A behavioural approach to improving HIV laboratory diagnoses
W. Kitson-Piggott1, V. Wilson2
1Caribbean Epidemiology Centre (CAREC/PAHO/WHO), 16-18 Jamaica Boulevard, Federation Park, Port
of Spain, Trinidad And Tobago, 2Caribbean Epidemiology Centre (CAREC/PAHO/WHO), Port of Spain,
Trinidad And Tobago
Issues: In developing countries, behavioural interventions often only target changing the behaviours of
persons at high risk for contracting or transmitting the HIV virus. Undeniably, reliable HIV laboratory test
results are critical to the detection and care of HIV infected persons, the prevention of HIV transmission,
the maintenance of safe blood supplies and the tracking of the epidemic. In many developing and resource
limited countries, however, in the absence of controlling legislation or official monitoring mechanisms,
the delivery of a reliable HIV laboratory test result is often very dependent on the behaviour of individual
technologists in complying with good laboratory practice critical to reliable HIV results.
Description: In ongoing interventions to strengthen the HIV diagnostic services in 21 member countries of
the Caribbean Epidemiology Centre (CAREC), traditional workshops were held for technologists which
focused on imparting technical information to improve their knowledge base, technical skills and by
assumption laboratory practices & the quality of HIV results. Follow-up investigations identified the
deficiencies in this approach and the major role that cultural beliefs, attitudes and behaviours played in the
production of a reliable result. The workshop format was restructured to influence behaviour changes
through exploring cultural beliefs and attitudes, increasing the understanding of personal responsibility for
patient outcome, sensitising technologists to the reality of laboratory error and the impact of ineffective
communication and poor management practices.
Conclusions: The modified approach has resulted in a much higher compliance with good laboratory
practice as evidenced by an increased understanding/acceptance of personal responsibility, increased
emphasis on error detection & prevention, increased willingness to develop procedure manuals and
implement Quality Control procedures, among other indicators of good laboratory practice.
Presenting author: W. Kitson-Piggott, Caribbean Epidemiology Centre (CAREC/PAHO/WHO), 16-18
Jamaica Boulevard, Federation Park, Port of Spain, Trinidad And Tobago, Tel.: +1-868-622-2153, Fax:
+1-868-622-9585, E-mail: piggotwe@carec.paho.org