Title : From knowledge to action: A cross-sectional study among healthcare workers about prevention of HIV vertical transmission in Punjab, Pakistan
Abstract:
Background: Prevention of Mother-to-Child Transmission (PMTCT) of HIV is a critical strategy for maternal and child health. Gaps in knowledge, attitudes, and practices (KAP) among frontline healthcare workers (HCWs) directly compromise PMTCT service delivery. This study assessed HCW KAP regarding PMTCT and identified its determinants at a designated PPTCT centre in Dera Ghazi Khan, Punjab, Pakistan.
Methods: A cross-sectional study enrolled 144 HCWs, physicians, doctors in training, nurses, and allied health professionals, with at least three months of experience in the OBGYN ward or ART centre. A validated questionnaire assessed KAP across five domains: transmission, counselling, treatment, stigma, and pre/post-exposure prophylaxis. Scores were expressed as mean percentages. Multivariable linear regression identified independent predictors of each KAP domain.
Results: Most participants were female (84.7%); doctors in training constituted 51.4%. Mean scores were: knowledge 62.0±11.5%, attitude 66.9±16.7%, and practice 64.2±14.8%. Knowledge differed significantly by professional category (p<0.001): doctors in training scored lowest (58.5±11.0%) versus physicians (67.2±13.0%) and nurses and allied health professionals (66.5±10.6%). On multivariable regression, doctors in training had significantly lower knowledge scores than physicians (adjusted β=−6.36; 95% CI: −11.94, −0.78). For attitude, nurses and allied health professionals scored more favorably than physicians (adjusted β=+9.59; 95% CI: 1.28, 17.90), and HCWs aged ≥30 years scored higher than those under 25 years (adjusted β=+12.22; 95% CI: 3.18, 21.26). For practice, HCWs aged 25–29 years outperformed the youngest group (adjusted β=+12.66; 95% CI: 6.33, 18.98).
Conclusion: Significant professional disparities exist in PMTCT knowledge, with doctors-in-training demonstrating the lowest scores despite constituting the majority of the frontline workforce. Younger HCWs enter the system with the least favorable attitudes, representing one of the vulnerabilities in Pakistan's PPTCT programme. System-level reform, embedding PMTCT competencies in undergraduate and postgraduate curricula, is essential to strengthen provider competency and accelerate paediatric HIV elimination.
Keywords: PMTCT; HIV; Knowledge; Attitudes; Practices; Healthcare Workers; Pakistan; Family Wellness
