Abstract

HIV/AIDS still remains a major public health problem all over the world, particularly in sub-Saharan Africa where it has caused incalculable human suffering, social and cultural disruption and huge economic losses. UNAIDS estimates 36.7 million people living with HIV (PLHIV) globally, and 25.6 million in SSA. HIV can be transmitted through unsafe use of therapeutic injections, blood transfusions, mother-to-child transmission (MTCT), unsafe sexual practices and some beauty treatments pedicure and barbershop shaving with unsterilized instruments.

This study investigates the perspective of barbers regarding HIV/AIDS prevention in the Buea Municipality.

A community-based cross-sectional study was employed. Data was collected using pretested questionnaires and analyses were done using statistical package for social sciences (SPSS) version 25. Statistical significance was set at P<0.05 and its 95% confidence interval.

The result obtained showed that the knowledge level of the barber’s regarding HIV/AIDS was good 79.0%. Knowledge was significantly associated with age group. There was a significant association between the attitude and Average Number of client per day. Also there was a significant association between the attitude and Mode of learning. The majority of the barbers’ attitude were positive (56.0%) towards HIV/AIDS. Majority of the participant exhibited good prevention practices regarding HIV/AIDS (72.0%).

The barbers in Buea municipality have good knowledge, positive attitude and have good practice towards the prevention of HIV/AIDS.

CHAPTER ONE

INTRODUCTION

1.1. Background of the Study

HIV/AIDS still remains a major public health problem all over the world, particularly in sub-Saharan Africa where it has caused incalculable human suffering, social and cultural disruption and huge economic losses, as UNAIDS estimates 36.7 million people living with HIV (PLHIV) globally, and 25.6 million in SSA [1]. The number of PLHIV in Cameroon as estimated by Cameroon Demographic and Health Survey is 500,000, with deaths due to AIDS being 7,800, and an HIV prevalence of 2.7% [2].

HIV-infected individuals may remain asymptomatic for years; thus, patients with HIV infection may be unaware of the infection and may spread it to others [3].HIV can be transmitted through unsafe use of therapeutic injections, blood transfusions, mother-to-child transmission (MTCT), unsafe sexual practices and some beauty treatments like tattooing, piercing, pedicure and barbershop shaving with unsterilized instruments [4].

Prevention is the only viable way to control HIV spread, as there is no cure for the infection presently. In Cameroon, efforts have focused mainly on prevention of HIV through sexual intercourse, blood transfusion and MTCT. This must have been informed by the fact that more than ninety percent of HIV transmission occurs through the combination of these routes [5].

However, HIV transmission through sharing of non-sterile sharp instruments such as those used for barbing, circumcision, facial scarification, incision, tattooing, ear perforation, injections and acupuncture have always been vaguely classified as ‘others’ and given less attention in the campaign against the spread of HIV.

Barbers are workers that undertake skin-piercing practices involving re-useable sharp instruments, which present risks of transmission of HIV and other blood-borne pathogens from one client to the other. Though barbers do not carry out procedures that deliberately penetrate the skin, the procedures can inadvertently damage the skin through abrasion or minor accidental cuts [4].

A simple nick caused by a clipper or razor blade is enough for HIV infection to occur [6]. In most cases, this sharp equipment is not often sterilized, thus exposing clients to blood borne pathogens, including HIV [7]. Due to the lipid envelope that protects HIV from dehydration, the virus can survive on the surfaces of barbing instruments for a period long enough for transmission to occur, particularly in commercial barbing shops [8]. Therefore, barbers can play a role in the spread of this infection.

During barbing, there are haircuts and shavings, which may accidentally expose barbers to client’s blood and transmit infection to them or transmit the infection from one client to another. In many parts of Africa, the widespread cultural practice of barbing at a shop or roadside is an underestimated route of blood-borne viral disease transmission.

Proper, effective and consistent decontamination of barbing instruments is important in preventing HIV transmission in barbing shops. Surgically, barbing instruments are semi-critical instruments that come into contact with damaged non-intact skin and require at least intermediate-level disinfection to make them safe [9].

Methods and agents that have been designed to inactivate other viruses such as hepatitis B, are also effective for HIV. These agents include alcohol (ethanol, isopropyl), chlorine (Sodium hypochlorite), phenolic compounds, quaternary ammonium compounds, iodine and iodophore. HIV on barbing instruments can also be inactivated by using sterilizing agents such as flame, dry heat, cream and ultraviolet light [10].

Barbers tend to concentrate their attention on providing decoration, air conditioning, sound system and also availability of television in their shops rather than on the risk factors associated with their profession [11]. The concept of universal precaution considers all blood and body fluids to be potentially infectious and all invasive instruments to be potentially contaminated if already used [12]. The responsibility to keep instruments free of infective agents lies on the barbers. There is scarcity of data regarding knowledge, attitudes and prevention practices of barbers in Cameroon with respect to the transmission of HIV. In Buea the prevalence of HIV is 3.2%[13]. Therefore this study  conducted to assess the perspectives of HIV/AIDS prevention amongst barbers in the Buea Municipality, Cameroon.

1.2. Statement of the problem

There are close to 18, 000 HIV patients currently receiving ART in all the treatment centers in Fako Division, SWR of Cameroon and this number is threatening to increase with the advent of the universal test and treat approach (UNAIDS.HIV/AIDS Epidemics updates 2017). The burden of this disease is evident as it affects the patients psychologically and financially. In Cameroon, efforts have focused mainly on prevention of HIV through sexual intercourse, blood transfusion and MTCT.

This must have been informed by the fact that more than ninety percent of HIV transmission occurs through the combination of these routes. However, HIV transmission through sharing of non-sterile sharp instruments such as those used for barbing, circumcision, facial scarification, incision, tattooing, ear perforation, injections and acupuncture have always been vaguely classified as ‘others’ and given less attention in the campaign against the spread of HIV.

Proper, effective and consistent decontamination of barbing instruments is important in preventing HIV transmission in barbing shops. Barbers tend to concentrate their attention on providing decoration, air conditioning, sound system and also availability of television in their shops rather than on the risk factors associated with their profession. The concept of universal precaution considers all blood and body fluids to be potentially infectious and all invasive instruments to be potentially contaminated if already used. The responsibility to keep instruments free of infective agents lies on the barbers. There is little or no research regarding knowledge, attitudes and prevention practices of barbers in Cameroon with respect to the transmission of HIV.

1.3. Research Questions

1. What is the level of knowledge of barbers on the prevention of HIV in the Buea Municipality?
2. What is the attitude of barbers towards the prevention of HIV in the Buea Municipality?
3. What is the practice of barbers regarding the prevention of HIV in the Buea Municipality?
4. What are the challenges faced by barbers in the prevention of HIV in the Buea Municipality?

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