The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 51 RESEARCH ARTICLE ABSTRACTS South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 © 2016 The Author(s) RESEARCH South African Family Practice 2016; 58(3):100–107 http://dx.doi.org/10.1080/20786190.2016.1167310 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 HIV-related knowledge and practices: a cross-sectional study among adults aged 50 years and above in Botswana Njoku Ola Amaa*, Sheila Shaibub and Jacqueline Denise Burnettec aDepartment of Statistics, University of Botswana, Gaborone, Botswana b School of Nursing, University of Botswana, Gaborone, Botswana cSchool of Social Work, University of Columbia, New York, NY, USA *Corresponding author, emails: amano@mopipi.ub.bw, njoku52@gmail.com Background: Older adults in Botswana have been shown to be sexually active and engage in risky sexual activities that make them vulnerable to HIV infection. In order to implement meaningful interventions to address older adults’ HIV and AIDS concerns it is important to understand how much knowledge they have concerning HIV and AIDS and practices. This study explored the knowledge of HIV and AIDS and sexual practices of 609 older adults in Botswana. Methods: The study was cross-sectional and used a survey design. A total of 609 older adults were recruited using respondent- driven sampling (RDS) from four purposively selected health districts and interviewed on their individual HIV and AIDS-related knowledge and practices. Data were analysed using descriptive statistics and multivariate logistic regression. Results: Although knowledge of HIV and AIDS was high (95.7%), knowledge of HIV infection through blood transfusion, transmission from mother to child, or sharing needles or syringes was lacking. Only 72% of males and 23.2% of females know that having fewer partners and avoiding blood transfusions (71% of males and 44.3% of females) can minimise risks of HIV infection. Age, marital status and employment status significantly predicted knowledge of transmission (p < 0.05), while sex significantly predicted knowledge of prevention and control methods. Conclusion: The study concludes that age-appropriate and culturally relevant education and training of older adults are necessary for the prevention and control of HIV infection. Keywords: Botswana, HIV, knowledge, older adults, practices Introduction Older adults in Botswana The 2013 Botswana AIDS Impact Study (BAIS IV)1 gives the HIV prevalence rate for older adults (50 years and over) as 26.3% for those aged 50–54; 22.8% for those aged 55–59; 20.9% for 60–64; and 10.4% for those aged 65 and over. The gender differentials show that females have a lower prevalence rate than males (males 31.8% and females 22.8%, for age 50–54; males 33.5% and females 16.2% for age 55–59  years). For older age groups, 60  years and above, the prevalence rate is higher for females than males. Of those in the age group who tested for HIV and declared their results, 23.2% were HIV positive (25.5% of males, 21.5% of females) and this number is likely to increase because of new entrants into this cohort as a result of the use of antiretroviral therapy (ART).2 These results for the older adults are comparable to those in the age groups 30–34 (33.9%), 35–39 (43.7%) and 40–44 (41.8%), yet there are no interventions specifically targeting the older adults while every intervention to curb the prevalence and incidence of HIV targets only those in the population below 50 years of age. Older adults are sexually active and consider sex an important part of life.3–5 Results from national surveys examining the sexual activity among persons over the age of 60 indicate that more than 92% of the respondents consider sex an important part of life and that 75% of those between 65 and 74 considered themselves sexually active.6 Yet, they often consider themselves not only at low risk for HIV infection, but also generally lack up- to-date information concerning disease prevention and transmission.7 Most HIV prevention efforts largely target younger people below 50  years of age and little is known about the knowledge of HIV and AIDS and sexual practices of the older adults that make them vulnerable to HIV infection. Normal ageing changes such as a decrease in vaginal lubrication and thinning of vaginal walls can put older women at higher risk for HIV infection during intercourse.8 A study by Negin and Cumming9 estimated that there are three million HIV-positive people in sub-Saharan Africa (SSA) aged 50 and older, representing more than 14% of those over the age of 15 infected with HIV and suggesting that increased attention is needed for older age groups. HelpAge International10 analysed the 25 core indicators identified at the 2001 Declaration of Commitment on HIV and AIDS and the 2006 Political Declaration on HIV/AIDS and found that no one specifically monitors the impact of the epidemic on older people. This impacts negatively on strategic healthcare planning for this age group. If the gap in knowledge on HIV in mature adults is not addressed, it may hinder UNAIDS’s vision of zero discrimination, zero new HIV infections and zero AIDS-related deaths through universal access to effective HIV prevention, treatment, care and support.11,12 It is, therefore, of urgent need to focus on older adults in the face of an ageing HIV-infected cohort. HIV-related knowledge and practices among people over 50 in Botswana is important for a number of reasons. Older adults are sexually active, and may engage in risky sexual activities such as not using a condom during sexual intercourse and having sex with older and younger adults who might be HIV infected1,2,13 Ama et al.2 showed that 99.4% of older adults sex with between 1 and 4 partners in the past 12 months at the time of the study. South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 © 2016 The Author(s) RESEARCH South African Family Practice 2016; 58(3):94–99 http://dx.doi.org/10.1080/20786190.2016.1187865 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Patient preferences regarding the dress code, conduct and resources used by doctors during consultations in the public healthcare sector in Bloemfontein, Free State JW Van der Merwea, M Rugunanana, J Rasa, E-M Röschera, BD Hendersonb and G Joubertc*  a School of Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa b Division Clinical Genetics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa c Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa *Corresponding author, email: gnbsgj@ufs.ac.za Background: The doctor–patient relationship is important in determining the quality of healthcare provided. This study aimed to identify patient preferences regarding dress code, conduct and resources used by doctors during consultations in the public healthcare sector, Bloemfontein. Information from this study can be of benefit in determining policies and dress codes within hospitals and medical schools. Methods: This was a descriptive, cross-sectional study. Self-administered anonymous questionnaires were distributed at Bloemfontein’s National District Hospital to patients 18 years and older, waiting in the pharmacy and consultation queues. Results: Of the 500 questionnaires distributed 410 were analysed. Patients preferred doctors to wear formal attire. For female doctors this included a neat blouse (77.9%), smart pants (62.5%) or straight-cut jeans (51.4%) and flat pumps (56.3%). Patients preferred male doctors to wear collared shirts (52.4% and 57.6% for long- and short-sleeved shirts, respectively) with smart pants (66.8%) or straight-cut jeans (45.9%), and smart shoes (70.3%). Patients did not condone eating and drinking by doctors during consultations; work-related calls were deemed acceptable. The use of technological resources was not preferred. Conclusion: Patients in the public healthcare sector prefer a formal, professional consulting environment that is determined largely by the doctor’s attire and conduct during the consultation. Keywords: dress-code, patient preferences, professional attire, professional behaviour, technology use Introduction It is doctors’ responsibility to fulfil the medical needs and expectations of their patients, but achieving this is becoming increasingly difficult. In 2009, Mahmud stated that ‘The doctor– patient relationship is central to the practice of medicine and is essential for high-quality health care in the diagnosis and treatment of diseases.’1 According to members of the Medical Professionalism Project,2 ‘In these circumstances, reaffirming the fundamental and universal principles and values of medical professionalism becomes all the more important’. It is for this reason that the project2 was launched in order to aid medical professionals in their efforts to act appropriately in the medical environment. The Charter on Medical Professionalism, its principal product, consists of three fundamental principles that create the basis for the core of the charter, a set of 10 commitments. ‘Commitment to professional responsibilities’ is one of the commitments of the charter. It includes, inter alia, the way doctors dress and conduct themselves during a consultation, factors that can affect the doctor–patient relationship and the patients’ confidence in their doctor (unpublished lecture notes; Myburg J. The Doctor and the Environment, February 19, 2013). By abiding by these principles and remembering their responsibilities, doctors not only improve their interactions with patients, but also improve the healthcare system as a whole.2 Universally, white coats are associated with the medical profession.3 A systematic review by Petrili et al.4 included 30 studies from 14 countries, involving 11 533 patients in a variety of medical settings. In 60% of these studies formal attire and white coats with other attire not specified were patients’ preference, more commonly in older patients and in studies conducted in Europe and Asia. A study in Japan found no difference between age groups, gender or region regarding the overall preference for white coats.5 A Brazilian study found a patient preference for white clothing for doctors.6 A small study in Hawaii found that, although by a small margin, patients did not prefer white coats. They approved of scrubs and blue jeans, but disapproved of slippers or shorts.7 With changing societal norms, tattoos and piercings have become more common, but patients do not find these acceptable for healthcare workers.6,8 The manner in which doctors introduce themselves as well as the manner in which they address patients are equally important. Studies have shown that most patients prefer being addressed by their first name and for the doctor to be introduced by their full name and title, all the while wearing a smile on their face.9,10 Practices have had to keep abreast with advances in technology.11 Computers are used in consultations as a means of history- and note-taking, and when access to the Internet is possible, they provide an easily accessible and efficient way of acquiring information about a condition, medication or prognosis. Their use has become so widespread that in a document providing consultation skill tips for new GP registrars when starting off in general practice, the strategic use of the computer in the consultation is one of the aspects covered.12 The computer is considered the third party in the consultation.13 In a qualitative study among family physicians, three distinct practice styles S Afr Fam Pract 2015; DOI:10.1080/20786190.2016.1187865 S Afr Fam Pract 2015; DOI: 10.1080/20786190.2016.1167310 Abstract (Full text available online at www.tandfonline.com/ojfp) Abstract (Full text available online at www.tandfonline.com/ojfp)