Assessment of the Knowledge, Attitude, and Practice of People Living with HIV/AIDS towards COVID-19 in Akwa Ibom State, Nigeria

Abstract:
Effective management of an
infectious disease like COVID-19 requires adequate knowledge, positive
attitudes, and appropriate practices. This study assessed the knowledge,
attitudes, and practices (KAP) regarding COVID-19 among individuals living with
HIV/AIDS in Uyo, Akwa-Ibom State, Nigeria. The study was a descriptive
cross-sectional survey of the knowledge, attitude, and practice regarding
COVID-19 among people living with HIV/AIDS at the ART clinic of St Luke’s
Hospital Anua Uyo in Akwa Ibom State. Participants were selected using random
sampling, and data were collected through a structured questionnaire. Data were
analysed using IBM SPSS version 25, with Chi-square statistics performed to
determine associations between variables. Statistical significance was set at p
< 0.05. 121 respondents participated in the study, with 66.1% being female.
Most respondents were aged 31-50 (60.4%), married (54.5%), had secondary
education (46.3%), and were self-employed (59.5%)—about half (50.4%) resided in
urban areas. COVID-19 awareness was universal (100%), though knowledge
decreased significantly with age, particularly among those over 60 (p<0.05).
Married and single respondents exhibited higher awareness compared to divorced,
separated, or widowed participants (p<0.05), and educated respondents had
significantly better knowledge than those with no formal education (p<0.05).
Urban residents were more knowledgeable than rural dwellers (p<0.05). While
attitudes towards COVID-19 were generally positive (81.8%), education level was
significantly associated with a positive attitude (p<0.05). However,
practices were poor overall (37.2%), especially among the less educated
(p<0.05). This study revealed important disparities in knowledge, attitudes,
and practices related to COVID-19 among people living with HIV/AIDS in Uyo.
These findings emphasize the need for targeted interventions to improve health
education and compliance with COVID-19 preventive measures among vulnerable
populations.
References:
[1]. Hu, B., Guo, H., Zhou, P., & Shi, Z., 2021,
Characteristics of SARS-CoV-2 and COVID-19. Nature Reviews Microbiology, 19(2),
141–154. https://doi.org/10.1038/s41579-020-00459-7
[2].
WHO. 2020a, Coronavirus Disease 2019, (COVID-19).
World Health Organization, Situation
Report—84. 2020.
[3]. Hassan, Z., Hashim, M. J., & Khan, G., 2020, Population
risk factors for COVID-19 deaths in Nigeria at sub-national level. The Pan
African Medical Journal, 35(Suppl 2), 131. https://doi.org/10.11604/pamj.supp.2020.35.131.25258
[4]. Ekanem, A. A., & Ibanga, S. E., 2023, Government
administrative practices and spread of COVID-19 in Akwa Ibom State, Nigeria. AKSU
Journal of Administration and Corporate Governance, 3(3), 253–264.
[5]. Essien, E., & Cyrus, S., 2019, Detection of urban
development in Uyo (Nigeria) using remote sensing. Land, 8(6), 102. https://doi.org/10.3390/land8060102
[6]. Mwanza, J., & Etokakpan, A., 2023, Accelerating progress
towards UNAIDS 95-95-95 goals: Data-use lessons from Akwa Ibom, Nigeria. PLOS
HIV.
[7].
WHO. 2020b, Coronavirus disease (COVID-19) advice for
the public. Myth Busters. https://www.who.int/emergencies/diseases/%0Anovel-coronavirus-2019/advice-for-public.
[8].
CDC. 2020, Coronavirus
Disease 2019 (COVID-19): Preventing Getting Sick. Centers for Disease
Control and Prevention.
[9].
Mirzaei, H., McFarland, W., Karamouzian, M., &
Sharifi, H., 2021, COVID-19 Among People Living with HIV: A Systematic Review. AIDS and Behavior, 25(1), 85–92. https://doi.org/10.1007/s10461-020-02983-2
[10].
AIDSinfo, 2020, Interim guidance for COVID-19 and
persons with HIV. U.S. Department of
Health and Human Services, 1–7. https://aidsinfo.nih.gov/guidelines/html/8/covid-19-and-persons-with-hiv--interim-guidance-/554/interim-guidance-for-covid-19-and-persons-with-hiv
[11].
Blanc, F. X., Laureillard, D., & Goldfeld,
A. E., 2020, Comment on: Effects of time of initiation of antiretroviral
therapy in the treatment of patients with HIV/TB co-infection, by Chelkeba L.
et al. Annals of Medicine and Surgery,
57, 22–23. https://doi.org/10.1016/j.amsu.2020.06.039
[12].
Segagni Lusignani, L., Quaglio, G., Atzori, A., Nsuka,
J., Grainger, R., Da Conceiçao Palma, M., Putoto, G., & Manenti, F., 2013,
Factors associated with patient and health care system delay in diagnosis for
tuberculosis in the province of Luanda, Angola. BMC Infectious Diseases, 13(1).
https://doi.org/10.1186/1471-2334-13-168
[13].
Ayinde, O. O., Usman, A. B., Posi, A., & Gbolahan,
A., 2020, A Cross-Sectional Study on Oyo State Health Care Worker’s Knowledge,
Attitude and Practice regarding Corona Virus Disease 2019 (COVID-19). Advances in Infectious Diseases, 10(03), 6–15. https://doi.org/10.4236/aid.2020.103002
[14].
Choi JS, Y. N., 2010, Perceived Knowledge, Attitude,
and Compliance with Preventive Behavior on Influenza A (H1N1) by University
Students. The Korean Academic Society of
Adult Nursing, 22(3), 250–259.
[15].
Zhong, B. L., Luo, W., Li, H. M., Zhang, Q. Q., Liu,
X. G., Li, W. T., & Li, Y., 2020, Knowledge, attitudes, and practices
towards COVID-19 among chinese residents during the rapid rise period of the
COVID-19 outbreak: A quick online cross-sectional survey. International Journal of Biological Sciences, 16(10), 1745–1752. https://doi.org/10.7150/ijbs.45221
[16].
Hussain, Z. A., Hussain, S. A., & Hussain, F. A.,
2012, Medical students’ knowledge, perceptions, and behavioral intentions
towards the H1N1 influenza, swine flu, in Pakistan: A brief report. American Journal of Infection Control, 40(3). https://doi.org/10.1016/j.ajic.2011.12.004
[17].
Aziz, M. M., Abd El-Megeed, H. S., & Abd Ellatif,
M. A. M., 2018, Pre-travel health seeking practices of Umrah pilgrims departing
from Assiut International Airport, Egypt. Travel
Medicine and Infectious Disease, 23,
72–76. https://doi.org/10.1016/j.tmaid.2018.04.012
[18].
Rahman, A., & Sathi, N. J., 2020, Knowledge,
attitude, and preventive practices toward COVID-19 among Bangladeshi internet
users. Electronic Journal of General
Medicine, 17(5). https://doi.org/10.29333/ejgm/8223
[19].
Person, B., Sy, F., Holton, K., Govert, B., &
Liang, A., 2004, National center for inectious diseases SCOT: Fear and stigma:
the epidemic within the SARS outbreak. Infectious
Diseases, 10, 358–363.
[20].
Tao, N., 2003, An analysis on reasons of SARS induced
psychological panic among students. J
Anhui Inst Educ, 21, 78–79.
[21].
Al-Hanawi, M. K., Angawi, K., Alshareef, N., Qattan,
A. M. N., Helmy, H. Z., Abudawood, Y., Alqurashi, M., Kattan, W. M., Kadasah,
N. A., Chirwa, G. C., & Alsharqi, O., 2020, Knowledge, Attitude and
Practice Toward COVID-19 Among the Public in the Kingdom of Saudi Arabia: A
Cross-Sectional Study. Frontiers in
Public Health, 8(May), 1–10. https://doi.org/10.3389/fpubh.2020.00217
[22]. Paul, A.,
Sikdar, D., Hossain, M. M., Amin, M. R., Deeba, F., Mahanta, J., Akib Jabed,
M., Mohaiminul Islam, M., Jahan Noon, S., & Kumar Nath, T., 2020,
Knowledge, attitudes, and practices toward the novel coronavirus among
Bangladeshis: Implications for mitigation measures. PLoS ONE, 15(9 September
2020), 1–18. https://doi.org/10.1371/journal.pone.0238492
[23].
Ghate, M. V., Shidhaye, P. R., Gadhe, K. R., Gurav, S.
G., & Deoraj, P., 2021, Knowledge, attitude and practices towards COVID-19
among people living with HIV in Pune, India: a cross-sectional study. International Journal of Research in Medical
Sciences, 9(5), 1458.
https://doi.org/10.18203/2320-6012.ijrms20211886
[24].
Okafor, N. B., 2020, Compliance to COVID 19 Preventive
Measures towards the Environmental Health in Nigeria Universities. International Journal of Trend in Scientific
Research and Development (IJTSRD) International Journal of Trend in Scientific
Research and Development, 4(6),
775–782. url: https://www.ijtsrd.com/papers/ijtsrd33353.pdf%0Ahttps://www.ijtsrd.com/other-scientific-research-area/enviormental-science/33353/compliance-to-covid19-preventive-measures-towards-the-environmental-health-in-nigeria-universities/okafor-b-n
[25].
Okoro, J., Ekeroku, A., Nweze, B., Odionye, T., Nkire,
J., Onuoha, M., Ezeonwuka, C., & Owoh, J., 2020, Attitude and preventive
practices towards COVID-19 disease and the impact of awareness training on
knowledge of the disease among correctional officers. Emerald Open Research, 2,
51. https://doi.org/10.35241/emeraldopenres.13839.1
[26].
Afzal, M. S., Khan, A., Qureshi, U. U. R., Saleem, S.,
Saqib, M. A. N., Shabbir, R. M. K., Naveed, M., Jabbar, M., Zahoor, S., &
Ahmed, H., 2021, Community-Based Assessment of Knowledge, Attitude, Practices
and Risk Factors Regarding COVID-19 Among Pakistanis Residents During a Recent
Outbreak: A Cross-Sectional Survey. Journal
of Community Health, 46(3),
476–486. https://doi.org/10.1007/s10900-020-00875-z
[27].
Al-Hazmi, A., Gosadi, I., Somily, A., Alsubaie, S.,
& Bin Saeed, A., 2018, Knowledge, attitude and practice of secondary
schools and university students toward Middle East Respiratory Syndrome
epidemic in Saudi Arabia: A cross-sectional study. Saudi Journal of Biological Sciences, 25(3), 572–577. https://doi.org/10.1016/j.sjbs.2016.01.032
[28].
Al-Naggar, R. A., & Osman, M. T., 2015, Knowledge
of Breast Cancer and its Association with Preventive Practice among Malaysian
School Teachers. International Archives
of Medicine. https://doi.org/10.3823/1800
[29].
Al-Rabee, N. A., Dallak, A. M., & Al-Awadi, F. G.,
2012, Knowledge, attitude and beliefs towards HIV/AIDS among students of health
institutes in Sana’a city. Eastern
Mediterranean Health Journal, 18(3),
221–226. https://doi.org/10.26719/2012.18.3.221
[30].
Alzoubi, H., Alnawaiseh, N., Al-Mnayyis, A.,
Abu-Lubad, M., Aqel, A., & Al-Shagahin, H., 2020, COVID-19 - Knowledge,
attitude and practice among medical and non-medical university students in
Jordan. Journal of Pure and Applied
Microbiology, 14(1), 17–24. https://doi.org/10.22207/JPAM.14.1.04
[31].
Asemahagn, M. A., 2020, Factors determining the
knowledge and prevention practice of healthcare workers towards COVID-19 in
Amhara region, Ethiopia: A cross-sectional survey. Tropical Medicine and Health, 48(1).
https://doi.org/10.1186/s41182-020-00254-3
[32].
Bekele, F., Sheleme, T., Fekadu, G., & Bekele, K.,
2020, Patterns and associated factors of COVID-19 knowledge, attitude, and
practice among general population and health care workers: A systematic review.
SAGE Open Medicine, 8, 205031212097072. https://doi.org/10.1177/2050312120970721
[33].
Erfani, A., Shahriarirad, R., Ranjbar, K.,
Mirahmadizadeh, A., & Moghadami, M., 2020, Knowledge, attitude and practice
toward the novel coronavirus (COVID-19) outbreak- A population-based survey in
Iran. Bulletin of the World Health
Organization, March, 2–3.
[34].
Kassa, A. M., Mekonen, A. M., Yesuf, K. A., Woday
Tadesse, A., & Bogale, G. G., 2020, Knowledge level and factors influencing
prevention of COVID-19 pandemic among residents of Dessie and Kombolcha City
administrations, North-East Ethiopia: A population-based cross-sectional study.
BMJ Open, 10(11), 44202. https://doi.org/10.1136/bmjopen-2020-044202
[35].
Lee, M., Kang, B. A., & You, M., 2021, Knowledge,
attitudes, and practices (KAP) toward COVID-19: a cross-sectional study in
South Korea. BMC Public Health, 21(1), 1–10. https://doi.org/10.1186/s12889-021-10285-y
[36].
Yousaf, M. A., Noreen, M., Saleem, T., & Yousaf,
I., 2020, A Cross-Sectional Survey of Knowledge, Attitude, and Practices (KAP)
Toward Pandemic COVID-19 Among the General Population of Jammu and Kashmir,
India. Social Work in Public Health, 35(7), 569–578. https://doi.org/10.1080/19371918.2020.1806983
[37].
Wong, C. L., Chen, J., Chow, K. M., Law, B. M. H.,
Chan, D. N. S., So, W. K. W., Leung, A. W. Y., & Chan, C. W. H., 2020,
Knowledge, attitudes and practices towards COVID-19 amongst ethnic minorities
in Hong Kong. International Journal of Environmental Research and Public
Health, 17(21), 1–13. https://doi.org/10.3390/ijerph17217878
[38].
Iradukunda, P. G., Pierre, G., Muhozi, V., Denhere,
K., & Dzinamarira, T., 2021, Knowledge, Attitude, and Practice Towards
COVID-19 Among People Living with HIV/AIDS in Kigali, Rwanda. Journal of Community Health, 46(2), 245–250. https://doi.org/10.1007/s10900-020-00938-1
[39].
Lau, L. L., Hung, N., Go, D. J., Ferma, J., Choi, M.,
Dodd, W., & Wei, X., 2020, Knowledge, attitudes and practices of COVID-19
among income-poor households in the Philippines: A cross-sectional study. Journal of Global Health, 10(1). https://doi.org/10.7189/JOGH.10.011007
[40].
Lin, Y., Huang, L., Nie, S., Liu, Z., Yu, H., Yan, W.,
& Xu, Y., 2011, Knowledge, Attitudes and Practices (KAP) related to the
Pandemic (H1N1) 2009 among Chinese General Population: A Telephone Survey. BMC Infectious Diseases, 11. https://doi.org/10.1186/1471-2334-11-128
[41].
Tandi, T. E., Kim, K., Cho, Y., & Choi, J. W.,
2018, Public health concerns, risk perception and information sources in
Cameroon. Cogent Medicine, 5(1), 1453005. https://doi.org/10.1080/2331205x.2018.1453005
[42].
Tangcharoensathien, V., Calleja, N., Nguyen, T.,
Purnat, T., D’Agostino, M., Garcia-Saiso, S., Landry, M., Rashidian, A.,
Hamilton, C., AbdAllah, A., Ghiga, I., Hill, A., Hougendobler, D., van Andel,
J., Nunn, M., Brooks, I., Sacco, P. L., de Domenico, M., Mai, P., … Briand, S.,
2020, Framework for managing the COVID-19 infodemic: Methods and results of an
online, crowdsourced who technical consultation. Journal of Medical Internet Research, 22(6). https://doi.org/10.2196/19659
[43].
Abdelhafiz, A. S., Mohammed, Z., Ibrahim, M. E.,
Ziady, H. H., Alorabi, M., Ayyad, M., & Sultan, E. A., 2020, Knowledge,
Perceptions, and Attitude of Egyptians Towards the Novel Coronavirus
Disease (COVID-19). Journal of
Community Health, 45(5), 881–890.
https://doi.org/10.1007/s10900-020-00827-7
[44].
Ahmed, N., Shakoor, M., Vohra, F., Abduljabbar, T.,
Mariam, Q., & Rehman, M. A., 2020, Knowledge, awareness and practice of
health care professionals amid sars-cov-2, corona virus disease outbreak. Pakistan Journal of Medical Sciences, 36(COVID19-S4), S49–S56. https://doi.org/10.12669/pjms.36.COVID19-S4.2704
[45].
Huynh, G., Nguyen, T., Tran, V., Vo, K., Vo, V., &
Pham, L., 2020, Knowledge and attitude toward COVID-19 among healthcare workers
at District 2 Hospital, Ho Chi Minh City. Asian
Pacific Journal of Tropical Medicine, 13(6),
260–265. https://doi.org/10.4103/1995-7645.280396
[46].
Lee, M., & You, M., 2020, Psychological and
behavioral responses in South Korea during the early stages of coronavirus
disease 2019 (COVID-19). International
Journal of Environmental Research and Public Health, 17(9). https://doi.org/10.3390/ijerph17092977
[47].
Zhou, M., Tang, F., Wang, Y., Nie, H., Zhang, L., … G. Y.-J. of
H., & 2020, U., 2020, Knowledge, attitude and practice regarding COVID-19
among health care workers in Henan, China. Journal
of Hospital Infection, 105,
183–187. https://www.sciencedirect.com/science/article/pii/S0195670120301870?casa_token=yRjAZCJAPwYAAAAA:fG9P4Wad8JZgtkcZmf4TvFPcoaqb33LVGtcl_gSIQD0of8ms0ZjK
[48].
Al-Ahdab, S., 2021, A cross-sectional survey of
knowledge, attitude and practice (KAP) towards COVID-19 pandemic among the
Syrian residents. BMC Public Health, 21(1), 1–7. https://doi.org/10.1186/s12889-021-10353-3
[49].
Edet, C. K., Wegbom, A. I., & Kiri, V. A., 2020, Knowledge, Attitude and Practice of Clients
towards COVID-19 at Primary Healthcare Facilities in Rivers State, Nigeria.
https://doi.org/10.21203/rs.3.rs-40966/v1
[50].
Gebretsadik, D., Gebremichael, S., & Belete, M. A.,
2021, Knowledge, attitude and practice toward covid-19 pandemic among
population visiting dessie health center for covid-19 screening, northeast
ethiopia. Infection and Drug Resistance,
14, 905–915. https://doi.org/10.2147/IDR.S297047
[51].
Kakemam, E., Ghoddoosi-Nejad, D., Chegini, Z., Momeni,
K., Salehiniya, H., Hassanipour, S., Ameri, H., & Arab-Zozani, M., 2020,
Knowledge, Attitudes, and Practices Among the General Population During
COVID-19 Outbreak in Iran: A National Cross-Sectional Online Survey. Frontiers in Public Health, 8(December), 1–8. https://doi.org/10.3389/fpubh.2020.585302
[52].
Mohamed, A., Elhassan, E., Mohamed, A., Mohammed, A.
A., edris, H. A., Mahgoop, M. A., Sharif, M. E., Bashir, M. I., Abderlahim, R.
B., Idriss, W. I., & Malik, E. M., 2020, Knowledge, attitude and practice of the Sudanese people towards
COVID-19: An online survey. 1–7. https://doi.org/10.21203/rs.3.rs-32375/v1
[53].
Zhang, M., Zhou, M., Tang, F., Wang, Y., Nie, H.,
Zhang, L., & You, G., 2020, Knowledge, attitude, and practice regarding
COVID-19 among healthcare workers in Henan, China. Journal of Hospital Infection, 105(2),
183–187. https://doi.org/10.1016/j.jhin.2020.04.012
[54].
Wolf, M. S., Serper, M., Opsasnick, L., O’Conor, R.
M., Curtis, L., Benavente, J. Y., Wismer, G., Batio, S., Eifler, M., Zheng, P.,
Russell, A., Arvanitis, M., Ladner, D., Kwasny, M., Persell, S. D., Rowe, T.,
Linder, J. A., & Bailey, S. C., 2020, Awareness, Attitudes, and Actions
Related to COVID-19 Among Adults With Chronic Conditions at the Onset of the
U.S. Outbreak: A Cross-sectional Survey. Annals of Internal Medicine,
173(2), 100–109. https://doi.org/10.7326/M20-1239
[55].
McEachan, R., Taylor, N., Harrison, R., Lawton, R.,
Gardner, P., & Conner, M., 2016, Meta-Analysis of the Reasoned Action
Approach (RAA) to Understanding Health Behaviors. Annals of Behavioral Medicine, 50(4),
592–612. https://doi.org/10.1007/s12160-016-9798-4
[56].
ALdowyan, N., Abdallah, A. S., & El-Gharabawy, R.,
2017, Knowledge, Attitude and Practice (KAP) Study about Middle East
Respiratory Syndrome Coronavirus (MERS-CoV) among Population in Saudi Arabia. International Archives of Medicine, 10. https://doi.org/10.3823/2524
[57].
Leung, G. M., Lam, T. H., Ho, L. M., Ho, S. Y., Chan,
B. H. Y., Wong, I. O. L., & Hedley, A. J., 2003, The impact of community
psychological responses on outbreak control for severe acute respiratory
syndrome in Hong Kong. Journal of
Epidemiology and Community Health, 57(11),
857–863. https://doi.org/10.1136/jech.57.11.857
[58].
Moran, K. R., & Del Valle, S. Y., 2016, A
meta-analysis of the association between gender and protective behaviors in
response to respiratory epidemics and pandemics. PLoS ONE, 11(10). https://doi.org/10.1371/journal.pone.0164541