Knowledge Attitudes and Practice about HIV Transmission, Prevention and Treatment among Elderly Patients with HIV/AIDS in Rural Lesotho

Abstract

Introduction: Lesotho is one of the world’s countries hardest hit by HIV, with the second highest HIV prevalence after Swaziland. Elderly persons face many prevention challenges such as lack of knowledge in HIV/AIDS, discrimination and stigmatization that can lead to late testing, diagnosis and reluctance in seeking medical services. This is the first study conducted in Lesotho to assess knowledge regarding HIV transmission, prevention and treatment among elderly patients in rural Lesotho. Methods: The study population composed of elderly HIV/AIDS patients aged ≥ 50 years, receiving clinical services within the catchment of four rural clinics of Maseru districts. A random sample of medical records of patients living with HIV/AIDS was selected from each of the four clinics. After intervention interview were carried out using the same tool that was used at baseline. Results: Before intervention, a total of 269 patients were interviewed. Majority of the patients were females (65.8%) and had achieved only a primary level of education (71.4%). A composite score was derived from all the questions relating to knowledge about HIV transmission and treatment. A patient who achieved a composite score ≥ 75% was defined as having ‘adequate knowledge’. The results showed that only 34.2% of the patients had adequate knowledge of transmission and treatment of HIV/AIDS. Adequate knowledge about HIV transmission, prevention and treatment was significantly associated with gender, females being more knowledgeable than males (OR=1.9, 95% CI: 1.1-3.5; P=0.022). Patients with secondary or higher level of education being more knowledgeable than those with less education (OR=2.8, 95% CI: 1.1-7.8; P=0.021). After controlling for age, gender and educational level, the results from multivariate logistic regression analysis showed similar associations to the unadjusted ORs. Over one-third of the patients (36.8%) had unprotected sex. After intervention, a total of 183 patients were interviewed. Patients with no formal education gained more knowledge (OR=6.5 95% CI: 1.5-59.3; P=0.005). Males also gained more knowledge after intervention (OR=4.4, 95% CI: 1.6-14.9; P=0.001). Age group of + 65 also gained more knowledge (OR=6.5 95% CI: 1.5-59.3; P=0.005). Conclusion: There is a lack of knowledge about transmission and prevention among elderly patients living with HIV/AIDS in rural Lesotho. It is imperative that a targeted strategy be developed for this vulnerable group, taking into cognisance their inherent lower level of education and to improve access to services. After intervention there was a significant amount of knowledge gained particularly by the groups of patients that had less knowledge about HIV transmission and prevention.