de Paoli Marina Manuela, Manongi Rachel, Klepp Knut-Inge
Institute for Nutrition Research, University of Oslo, Oslo, Norway.
Reprod Health Matters. 2002 Nov;10(20):144-56. doi: 10.1016/s0968-8080(02)00088-5.
This study investigated the infant feeding advice that counsellors were giving HIV-infected pregnant women in Moshi, Tanzania, the factors they thought had an impact on women's infant feeding choices and their role in influencing these decisions. The data are drawn from in-depth interviews with 16 nurses working as counsellors in their spare time in an antenatal trial of prevention of mother-to-child transmission, five local HIV/AIDS counsellors and two medical doctors, whose counselling experience ranged from less than six months to nine years. Informed choice of infant feeding method by HIV-infected women, as recommended by UNAIDS/WHO/UNICEF Guidelines, was seriously compromised by the actual advice given, directive counselling, lack of time to cope with a positive HIV test result, and lack of follow-up support, regardless of socio-economic status. Infant feeding options were not always accurately explained, but counsellors believed most women had little choice but to breastfeed and were unlikely to exclusively breastfeed, despite advice. It was apparent that the risks and benefits of the options open to HIV-infected women were complicated for the counsellors, not only the women. Counsellors needed additional training in non-directive counselling and infant feeding options to ensure a better quality of advice-giving and support to follow-up women at home.
本研究调查了坦桑尼亚莫希地区的咨询员向感染艾滋病毒的孕妇提供的婴儿喂养建议、他们认为对妇女婴儿喂养选择有影响的因素以及他们在影响这些决定中所起的作用。数据来自对16名护士、5名当地艾滋病毒/艾滋病咨询员和2名医生的深入访谈，这些护士在预防母婴传播的产前试验中利用业余时间担任咨询员，他们的咨询经验从不到6个月到9年不等。无论社会经济地位如何，根据联合国艾滋病规划署/世界卫生组织/联合国儿童基金会的指导方针，感染艾滋病毒的妇女对婴儿喂养方法的知情选择都因所提供的实际建议、指导性咨询、应对艾滋病毒检测呈阳性结果的时间不足以及缺乏后续支持而受到严重影响。婴儿喂养选择并不总是得到准确解释，但咨询员认为，大多数妇女别无选择，只能进行母乳喂养，而且尽管有建议，她们也不太可能进行纯母乳喂养。显然，对于咨询员来说，感染艾滋病毒的妇女可选择的方案的风险和益处都很复杂，对妇女来说更是如此。咨询员需要接受关于非指导性咨询和婴儿喂养选择的额外培训，以确保提供更高质量的建议，并为在家中的后续妇女提供支持。
