication after occupational exposure? | 720 (74.1) | |
Which treatment is not correct if stabbed by HIV-contaminated needles? | 681 (70.1) | |
Which is not a principle that is commonly followed by parties and the relevant departments after HIV occupational exposure? | 564 (58.0) | |
Which is not the main basis for assessing the risk of HIV exposure? | 556 (57.2) | |
How many days is the course of preventive medication after occupational exposure? | 491 (50.5) | |
How should one to treat the eye mucosa after it is splashed by HIV-infected fluid? | 460 (47.3) | |
Which is the correct operation to prevent occupational exposure to HIV? | 214 (22.0) |
Personal attitudes at work
Personal attitudes | N (%) |
---|---|
Evaluation of occupational exposure protection system | |
Satisfaction | 321 (33.0%) |
Neutral | 557 (57.2%) |
Dissatisfaction | 94 (9.7%) |
Fear of work-related HIV exposure | |
Substantial fear | 158 (16.3%) |
Some fear | 611 (62.9%) |
No fear | 203 (20.9%) |
I would provide general treatment for PLWHA | |
Yes | 828 (85.2%) |
No | 144 (14.8%) |
I would provide high-risk treatment for PLWHA | |
Yes | 765 (78.7%) |
No | 207 (21.3%) |
Discrimination against PLWHA
Had experience in the diagnosis and treatment of PLWHA | Had no experience | |||
---|---|---|---|---|
Yes | No | Total | ||
Refused to treat | 149 (38.6) | 237 (61.4) | 386 | 586 |
Forced detection | 252 (65.3) | 134 (34.7) | 386 | 586 |
Differential treatment | 197 (51.0) | 189 (49.0) | 386 | 586 |
Disclosed information | 179 (46.4) | 207 (53.6) | 386 | 586 |
Bivariate results
Refused treatment (n = 386) | Forced detection (n = 386) | Differential treatment (n = 386) | Disclosed information (n = 386) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Yes | No |
χ
2
| Yes | No |
χ
2
| Yes | No |
χ
2
| Yes | No |
χ
2
| |
Level of care | ||||||||||||
Tertiary hospital | 87 (31.3) | 191 (68.7) | 22.38a | 171 (61.5) | 107 (38.5) | 6.23 b | 142 (51.1) | 136 (48.9) | 0.00 | 130 (46.8) | 148 (53.2) | 0.06 |
Secondary hospital and lower | 62 (57.4) | 46 (42.6) | 81 (75.0) | 27 (25.0) | 55 (50.9) | 53 (49.1) | 49 (45.4) | 59 (54.6) | ||||
Number of years working | ||||||||||||
≤ 2 years | 46 (34.6) | 87 (65.4) | 6.84 b | 85 (63.9) | 48 (36.1) | 0.19 | 68 (51.1) | 65 (48.9) | 0.03 | 68 (51.1) | 65 (48.9) | 3.19 |
3–7 years | 55 (48.7) | 58 (51.3) | 74 (65.5) | 39 (34.5) | 57 (50.4) | 56 (49.6) | 45 (39.8) | 68 (60.2) | ||||
≥ 8 years | 48 (34.3) | 92 (65.7) | 93 (66.4) | 47 (33.6) | 72 (51.4) | 68 (48.6) | 66 (47.1) | 74 (52.9) | ||||
Profession | ||||||||||||
Doctor | 63 (37.3) | 106 (62.7) | 3.26 | 105 (62.1) | 64 (37.9) | 5.13 | 91 (53.8) | 78 (46.2) | 2.15 | 77 (45.6) | 92 (54.4) | 0.35 |
Nurse | 82 (41.4) | 116 (58.6) | 138 (69.7) | 60 (30.3) | 99 (50.0) | 99 (50.0) | 92 (46.5) | 106 (53.5) | ||||
Laboratory technician | 4 (21.1) | 15 (78.9) | 9 (47.4) | 10 (52.6) | 7 (36.8) | 12 (63.2) | 10 (52.6) | 9 (47.4) | ||||
Department | ||||||||||||
Internal medicine | 48 (37.2) | 81 (62.8) | 6.14 | 71 (55.0) | 58 (45.0) | 11.93a | 52 (40.3) | 77 (59.7) | 11.27a | 66 (51.2) | 63 (48.8) | 3.88 |
Surgical department | 65 (38.9) | 102 (61.1) | 119 (71.3) | 48 (28.7) | 100 (59.9) | 67 (40.1) | 68 (40.7) | 99 (59.3) | ||||
Clinical laboratory department | 3 (15.8) | 16 (84.2) | 10 (52.6) | 9 (47.4) | 9 (47.4) | 10 (52.6) | 10 (52.6) | 9 (47.4) | ||||
Administrative department | 33 (46.5) | 38 (53.5) | 52 (73.2) | 19 (26.8) | 36 (50.7) | 35 (49.3) | 35 (49.3) | 36 (50.7) | ||||
HIV transmission knowledge | ||||||||||||
Low score | 96 (43.8) | 123 (56.2) | 5.85b | 157 (71.7) | 62 (28.3) | 9.16b | 115 (52.5) | 104 (47.5) | 0.44 | 113 (51.6) | 106 (48.4) | 5.56 b |
High score | 53 (31.7) | 114 (68.3) | 95 (56.9) | 72 (43.1) | 82 (49.1) | 85 (50.9) | 66 (39.5) | 101 (60.5) | ||||
Exposure prevention knowledge | ||||||||||||
Low score | 97 (42.9) | 129 (57.1) | 4.29b | 152 (67.3) | 74 (32.7) | 0.94 | 122 (54.0) | 104 (46.0) | 1.89 | 110 (48.7) | 116 (51.3) | 1.16 |
High score | 52 (32.5) | 108 (67.5) | 100 (62.5) | 60 (37.5) | 75 (46.9) | 85 (53.1) | 69 (43.1) | 91 (56.9) | ||||
Training | ||||||||||||
No | 74 (44.3) | 93 (55.7) | 4.05b | 111 (66.5) | 56 (33.5) | 0.18 | 92 (55.1) | 75 (44.9) | 1.94 | 80 (47.9) | 87 (52.1) | 0.28 |
Yes | 75 (34.2) | 144 (65.8) | 141 (64.4) | 78 (35.6) | 105 (47.9) | 114 (52.1) | 99 (45.2) | 120 (54.8) | ||||
Evaluation of occupational exposure protection system | ||||||||||||
Satisfaction | 62 (44.0) | 79 (56.0) | 2.82 | 89 (63.1) | 52 (36.9) | 8.27 a | 64 (45.4) | 77 (54.6) | 2.85 | 63 (44.7) | 78 (55.3) | 0.44 |
Neutral | 70 (35.0) | 130 (65.0) | 125 (62.5) | 75 (37.5) | 109 (54.5) | 91 (45.5) | 96 (48.0) | 104 (52.0) | ||||
Dissatisfaction | 17 (37.8) | 28 (62.2) | 38 (84.4) | 7 (15.6) | 24 (53.3) | 21 (46.7) | 20 (44.4) | 25 (55.6) | ||||
Fear | ||||||||||||
Substantial fear | 41 (54.7) | 34 (45.6) | 10.16 a | 67 (89.3) | 8 (10.7) | 27.43 a | 58 (77.3) | 17 (22.7) | 26.12 a | 43 (57.3) | 32 (42.7) | 4.52 |
Some fear | 80 (34.5) | 152 (65.5) | 131 (56.5) | 101 (43.5) | 106 (45.7) | 126 (54.3) | 102 (44.0) | 130 (56.0) | ||||
No fear | 28 (35.4) | 51 (64.6) | 54 (68.4) | 25 (31.6) | 33 (41.8) | 46 (58.2) | 34 (43.0) | 45 (57.0) |
Multivariate results
Discrimination | Variables | Wald | OR (95% CI) |
---|---|---|---|
Refused treatment (0 = No, 1 = Yes) | Level of care (ref: Tertiary hospital) | ||
Secondary hospital or lower | 19.405 | 2.997 (1.839, 4.885) | |
Number of years working (ref: ≥8 years) | 6.097 | ||
3–7 years | 5.179 | 1.877 (1.091, 3.227) | |
≤2 years | 0.080 | 1.083 (0.624, 1.881) | |
HIV transmission knowledge (ref: High score) | |||
Low score | 5.797 | 1.741 (1.109, 2.735) | |
Fear (ref: No fear) | 9.316 | ||
Some fear | 0.369 | 0.840 (0.478, 1.474) | |
Substantial fear | 4.115 | 2.021 (1.024, 3.987) | |
Forced detection (0 = No, 1 = Yes) | Level of care (ref: Tertiary hospital) | ||
Secondary hospital or lower | 5.444 | 1.900 (1.108, 3.258) | |
Department (ref: Internal medicine) | 12.558 | ||
Surgical department | 9.202 | 2.221 (1.326, 3.720) | |
Clinical laboratory department | 0.411 | 0.710 (0.249, 2.024) | |
Administrative department | 4.249 | 2.031 (1.035, 3.985) | |
Evaluation of Occupational Exposure Protection System (ref: Satisfaction) | 6.638 | ||
Neutral | 0.053 | 1.058 (0.653, 1.714) | |
Dissatisfaction | 6.320 | 3.276 (1.299, 8.262) | |
Fear (ref: No fear) | 23.348 | ||
Some fear | 3.440 | 0.585 (0.332, 1.031) | |
Substantial fear | 9.113 | 4.014 (1.628, 9.898) | |
Differential treatment (0 = No, 1 = Yes) | Department (ref: Internal medicine) | 13.779 | |
Surgical department | 13.490 | 2.520 (1.539, 4.127) | |
Clinical laboratory department | 0.393 | 1.383 (0.502, 3.815) | |
Administrative department | 1.647 | 1.492 (0.810, 2.751) | |
Fear (ref: No fear) | 25.99 | ||
Some fear | 0.819 | 1.277 (0.752, 2.169) | |
Substantial fear | 21.741 | 5.583 (2.710, 11.504) | |
Disclosed information (0 = No, 1 = Yes) | HIV transmission knowledge (ref: High score) | ||
Low score | 5.527 | 1.631 (1.085, 2.453) |