AIDS-related stigmatisation in the healthcare setting: a study of primary healthcare centres that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria

Objective: To assess AIDS stigmatising attitudes and behaviours by prevention of mother-to-child transmission (PMTCT) service providers in primary healthcare centres in Lagos, Nigeria. Design: Cross-sectional survey. Setting: Thirty-eight primary healthcare centres in Lagos, Nigeria. Participants: One hundred and sixty-one PMTCT service providers. Outcome measures PMTCT service providers' discriminatory behaviours, opinions and stigmatising attitudes towards persons living with HIV/AIDS (PLWHAs), and nature of the work environment (HIV/AIDS-related policies and infection-control guidelines/supplies). Results: Reported AIDS-related stigmatisation was low: few respondents (4%) reported hearing coworkers talk badly about PLWHAs or observed provision of poor-quality care to PLWHAs (15%). Health workers were not worried about secondary AIDS stigmatisation due to their occupation (86%). Opinions about PLWHAs were generally supportive; providers strongly agreed that women living with HIV should be allowed to have babies if they wished (94%). PMTCT service providers knew that consent was needed prior to HIV testing (86%) and noted that they would get in trouble at work if they discriminated against PLWHAs (83%). A minority reported discriminatory attitudes and behaviours; 39% reported wearing double gloves and 41% used other special infection-control measures when providing services to PLWHAs. Discriminatory behaviours were correlated with negative opinions about PLWHAs (r=0.21, p<0.01), fear of HIV infection (r=0.16, p<0.05) and professional resistance (r=0.32, p<0.001). Those who underwent HIV training had less fear of contagion. Conclusions: This study documented generally low levels of reported AIDS-related stigmatisation by PMTCT service providers in primary healthcare centres in Lagos. Policies that reduce stigmatisation against PLWHA in the healthcare setting should be supported by the provision of basic resources for infection control. This may reassure healthcare workers of their safety, thus reducing their fear of contagion and professional resistance to care for individuals who are perceived to be at high risk of HIV.Fulbright Scholar program, a program of the United States Department of State, Bureau of Educational and Cultural AffairsOpen access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Pharmacists' perceptions of the pharmacists' patient care process and performance in a simulated patient interaction

Objectives: To (1) evaluate the use of the pharmacists' patient care process (PPCP) by licensed pharmacists through a simulated patient activity and (2) describe pharmacists' awareness and perceptions of the PPCP in the state of Arizona. Design: Interviews were conducted to elicit pharmacists' perceptions and awareness of the PPCP. A simulated patient activity involved a role-play pharmacist-patient interaction in a community pharmacy setting. The PPCP was employed as the evaluative framework to assess pharmacist behavior. Setting and participants: Pharmacists licensed in the state of Arizona practicing in various pharmacy settings were recruited through e-mail list serves and snowball recruitment. Data were collected in person, by telephone, and via video chat. Outcome measures: Emergent qualitative themes from interviews were used to describe pharmacists' awareness and perceptions of the PPCP. The presence or absence of PPCP elements were assessed during the simulations. Results: A total of 17 pharmacists were interviewed; 16 participated in the simulated activity. Of these, 7 (41.2%) participants recalled specific details regarding the PPCP process. Participants felt that the PPCP accurately reflected their daily workflow. Accordingly, a mean of 15.8 of the 19 PPCP elements was observed in simulated pharmacist-patient interactions, still allowing room for improvement in pharmacist-led care planning. Participants indicated perceived value in a shared patient care process that facilitates collaboration with myriad health professionals and as an aid to leverage pharmacists' role on health care teams. Conclusion: In this study, pharmacists practicing in Arizona in various settings expressed an awareness of the PPCP, felt it accurately reflected the work they do, and expressed that the tool potentially added value to their work. (C) 2020 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.12 month embargo; published 31 March 2020This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Regional Variation of Pancreatic Cancer Incidence in the Nile Delta Region of Egypt over a Twelve-Year Period

Background. Pancreatic cancer is one of the deadliest forms of cancer, with incidence rates rising in many countries around the world. Geographic variation in pancreatic cancer incidence has not been studied extensively, especially in low- and middle-income countries. The aim of this study was to characterize the distribution of pancreatic cancer incidence in the central Nile Delta region of Egypt and to examine differences by urban and rural patient residence using the nation's only population-based cancer registry.Methods. Utilizing the Gharbiah province population-based cancer registry, data were abstracted for 1,089 pancreatic cancer cases diagnosed over twelve years from 1999 to 2010. Age- and sex-specific incidence rates were calculated and compared for urban and rural areas of the eight districts of Gharbiah.Results. Age-adjusted incidence of pancreatic cancer within Gharbiah varied considerably by urban/rural patient residence and by district. Incidence rates were 1.3 times higher in urban compared to rural areas (4.45 per 100,000 in urban areas and 3.43 per 100,000 in rural areas). The highest incidence rates were observed in urban centers of Kotour, El Santa, and Kafr El-Zayat districts (12.94, 8.32, and 7.89, respectively).Conclusion. Incidence rates varied greatly by urban and rural areas and by district of residence in the Nile Delta region of Egypt. Future studies should examine potential environmental risk factors that may contribute to the geographic distribution of pancreatic cancer in this region.Open access articleThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]