Pool R, Nyanzi S, Whitworth J A
Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda.
AIDS Care. 2001 Oct;13(5):605-15. doi: 10.1080/09540120120063232.
This paper describes the results of a study exploring the attitudes of women attending maternity clinics to voluntary counselling and testing during pregnancy in rural areas in south-west Uganda. It was a qualitative study using focus group discussions (FGDs). Twenty-four FGDs were carried out with 208 women attending maternity clinics in three sites in rural south-west Uganda. The FGDs were all recorded and transcribed, and analysed using standard computer-based qualitative techniques. Almost all women were willing in principle to take an HIV test in the event of pregnancy, and to reveal their HIV status to maternity staff. They were anxious, however, about confidentiality, and there was a widespread fear that maternity staff might refuse to assist them when the time came to deliver if their status were known. This applied more to traditional birth attendants than to biomedical health staff. There were also rumours about medical staff intentionally killing HIV-positive patients in order to stem the spread of the epidemic. Women were concerned that if their husbands found out they were HIV-positive they would be blamed and separation or domestic violence might result.
although VCT during pregnancy is acceptable in principle, much will need to be done to ensure confidentiality and allay women's fears of stigmatisation and discrimination during delivery. Community sensitisation will be necessary and male partners will have to be involved if interventions are to be acceptable.
本文描述了一项研究的结果,该研究探讨了乌干达西南部农村地区产科诊所的女性对孕期自愿咨询和检测的态度。这是一项采用焦点小组讨论(FGD)的定性研究。在乌干达西南部农村的三个地点,对208名前往产科诊所的女性进行了24次焦点小组讨论。所有焦点小组讨论都进行了录音和转录,并使用基于计算机的标准定性技术进行分析。几乎所有女性原则上都愿意在怀孕时接受艾滋病毒检测,并向产科工作人员透露自己的艾滋病毒感染状况。然而,她们担心保密性,并且普遍担心如果她们的感染状况被知晓,产科工作人员在分娩时可能会拒绝协助她们。这一点在传统助产士身上比在生物医学卫生工作人员身上体现得更明显。还有传言称医务人员故意杀害艾滋病毒呈阳性的患者以阻止疫情传播。女性担心如果丈夫发现她们艾滋病毒呈阳性,她们会受到指责,可能导致分居或家庭暴力。
尽管孕期自愿咨询检测原则上是可以接受的,但需要做很多工作来确保保密性,并消除女性在分娩期间对污名化和歧视的恐惧。如果干预措施要被接受,社区宣传将是必要的,并且必须让男性伴侣参与进来。