Ginwalla S K, Grant A D, Day J H, Dlova T W, Macintyre S, Baggaley R, Churchyard G J
Clinical Research Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
AIDS Care. 2002 Oct;14(5):707-26. doi: 10.1080/0954012021000005533.
HIV voluntary counselling and testing (VCT) is now an integral part of many HIV care and control programmes. However, very little work has been done to assess the quality of VCT services. An evaluation of VCT services for mineworkers in Welkom, South Africa was conducted to assess client and counsellor satisfaction, the quality of the services and to identify barriers to uptake of VCT. A cross-sectional survey was carried out using tools developed by UNAIDS, consisting of semi-structured interviews and observation of counselling sessions. Twenty-two nurse counsellors and six community volunteers were interviewed. Twenty-four counselling sessions were observed and 24 client exit interviews were conducted. Although nine of the 22 nurse counsellors had only in-service rather than formal training for HIV counselling whereas all community volunteers had been formally trained, nurse counsellors demonstrated better interpersonal skills than did community volunteers. Both clients and counsellors identified fear of a positive result as a major barrier to HIV testing. Clients also raised concerns about confidentiality. UNAIDS evaluation tools were a feasible and an acceptable method of assessing VCT in this operational setting. The study identified areas where training needs to be strengthened and suggested ways of improving the services, and changes to the service have now been implemented in line with these recommendations.
艾滋病毒自愿咨询和检测（VCT）如今已成为许多艾滋病毒防治项目不可或缺的一部分。然而，在评估VCT服务质量方面所做的工作极少。对南非韦尔科姆金矿工人的VCT服务进行了一项评估，以评估服务对象和咨询员的满意度、服务质量，并找出VCT推广的障碍。采用联合国艾滋病规划署开发的工具进行了一项横断面调查，包括半结构化访谈和咨询环节观察。对22名护士咨询员和6名社区志愿者进行了访谈。观察了24次咨询环节，并与24名服务对象进行了离场访谈。虽然22名护士咨询员中有9人仅接受过艾滋病毒咨询在职培训而非正规培训，而所有社区志愿者都接受过正规培训，但护士咨询员的人际沟通技巧比社区志愿者更好。服务对象和咨询员都认为害怕检测结果呈阳性是艾滋病毒检测的主要障碍。服务对象还对保密问题表示担忧。联合国艾滋病规划署的评估工具是在这种实际工作环境中评估VCT的一种可行且可接受的方法。该研究确定了需要加强培训的领域，并提出了改进服务的方法，目前已根据这些建议对服务进行了调整。
