Status and influencing factors of HIV/AIDS referrals actively offered by medical staff
NONG Li-ping1, HE Bo1, TANG Hong-yang1, LI Huo-jia2, CEN Ping1, LIN Qian1,LI Si-si1, XU Hong1, YAO Min1, QIN Wei-ao1, DENG Xiao-fang1
1.Nanning Municipal Center for Disease Control and Prevention, Nanning, Guangxi 530023, China; 2.Guangxi Zhuang Autonomous Region Institute of Health Supervision, Nanning, Guangxi 530021, China
Abstract:Objective To investigate the current situation and existing problems of referral services actively provided by medical staff in medical institutions for HIV/AIDS patients, to explore the factors influencing HIV/AIDS referral work, and to provide a basis for rationally formulating HIV/AIDS prevention and control strategies in local areas. Methods A face-to-face questionnaire survey was conducted among 249 medical professionals from 20 medical institutions in 15 counties (districts) in Nanning city, Guangxi province in July-August 2018, and the development of HIV/AIDS referral services was analyzed. Results The proportion of all HIV/AIDS patients who were found or managed and referred by the participants was 56.63%. Analysis of the institutional levels based on the proportions of providing referral services indicated that provincial institutions were the highest (67.12%), while county (district) institutions were the lowest (47.46%), without a statistically significant difference (χ2=5.463, P=0.131). Analysis of the nature of the institutions revealed that centers for disease control and prevention (CDCs) were the highest (88.23%), while general hospitals were the lowest (52.24%), with a statistically significant difference (χ2=7.980, P=0.046). The main reason for doctors’ not providing referral services was to forget to refer (88.89%). Univariate analysis showed that the years engaged in AIDS prevention and control work, the nature of institution, whether receiving training regarding AIDS prevention and control knowledge and referral skills, and other factors were statistically related to whether medical staff actively offered referral services to the patients (P<0.05). Multivariate analysis showed that the nature of the institution was CDC (OR=10.426, 95%CI:1.745-62.294), having 5 years and above working experience in anti-HIV/AIDS (OR=2.598, 95%CI:1.447-4.666) and receiving training in knowledge and skills of AIDS prevention and control (OR=12.066, 95%CI:4.518-32.223) were positive factors for medical staff to actively provide referrals services. Conclusions The proportion of medical staff to actively provide HIV/AIDS referral services for HIV/AIDS patients is still lower. The main reason for doctors’ not providing referral services is to forget to refer. To make certain the effective implementation of HIV/AIDS referral, it is necessary to establish the system of first doctor responsibility and referral assessment and reward, simultaneously further enhance the training among medical staff, especially in medical professionals from general hospitals and with less working experience in HIV/AIDS prevention and control, encourage them to actively provide targeted referrals for patients, and ensure the effective management and treatment of HIV/AIDS patients.
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