Knowledge and Attitudes toward HIV and People Living with HIV (PLWH) among Public Health Midwives in the Galle District, Sri Lanka

Background: Even though a recent increase in HIV prevalence has been noticed in Sri Lanka, not many studies have been done there relating to HIV/AIDS. In particular, little is known about HIV-related stigma among healthcare workers, which has been identified as an obstacle to addressing the HIV epidemic. To examine this issue, this study first aimed to assess knowledge and attitudes of PHMs, the frontline community health workers in Sri Lanka. Second, the study examined the factors associated with their knowledge and attitudes. Lastly, the study examined the association of demographic information, knowledge, and attitudes with extra precautionary behaviors. Methods: Two hundred and ninety-one PHMs were recruited for this cross-sectional study. The study team visited each of the 20 Medical Officers of Health areas (MOH: administrative division) in the Galle District and surveyed PHMs during their monthly meetings. The study utilized two questionnaires to assess knowledge (16 items), attitudes and stigma (37 items). After assessing the PHMs knowledge and attitudes, the study explored the association of demographic information with knowledge and attitudes, and then examined how such individual factors, knowledge, and attitudes were associated with extra precautionary behaviors. Results: PHMs’ knowledge level was good (79.9% of answers were correct) but could be improved. Those more knowledgeable about HIV and with higher education demonstrated a more positive attitude towards PLWH. A more negative attitude was associated with having a stronger intention to engage in extra precautionary behaviors. Conclusions: As PHMs are community health workers whose attitude can potentially influence to the general public’s point of view, they need further HIV training to improve their knowledge so as to better educate the community. By reducing the PHMs misperceptions about HIV, they may develop a more positive attitude and thus help reduce stigma towards PLWH.