HIV/STI-related KAP Of Outpatients At STI Clinics Of County-level Hospitals In Anhui And Jiangsu Provinces

Objectives To explore status quo of HIV/STI-related knowledge, attitude and practice (KAP) among outpatients of STI clinics and factors influencing their KAP and inform future intervention and policy development.Methods A total of 719 STI outpatients were drawn from the STI clinics of 30 county hospitals in Jiangsu and Anhui Provinces using a continuous accumulative sampling method. Well-trained investigators conducted the survey through face-to-face interviews using a structured questionnaire. Data collected from the field were double entered via EPIDATA3.1 first and then transferred into SPSS16.0 system to perform statistical analysis. Rate and frequency distributions were derived using the descriptive analysis functions and differences between groups were tested using chi-square or T tests and P<0.05 was set as the power level to determine whether a difference between groups was statistically significant.Results (1) Demographic characteristics: The number of male patients completed our survey was much larger than that of female patients, being 574 and 145 respectively; Most of these patients aged between 30 and 40. (2) Knowledge: The patients'correct answers to questions about HIV transmission accounted for only 59.7%; Statistically significant differences in this regard were found between different age groups (P<0.01); The respondents'correct answer to questions about condom using added up to 66.9% with patients over 40 years old being the least educated about common using (P<0.01); Their correct responses toward HIV/STI effects and prognosis were estimated as between 15.1% and 75.4% and age were negatively correlated with knowledge in this aspect (P<0.05); The knowledge about HIV test availability differed significantly between gender and age groups (P<0.05). (3) Attitudes: Agreement rates with statements concerning acceptance of HIV- infected/affected ranged from 25.2% and 72.6%. (4) Self-efficacy in protective behaviors: Female patients had more confidence than male patients did in seeking HIV test when needed, refusing unwanted sex and using condoms (P<0.01); and age was negatively related with confidence in persuading partners to use condoms (P<0.01). (5) Behaviors: The male STI patients had more sexual partners than did female patients (P<0.05); age was positively linked with number of partners who were commercial sex workers (P<0.05); 2.96% of the respondents reported homosexual sex and 0.47% reported bisexual sex; 52.14% of the patients had never used condoms and older patients tended to be less likely to use condoms; the proportion of patients who had practiced oral and anal sex accounted for 21.92% and 6.7% respectively; the rank order of persons to whom the patients would like to disclose their HIV/STI status if diagnosed positive was doctors (95.51%), spouse/lover/boyfriend/girlfriend (69.69%), family members(27.06%), friends(18.97%), occasional partners and commercial sex workers (10.24%), colleagues (9.50%); only 7.15% of the respondents had ever had HIV test; proportion of male patients (32.62%) who were willing to seek HIV test in the future was statistically higher than that of female patients(20.42%). (6) Perceived susceptibility: most patients perceived unprotected commercial sex as risky for getting HIV/STIs; male patients'perceived risk was higher than that female patients (P<0.01). (7) Perceived seriousness: more male patients than female patients agreed that STI could affect one's sexual functions (P <0.01) and older patients were more likely to believe that"STI would ruin a person's reputation"(P<0.05). (8) Perceived effectiveness: the respondents'agreements to the statements regarding the effectiveness of protective behaviors ranged timely professional service (77.67%), use of condoms (73.33%), limiting number of sexual partners (68%), avoiding sex when having STI (67.67%), disclosing HIV/STI status to partners (64.33%), seeking HIV test (63.33%), cleaning genital organs (53%), nutrient intake (35.33%). (9) Perceived barriers: Of the 22 statements of barriers to protective behaviors,"Physicians may ask me some awkward questions if I have HIV test","I don't know where to get free HIV test"and"It's embarrassing for me to tell my partner that I have got STIs"were given the highest agreement ratings, being 2.92±0.04, 2.87±0.04 and 2.82±0.04 respectively.Conclusions The proportion of STI outpatients at county hospitals practicing high-risk behaviors was high; while percentage of patients taking protective measures was low. These findings were not only consistent with the findings of low general knowledge about and negative attitudes toward HIV/STIs among the respondents, but also consistent with results in the perceived, by the respondents, susceptibility to the infections, seriousness of the infections, effectiveness of protective behaviors and barriers to protective behaviors.