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Belizean nurses role in HIV prevention
– Reported, January 26, 2013
The small country of Belize has a population of roughly 280 000, yet has the highest average annual prevalence rate (2.1%) of human immunodeficiency virus (HIV) of any country in Central America (UNAIDS 2008). The last quarter of 2007 saw a dramatic increase in the prevalence of this disease to 6% [National Acquired Immunodeficiency Syndrome (AIDS) Commission (NAC), Belize. Currently, approximately 80% of the new cases of HIV in Belize are found among 2049 year olds. This age group is generally considered the most economically productive group, and therefore, the increased prevalence of HIV in this age group has far-reaching economic implications.
The need to focus not just on awareness of the need to use condoms, but how to use them is critical. This need must be addressed from a gender perspective. Reshaping gender roles, such as educating more women about safe-sex practices, use of condoms, lessons on negotiating safe sex, and awareness campaigns about where to seek testing and treatment are needed.
Power in sexual relationships, including decision-making regarding condom use for the reduction of HIV transmission, appears to be an important consideration in addressing this epidemic. In a US study, women with a high level of relationship power were 5.96 times more likely to report consistent condom use than women with a low level of relationship power. Although this issue has been studied among women in general, its influence among nurses (most of which are female) and its impact on the delivery of health promotion information, specifically condom use, have not been fully examined.
The International Council of Nurses, of which the Nurses’ Association of Belize is a member, has been a key leader in bringing international attention to the issue of women, and HIV and AIDS.
Nurses are in a pivotal position to effectively teach HIV prevention through the practice of safe sex, including condom use, to their female patients. There are abundant opportunities for nurses to promote and teach condom use to women to reduce the risk of contracting HIV. Nurses in Belize are employed in various settings including rural and urban community practices as well as in organizations that specifically address issues impacting women such as the Belize Family Life Association. Key health-care leaders in Belize note that unfortunately, nurses may not be routinely teaching safe sex practices, especially condom use. There also are expressions of the need to do more to educate women in general about condom use.
With the vast majority of nurses in Belize being female, the issue of sexual relationship power in their own relationships may impact their self-efficacy to provide information regarding condom use to their female clients to reduce the risk of contracting HIV. The relationship between this variable and previously identified contributing variables of self-efficacy such as vicarious experience in Belizean nurses had not been established.
The specific aim of this study was to evaluate the relationship between selected variables and a nurses’ self-efficacy to promote and teach condom use to women in Belize to reduce the risk of contracting HIV. These selected variables included the nurses’ positive vicarious experience observing other nurses or health-care providers promoting and teaching condom use to women, interpersonal/socio-cultural variables and the nurses’ sexual relationship power in their own primary sexual relationship.
The findings from this study clearly demonstrate that vicarious experience promoting and teaching condom use to women to reduce the risk of contracting HIV is related to Belizean nurse’s self-efficacy to do so. Studies have demonstrated that programmes based on social cognitive theory are effective in improving nurse’s intent to provide HIV prevention messages. A strong relationship between self-efficacy and professional practice behaviours supports the need to provide ongoing opportunities for nurses to enhance self-efficacy.Education level was found to be a significant variable contributing to the self-efficacy of Belizean nurses to promote and teach condom use to women to reduce the risk of HIV. It may be that being in school longer may increase the opportunities for positive vicarious experience.
It is not without the understanding that the promotion and teaching of condom use to women to reduce HIV risk takes place in an environment that has been identified as one with many extrinsic and intrinsic factors that are working against achieving this goal.
CREDITS:
W.A. Nash
http://onlinelibrary.wiley.com/
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