Maman S, Mbwambo J, Hogan N M, Kilonzo G P, Sweat M
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA.
AIDS Care. 2001 Oct;13(5):595-603. doi: 10.1080/09540120120063223.
In view of the ever-increasing HIV/AIDS epidemic in sub-Saharan Africa, the expansion of HIV-1 voluntary counselling and testing (VCT) as an integral part of prevention strategies and medical research is both a reality and an urgent need. As the availability of HIV-1 VCT grows two limitations need to be addressed, namely: low rates of HIV-1 serostatus disclosure to sexual partners and negative outcomes of serostatus disclosure. Results from a study among men, women and couples at an HIV-1 VCT clinic in Dar es Salaam, Tanzania are presented. The individual, relational and environmental factors that influence the decision to test for HIV-1 and to share test results with partners are described. The most salient barriers to HIV-1 testing and serostatus disclosure described by women include fear of partners' reaction, decision-making and communication patterns between partners, and partners' attitudes towards HIV-1 testing. Perception of personal risk for HIV-1 is the major factor driving women to overcome barriers to HIV-1 testing. The implications of findings for the promotion of HIV-1 VCT programmes, the implementation of partner notification policies and the development of post-test support services are discussed.
鉴于撒哈拉以南非洲地区艾滋病毒/艾滋病疫情不断加剧,扩大艾滋病毒-1自愿咨询检测(VCT)作为预防策略和医学研究的一个组成部分,既是现实需求,也是当务之急。随着艾滋病毒-1 VCT服务的普及,有两个限制因素需要解决,即:向性伴侣披露艾滋病毒-1血清学状态的比例较低,以及血清学状态披露的负面结果。本文介绍了在坦桑尼亚达累斯萨拉姆一家艾滋病毒-1 VCT诊所对男性、女性及伴侣开展的一项研究结果。文中描述了影响艾滋病毒-1检测决定以及与伴侣分享检测结果的个人、关系及环境因素。女性描述的艾滋病毒-1检测及血清学状态披露最突出的障碍包括担心伴侣的反应、伴侣之间的决策和沟通模式,以及伴侣对艾滋病毒-1检测的态度。对个人感染艾滋病毒-1风险的认知是促使女性克服艾滋病毒-1检测障碍的主要因素。文中讨论了研究结果对促进艾滋病毒-1 VCT项目、实施性伴侣通知政策以及开展检测后支持服务的意义。