Effectiveness of clinician client centered counseling on condom use and status disclosure of adult HIV positive patients enrolled in care in Yola, Nigeria: a randomized clinical trial

This study assessed the effectiveness of a developed and implemented Clinician Client Centered Counseling Module on improving condom use and increasing HIV status disclosure to spouses and or sex partners of adult patients living with HIV enrolled in care in Yola, Nigeria. The study was a three arm randomized single blind clinical trial involving 386 randomly selected and allocated adult patients living with HIV who were enrolled into ART care at any of the four comprehensive ART sites in Yola. A clinician client centered training module was developed based on the Information Behavior and Motivation (IBM) Model. Nine Clinicians involved in ART care were trained with this module to deliver a 10 to 15 minutes clinic based intervention (Clinician Client Centered counseling). Intervention group one received two counseling sessions; at baseline and at two month, intervention group two received a counseling session at baseline and the control group received routine care. An interviewer administered structured questionnaire was used for data collection. Data was collected at baseline, two months and six months. Outcome measures were condom use and HIV status disclosure. Data was analyzed using SPSS version 22. At six months a significantly higher median condom use score was seen in intervention group one compared to intervention group two (1.00 vs 0.50; p = 0.01), and in intervention group one compared to the control group (1.00 vs 0.00; p = 0.01). A significant change in median condom use scores from baseline to 6 months was seen for intervention group one (p = 0.02). At six months a significantly higher mean HIV status disclosure was seen in intervention group one compared to the control group (0.30 vs 0.25; p = 0.01) and in the intervention group two compared to the control group (0.30 vs 0.25; p = 0.01). A significant main effect for time was seen for HIV status disclosure to spouse and/or sexual partners (p = 0.01). Clinician Client Centered counseling is an effective behavioral intervention in improving condom use and status disclosure of adult patients living with HIV

Knowledge and attitudes of adult HIV positive patients to HIV/AIDS in Selected ART Clinics in Yola, Nigeria

Though cases of AIDS are visible in Nigeria and awareness of HIV is high, correct knowledge on HIV transmission and prevention has remained low with significant numbers of people living with HIV/AIDS having low attitudes towards life and the disease itself. This study determined the baseline knowledge on HIV transmission and prevention, and attitudes towards HIV/AIDS of adult HIV positive patient enrolled into care at all four comprehensive antiretroviral therapy (ART) sites in Yola, Nigeria. Baseline reports on the knowledge and attitudes of adult HIV positive patients were obtained from a three arm randomized single blind clinical trial involving 386 randomly selected adult HIV patients who were enrolled into ART care at all four comprehensive ART sites in Yola. An administered, validated structured questionnaire was used for data collection. Outcome measures were sound knowledge on HIV transmission and prevention, and attitudes towards HIV/AIDS. Data was analyzed using SPSS version 22. Test of significance was at α level 0.05. Overall 237 (61.4%) had sound knowledge on HIV transmission and prevention, while 346 (89.6%) of respondents had high attitudes towards HIV/AIDS. Though majority of respondents had sound knowledge on HIV transmission and prevention as well as high attitudes towards HIV/AIDS, interventions to improve knowledge and attitudes among this group of individuals would improve positive preventive strategies

Effectiveness of clinician client-centered counseling on knowledge, attitudes and sexual bahaviors of antiretroviral therapy patients in Yola, Nigeria

Background: HIV/AIDS is a major challenge to public health in recent times. An estimated 34.0 million people are living with HIV/AIDS globally. Nearly one in twenty adults (4.9%) are living with HIV in Sub- Saharan Africa accounting for about 69% of the global burden. Prevalence in Nigeria is 4.1%. Adamawa state with Yola as capital has a prevalence of 3.8%.Despite better awareness and understanding of HIV in Nigeria, unhealthy sexual behaviors such as;continued unprotected sexual intercourse among HIV positive individuals with partners who are HIV negative or of unknown status, none or inconsistent condom use, multiple sexual partners and non-disclosure of status to spouses and/or sexual partners are noted. Thus behavioral change preventive interventions are still a driving force against HIV. Objective: To develop, implement and evaluate the effectiveness of a clinician client centered counseling module on improving knowledge on HIV transmission and prevention, attitudes towards HIV/AIDS, reducing multiple sexual partners, improving condom use and increasing HIV status disclosure to spouse/sex partners of ART patients in Yola, Nigeria. Methodology: This study was a three arm randomized single blind clinical trial involving 386 randomly selected and allocated adult HIV patients who were enrolled into Antiretroviral Therapy (ART) at all four comprehensive ART sites in Yola. A clinician client centered training module was developed based on the Information Behavior and Motivation (IBM) Model. Nine Clinicians were trained with this module to deliver a 10 to 15 minutes clinic based intervention (Clinician client centered counseling). The three groups were; intervention group one, intervention group two and the control group. Intervention group one received two counseling sessions; at baseline then at two months. Intervention group two received one counseling session at baseline only and the control group received routine care. An interviewer administered validated and reliable structured questionnaire was used for data collection. Data was collected at baseline, two months and six months. Outcome measures included;knowledge on HIV transmission and prevention, attitudes towards HIV/AIDS,number of sexual partners, frequency of condom use and status disclosure rates. Data was analyzed using SPSS version 22. Test of significance was at α level 0.05. Results: A significant statistical effect was seen for group (F (2, 331) = 17.410,p = 0.0001), time (F (2) = 49.826, p = 0.0001) and group and time interaction (F (2, 331) = 4.239, p = 0.002) for HIV knowledge. There was a significant main effect for groups (F (2) =11.107, p = 0.0001) and time (F (2) = 34.088, p = 0.0001) for attitudes towards HIV/AIDS. A significant change in median condom use scores from baseline to six months was seen for intervention group one;Friedman’s ANOVA ( ) = 12.410, p = 0.002. There was a significant main effect for time (F (2, 219) = 4.093, p = 0.020) for HIV status disclosure to spouse and/or sexual partners. Reductions were seen in numbers of respondents who had sex with unsteady partners in all study groups. Conclusion: Clinician client centered counseling is an effective behavioral intervention in improving knowledge, attitudes and sexual behaviors of ART patients. Keywords: Adult HIV positive patients; knowledge; attitudes; sexual behaviors;status disclosur

Sexual behaviors and status disclosure of adult HIV positive patients enrolled in care in Yola, Nigeria

With the availability of ART in most parts of Nigeria, more HIV positive individuals are living healthy lives. In periods of illness, sexual activity may be the last thing on the mind of a HIV positive individual but when in good health, sexual activity is definitely expected. This study describes the baseline sexual behaviors and status behavior of a three arm single blind randomized controlled clinical trial involving 386 randomly selected and allocated adult HIV patients who were enrolled into ART at all four comprehensive ART sites in Yola. The intervention was 10 to 15 minutes clinic based Clinician Client Centered counseling. An interviewer administered validated structured questionnaire was used for data collection. One hundred and eleven (62.4%) of respondents were inconsistent condom users, 29 (7.5%) had more than one sexual partner/spouse while 33 (11.3%) were yet to disclose their status to their spouse(s) and/or sex partners. Inconsistent condom use, non-status disclosure and sex with an unsteady partner were the most common high risk behaviors. Behavioral interventions are thus needed to reduce HIV spread in these groups of people

Sexual behaviours of adult HIV positive patients enrolled in care in Yola, Nigeria

Introduction: The objective of this study was to determine the effectiveness of a newly developed Clinician Client Cantered Counselling Module on improving knowledge, attitudes and sexual behaviours of adult HIV positive patients in Yola, Nigeria. The objective of this paper is to presents the baseline sexual behaviours of adult HIV positive patients enrolled into care at all four comprehensive Anti-Retroviral Therapy (ART) sites in Yola. Methodology: Baseline reports on the sexual behaviours of adult HIV positive patients were obtained from a 3-arm randomised single blind clinical trial involving 386 randomly selected and allocated adult HIV patients who were enrolled into care at all four comprehensive ART sites in Yola. The intervention was 10 to 15 minutes clinic based Clinician Client Cantered Counselling. The three groups were; intervention group 1, intervention group 2 and the control group. An interviewer administered structured questionnaire was used for data collection. Outcome measures included; frequency of condom use in sexual activity, number of sexual partners, sex with an unsteady partner and number of spouses/sexual partners, HIV status had been disclosed to in preceding 30 days. Data was analysed using SPSS version 22. Test of significance was at α level 0.05. Results: One hundred and one (62.4%) respondents were inconsistent condom users, 7.5% had more than one sexual partner/spouse, 5.2% had sex with an unsteady partner while 11.3% were yet to disclose their HIV status to their sex partners/spouses. Conclusion: Inconsistent condom use, non-status disclosure and sex with an unsteady partner were the most common high risk sexual behaviours. Behavioural intervention as a positive preventive strategy is thus needed to reduce HIV spread among this group of people