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'Everyone is scared of it inside so they start being a bit irrational': HIV/AIDS education within midwifery
1Department of Midwifery, City University, Philpot Street, London EI 2EA, UK.
Objective:
To describe views put forward by student midwives and lecturers about education on the human immunodeficiency virus (HIV).
Design:
Multi-method. Participants completed a questionnaire containing open and closed questions, and took part in focus-group discussions.
Setting:
All institutions providing pre-registration midwifery education in the South Thames Region of the UK.
Participants:
Students (n = 336) and lecturers of midwifery (n = 51).
Measurements:
Closed questions from the questionnaire were analysed for frequency distributions, intra-group cross tabulations of selected variables and inter-group comparisons. Open questions from the questionnaire and transcripts of focus group discussions were investigated using thematic analysis and constant comparative techniques.
Findings:
Recent structural changes within midwifery education had increased lecturers' workloads. Curriculum pressures led to lecturers making assumptions about students' existing levels of knowledge, particularly regarding universal precautions, although both lecturers' and students' weakest areas of knowledge in relation to HIV were those specifically related to midwifery. The perceived risk of occupational infection was relatively high and linked to individual perceptions of the virus. However, neither anxiety nor knowledge levels were reflected by consistent use of universal precautions.
Key Conclusions:
Knowledge obtained within midwifery education may be difficult to translate into clinical practice. Underlying issues such as perceptions of the virus and orthodoxies of midwifery practice inhibited students from using universal precautions, even when they recognised that consistent use of universal precautions could help reduce the risk of occupational transmission of HIV. The social construction of HIV and ideological constructions of midwifery practice, such as the client/midwife relationship, may be sufficiently powerful to have an effect on clinical practice and reduce the use of universal precautions.
Implications For Practice:
Emphasising the place of clinical knowledge within a broader issue-based context may help lecturers and students address the challenge of implementing safe, non-discriminatory use of universal precautions.