Abstract
OBJECTIVE:
The aim of this study was to assess Bilbila Sokota Road Project workers’ knowledge, attitude and practice on HIV/AIDS in China first highway engineering Company.
METHODS
: A cross sectional Survey was conducted among workers in China first high way engineering Company at Bilbila Sokota road project, Sokota, Ethiopia. Fifty-five workers were taken from project site/company. Data was collected using a validated self-administrated standardized questionnaire on Knowledge, attitude and practice including behavioral change regarding HIV/AIDS. Descriptive statistics and multivariate and bivaraite logistic regression were employed. Data were analyzed using SPSS version 20 statistical soft ware. P-value
RESULT:
Among the 54 workers’ who participated in the study, most (96.3%) had ever heard of the diseases HIV/AIDS. The majority 32 (59.3%) of participants were respond that mass media. Followed by NGOs (29.6%). Thirty-three (61.1%) of the study participant were believed that HIV
CONCLUSION:
The findings shown that participants had ever heard about HIV/AIDS. Only Mass media and NGOs were used as the major source of information about HIV/AIDS. This implies it may be lack of further health education and training about all source of information regarding HIV/AIDS. HIV/AIDS prevention and control training and health education efforts should be intensified to improve the attitude and practice workers in china first highway engineering company at Bilbila Sokota Road Project.
Introduction
Human Immunio Deficiency Viruses (HIV)/ Acquired Immunio Deficiency Syndrome (AIDS) have been raised with Young people at increased risk of infection worldwide. Even though Sexual behavior change are still remains as the most effective way of preventing further HIV/AIDS and related diseases transmission [1], people live with Human Immunodeficiency Virus (HIV) has been reached about 35 million in world notion. However, of those estimated PLWHIV, two-third (70%) of them is in Sub-Sharan Africa [2]. It has become one of the most devastating diseases humanity has ever faced in the region. As a result, it has become a major public health concern [3]. Evidence show that some sort of positive attitudes of student toward HIV in Iran; however, their knowledge still needs to be improved to enable them to deliver more accurate information to the community during the course of their speeches [4].
Few research finding indicates that the major risk of HIV transmission may be much higher than these averages if biological risk factors are present as such STIs and some vaginal conditions can increase the risk of HIV transmission by up to 8 times [5, 6, 7]. Furthermore, it transmitted from blood transfusion [8]. Phelps and colleagues suggested that blood donor screening had been reduced the diagnostic window period for HIV [9]. Hence, HIV risk behaviors and laboratory testing of each donated unit of blood for antibodies to HIV-1 and HIV-2 need the major interventions that are used to minimize this risk [10, 11]. Moreover, the spread of the HIV through needle sharing among drug users is the infectivity [12]. It is very high if any person uses injection equipment that someone who is HIV
In general, HIV is largely preventable; however, its rapid spread throughout a population due to lack of knowledge and practices toward to HIV/AIDS [15]. Behavioral practices among HIV
Methods and materials
Study design
A Community based cross-sectional study design was employed.
Study area and period
The study was conducted in China first highway Engineering at Bilbala 120, K126 200, based camp at Asketema 150, K175 150 from September, 2016 up to January, 2017. China First Highway Engineering Co., Ltd (CFHEC) was established in April, 1963. CFHEC now affiliates to China Communications Construction Company and locates its headquarters in Beijing. It has grown into a national special-class general contractor in major highway projects, focusing on construction of high-class highways and large bridges at home and abroad, integrating construction, design, supervising, research, measuring, and machinery manufacturing. The Ethiopian Roads Authority (ERA) on April 14, 2015 signed three road project contracts worth 6.2 billion Br, which will be fully covered by the Ethiopian government’s budget. The Bilbila Sokota road project consist 620 staffs and 120 PLWHIV.
Source of population
The source of population was all staffs found in China first highway engineering at Bilbila Sokota Road Project.
Study population
The study populations included a sample of staff found in China first highway engineering at Bilbila Sokota Road Project.
Inclusion criteria
Staffs who are working at China first highway engineering at Bilbila Sokota Road Project related with HIV/AIDS prevention and control program.
Exclusion criteria
Seriously ill participants who cannot respond to the questions, and who are on grief and wedding, who are not present at data collection time were excluded.
Sample size determination
A purposively 55 workers were recruited.
Sampling methods and procedures
In China first highway engineering at Bilbila Sokota Road Project, there are 620 staffs and 120 PLWHIV. A purposefully sampling method was used for recruit the participants. Snowball sampling was used. It is the common approaches of sequential sampling.
Variables of the study
Dependent variable
Knowledge with HIV/AIDS prevention and control programs; Attitude towards HIV/AIDS prevention and control programs; Practices on HIV/AIDS prevention and control programs; Behavioral change related with HIV risk contributing factors.
For the current study, the independent or predictor variables are age, sex, educational back ground, position at work, work experience and marital status.
Data collection instruments
A structured pre-tested questionnaire, prepared via reviewing of literatures, was used. The questionnaire was initially prepared in English and translated into Amharic (National language) and again translated back to English to check for any inconsistencies or distortions in the meaning of words and concepts. However, the company consists both English speakers (Chinese) and Amharic speaker (Ethiopian).Therefore; the questionnaires were disseminated with two various languages in order to be relaxed with this study.
Data collection techniques
Face to face interview was the technique of data collection. The interview were used semi-structure so as to let the interview express their thoughts and views using the few prelisted questions as elements to guide the course of interview to only relevant points and prevent the data become forest of information.
Data processing and analysis
All collected data were entered to SPSS version 20 statistical software for its analysis. Data was coded, and cleaned for completeness and consistency. Binary logistic regression model was used for analysis. Descriptive and bivariate analysis were computed to see the frequency distribution and to test whether there is association between dependent variables and selected independent variables respectively. Moreover, P-value less than 0.05 at 95% confidence interval was considered as statistically significant.
Data quality assurance
To assure data quality, the data collection tool was translated to local language (Amharic) and used directly English version questionnaire for foreigners. The recruited data collectors and their supervisors were trained for three days on the tools, objectives, confidentiality and so on. The structured questionnaire was pretested on 5% of the sample size outside of the study area, near to the city, for consistent understanding of the survey tool modifications was done accordingly. Close supervision was undertaken during data collection. Questionnaire was checked for completeness and consistency before data entry by the principal investigator.
Validity of instruments
The instrument was also critiqued by experts consisting of DM health and health related consultant. The content of validity of the translated instruments was approved by DM health and health related consultancy officer. The investigator carried out a pilot study to ensure content validity.
Data quality control and assurance
The principal investigator reviewed the respondent filled questionnaire for completeness of the collected data. The questionnaire was used for the data collection was kept sequentially. The data was stored in safe and secure place.
Ethical considerations
Ethical clearance was obtained from the ethical review Board of DM health and Health related Consultancy. Official permissions obtained from China first highway engineering at Bilbila Sokota road project. Written informed consent was obtained from each study participant to confirm willingness for participation after explaining the objective, procedure and general purpose of the study. Confidentiality of the information was maintained throughout by excluding names and keeping their privacy during the interview, by interviewing them alone. Participants have the right to with draw any time from the interview.
Results
A total of 55 participants were including in this study with a response rate of 99.4%. The majority 40 (74.1%) of the participants were male. Regarding age of the participants, the majority 14 (25.9%) of them were at age between 25 and 29. The majority 26 (48.1%) of the participant were secondary level of education. According to position at work, the majority 24 (44.4%) were Military. Twenty-eight (51.9%) had 1 and 2 years work experience. The majority 34 (63%) were married (Table 1).
Distribution of Socio-democratic information of respondents among China first highway engineering Company workers, Bilibila Sokota Road Project, Ethiopia, 2017
Distribution of Socio-democratic information of respondents among China first highway engineering Company workers, Bilibila Sokota Road Project, Ethiopia, 2017
HIV/AIDS related knowledge among China first highway engineering Company workers, Bilibila Sokota Road Project, Ethiopia, 2017
HIV/AIDS related Attitude among China first highway engineering Company workers, Bilibila Sokota Road Project, Ethiopia, 2017
HIV/AIDS related practice among China first highway engineering Company workers, Bilibila Sokota Road Project, Ethiopia, 2017
Mean knowledge scores for all respondents in China first highway engineering Company workers, Bilibila Sokota Road Project, Ethiopia, 2017
Most (96.3%) had ever heard of the diseases HIV/ AIDS in study area. Regarding the source which have heard about HIV/AIDs, the majority 34 (63%) were respond mass media and followed by Non Governmental organizations (NGOs) (
HIV/AIDS related attitude
The majority 46 (85.2%) of participants had knew about how to use a condom correctly. Forty (74.1%) were agreed that is acceptable for single men or women to use condom. Thirty seven (68.5%) of participants were willing to use the same toilet as a co-worker who is HIV positive. Followed by non willing 12 (22.2%). However, the remaining 5 (9.3%) were no response any and they did not know about it. The majority of the group studied 37 (68.5%) were willing to buy food prepared by a vendor who is HIV positive. Regarding of attitude 27 (50%) of the sample population, were in willing to share utensils with co-workers who is HIV whereas the lowest frequent sample were of no response about their willingness (90). The highest percentage (79.6%) of participants would have willing to hold hands with someone who is HIV positive. Regarding sharing the room with someone living with HIV/AIDS, 43 (79.6%) the majority of participants were willing. Thirty-three (61.1%) of the study participant were believed that HIV
The best source of information about HIV/AIDS
Figure 1 indicated that the majority 32 (59.3%) of participants were respond that mass media. Followed by NGOs (29.6%).
The best sources of information about HIV/AIDS among China first highway engineering Company workers, Bilibila Sokota Road Project, Ethiopia, 2017.
Almost half (40.7%) of the study participants were sexually active. Meanwhile, out of those who are sexually active, the majority 13 (24.1%) had a sexual partners other than their spouse. Twenty-seven (50%) of the participants had not any sexual practice with a person other than their spouse in the past three months. However, 16 (29.6%) were did. The majority 24 (44.4%) of the participant had not used condom the last two times they had sex with other than their spouse. Only 18 (33.3%) of them had used condom during last two times sexual intercourse with other partners. Regarding to reduce the risk of HIV, the majority 17 (31.5%) believed that we had intentionally reduced the number of those partners in the past 6 months in order to reduce the risk of HIV. However, 17 (31.5%) were not. The remaining 20 (37%) were not respond about the question and they do not know about it. The majority 27 (50%) of participants did not feel about their risk of becoming infected with HIV or another sexually transmitted infection. But, 10 (18.5%) were feel they are at risk of becoming infected with HIV or another sexually transmitted infection in study area. Regarding behavioral change, the majority 32 (59.3%) had thought that they can change their behavior in order to reduce their risk of becoming infected with HIV (Tables 3 and 4).
The mean attitude score of willing to share utensils with a co-worker who is HIV positive (1.80
Mean Attitude scores for all respondents in China first highway engineering Company workers, Bilibila Sokota Road Project, Ethiopia, 2017
Mean Attitude scores for all respondents in China first highway engineering Company workers, Bilibila Sokota Road Project, Ethiopia, 2017
Multiple regression tests were used to see among variables, which one can predict the attitude related to HIV/AIDS among workers’ in China first high way engineering Company at Bilbila Sokota Road Project. In performing this test, sex (
Regression analysis results on attitude towards to HIV/AIDS among workers in China first highway engineering Company workers, Bilibila Sokota Road Project, Ethiopia, 2017
ANOVA of attitude towards to HIV/AIDS among workers in China first highway engineering Company workers, Bilibila Sokota Road Project, Ethiopia, 2017
This study showed that the knowledge, attitude, and practice of workers’ in China first highway engineering Company at Bilbila Sokota Road Project. The majority (74.1%) of the participants were male. It indicated that till there was less female participation in the study area. In contrast, study was done by Shamsuddin and colleagues [23] found that both male and female had participated in study regarding KAP toward to HIV/AIDS among university students in Xinjing, China. The difference may be due to work characteristics. In this study the participants were working at road project. Therefore, the Company need male in order to hard work situation. This study result shown that the mean age of workers’ was 3.06 (SD
This study result revealed that most (96.3%) of participants had ever heard about HIV/AIDS. This figure was similar with Megabiaw and Awoke [25] study in Ethiopia, in which the majority (96.9%) had ever heard about HIV/AIDS. However, the awareness about methods of prevention of HIV/AIDS in Lucknow was low [16]. In this study Mass media and Non Governmental organizations (NGOs) were the major source of information about HIV/AIDS. In contrast, study conducted in North-Eastern part of India in 2013 [26] found that electronic media and print media were the major source of information. Furthermore, Megabiaw and Awoke [25] suggested that radio, Neighbors and friends had a main source of information about HIV/AIDS.
This study result shown that almost half of participants agreed that we can become infected by HIV due to unprotected sex with a person who is infected with HIV. Meanwhile, blood transfusion or blood products might be infected them or transmitted HIV/AIDS. It is supported by CDC; HIV diagnoses among persons who inject drugs declined 48% from 2008 to 2014. In contrast, the same study finding indicated that injection drug used in rural areas has been created prevention challenges and it has been placed new populations at risk for HIV [6, 16]. Moreover, the risk of HIV transmission increases by 2 to 3 times if viral load is increased 10 folded [15, 16]. It supported by [15, 16] the extremely high viral load during acute HIV infection might be increased the risk of HIV transmission by up to 26-fold. As a result, unprotected sex with an HIV-positive person who has acute HIV infection could carry a transmission risk of up to 2% for receptive vaginal sex and over 20% receptive anal sex [15, 16].
The present study finding indicated that the majority (61.1%) of participants had respond that sharing needles with a person who are infected with HIV can become infected. Condom is used during sexual intercourse with a person other than our spouse. This attitude of workers’ was opposite to the findings of Davhana-Maselesele and colleagues [15, 16] study in Vhemebe district, in which sharing of needle s and razors was cited as the second means (male 39.7% and female 35%) of HIV transmission after sexual intercourse by both girls and boys. This study result shown that participants had known about how to use a condom correctly. They had agreed upon condom use for both single men and women. In contrast [25], suggested that only 23.7% of participants had favorable attitude used condom in their recent sexual intercourse.
This study finding shown that most (68.5%) of participants were willing to use the same toilet as a co-worker who is HIV positive. They are willing to buy food prepared by a vendor who is HIV positive. However, 50% are willing to share utensils with co-workers who are HIV whereas the lowest frequent samples were of no response about their willingness. In similar, study was conducted in Lucknow [16] the students have favorable attitude towards persons infected with HIV/AIDS they were not aware of the fact that it is not a curable disease.
This study results shown that the majority (79.6%) would have willing to hold hands with someone who is HIV positive. Furthermore, they are sharing the room with someone living with HIV/AIDS. In contrast, a study was conducted by Gnimbar and Sondet [24] found that about 59.3% felt that AIDS can be transmitted by sharing meals, 56.73% were of the opinion that HIV/AIDs can be spread by using same toilet and cloths. It indicated that there is good attitude at this study area when compared with the previous study. However, till it needs continuous follow up through the Company. Because it may be due to small sample size.
This study result revealed that near to half (40.7%) of the study participants were sexually active. Some of them had sexual partners other than their spouse. This study result shown that the majority (44.4%) of the participant had not used condom the last two times they had sex with other than their spouse. But, it indicated that only 33.3% of them had used condom during last two times sexual intercourse with other partners. Evidenced by [24] found that almost a third (30.4%) had more than one sex partner in the last one year and only 27.7% had used condom in their recent sexual intercourse. It indicates that still there is knowledge, attitude and practice gap in the study area.
This study finding indicated that about 31.5% had agreed on intentionally reduced the number of those partners in the past 6 months in order to reduce the risk of HIV. Meanwhile half of the participants did not feel about their risk of becoming infected with HIV or another sexually transmitted infection. But, 18.5% were feel they are at risk of becoming infected with HIV or another sexually transmitted infection in study area. Evidence suggested 39% of unprotected anal sex with steady or casual partners in the previous 6 months. It supported by [15, 16] found that after 6 month follow up, 82% patients write sexual contact as major mode of transmission, and Use of condom was most important preventive measure (68%) [15, 16].
Conclusion
Still HIV/AIDS in public health problem of the major significance in most parts of the world, some of workers’ in China first high way engineering Company at Bilbila Sokota Road Project still have gap on knowledge, attitude, and practice toward to HIV/AIDS. The findings shown that participants had ever heard about HIV/AIDS. However, only Mass media and Non Governmental organizations (NGOs) were used as the major source of information about HIV/AIDS. This imply that it may be lack of further health education and training about all source of information regarding HIV/AIDS for those workers’ who have been in working in the Company. Almost half of participants agreed that we can become infected by HIV due to unprotected sex with a person who is infected with HIV. Moreover, blood transfusion or blood products might be infected them or transmitted HIV/AIDS. However, figure still very low when compared with other all previous studies. Evidence which indicated that there is 120 PLWHIV in study area. Conceivably since HIV/AIDS has only faced in the years ago, workers’ in the first highway Company may be unfamiliar with all the facts about HIV virus and AIDS or have been low access regarding health education towards HIV/AIDS.
This study revealed that sharing needles with a person who are infected with HIV can become infected. Meanwhile, Condom is used during sexual intercourse with a person other than our spouse. They were willing to use the same toilet as a co-worker and buy food prepared by a vendor who is HIV. However, half of them are willing to share utensils. It indicated that there is good attitude at this study area when compared with the previous study. However, still it needs continuous follow up through the Company. Because it may be due to small sample size.
Attitude of HIV/AIDS is good but near to half of participants were sexually active. Some of them had sexual partners other than their spouse. Furthermore, they had not used condom the last two times they had sex with other than their spouse. But, only one-third of them had ever used condom during last two time’s sexual intercourse with other partners. This bad practice will lead to discrimination and increases number of PLWHIV and HIV/AIDS risk behavior among workers and communities around it. At the same time about 67% of these workers reported have not used any condom.
Limitation of the study
Some part of the Bilibila Sokota Road Project workers of HIV/AIDs prevention and control program is still at its initial stage of implementation and has not fully settled down. Therefore the observations made by the researcher may not be representative the whole country.
Footnotes
Recommendation
Formulating strategy needed for prevention and control of HIV/AIDS transmission. Both Governmental and non-governmental organization should be adapted support for those who are PLWHIV with continue HIV/AIDS prevention and control programmes. It should be required of collaborative approach by all stakeholders in study area and over all the country. Encourage funders in order to support for peoples living with HIV Especially, Nongovernmental organization should be considered how to develop the consultation program and to be able to reflect accurately the information about their HIV/AIDS activities and also be able to contribute to on-going monitoring activities at a study area and a national level including SDGs. Health providers should need to routinely initiate discussions with clients about childbearing intentions and to be enabled with approved guidelines and training to support client access to safer conception methods. Information, education, and communication activities are imperative to educate persons living with HIV/AIDS about life-long nature of the disease, modes of its transmission, and significance of preventive measures to bridge the gaps in their knowledge. Improvement in individual economic status, education, and health services remains highly desirable; mass media can play a pivotal role in creating awareness among masses. Tailored HIV prevention programs targeting company need to be developed and implemented at all working days. It should be increased efforts to prevent further growth of the HIV epidemic in study area and national level. Educational programmes with specific interventions are recommended to increase KAPs and to prevent new HIV infections among workers in China first highway engineering Company at Bilbila Sokota Road Project. HIV/AIDS health education efforts should be intensified to improve the attitude and practice workers in China first highway engineering Company at Bilbila Sokota Road Project.
