Painter Thomas M, Diaby Kassamba L, Matia Danielle M, Lin Lillian S, Sibailly Toussaint S, Kouassi Moïse K, Ekpini Ehounou R, Roels Thierry H, Wiktor Stefan Z
Division of HIV/AIDS Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mail stop E-37, Atlanta, Georgia 30333, USA.
BMJ. 2004 Sep 4;329(7465):543. doi: 10.1136/bmj.329.7465.543.
To find out why pregnant women who receive HIV-1 positive test results and are offered short course antiretroviral prophylaxis to prevent transmission of HIV from mother to child do not participate in necessary follow up visits before starting prophylaxis.
Qualitative interview study.
A programme aiming to prevent transmission of HIV from mother to child at a public antenatal clinic in Abidjan, Côte d'Ivoire.
Purposive sample of 27 women who had received HIV-1 positive test results and were invited to return for monthly follow up visits before starting prophylaxis with zidovudine at 36 weeks' gestation, but who had either refused or discontinued the visits. None of the women started prophylaxis.
Most of the women explained their non-participation in follow up visits by referring to negative experiences that they had had while interacting with programme staff or to their views about the programme. Additional reasons concerned their disbelief of HIV positive test results and personal factors.
Difficulties experienced by women during their contacts with staff working on the prevention programme and negative views that they have about the programme can contribute to their non-participation in prophylaxis. Training and supervision of programme staff may increase the likelihood of positive interactions between staff and clients, thereby facilitating women's participation in preventing transmission of HIV from mother to child. Outreach and mobilisation in communities that are served by prevention programmes may complement these measures at programme level by contributing to increased social support for women's efforts to prevent transmission of HIV from mother to child.
探究为何接受人类免疫缺陷病毒1型（HIV-1）检测结果呈阳性并被提供短期抗逆转录病毒药物预防措施以防止母婴传播HIV的孕妇，在开始预防用药前未参与必要的后续随访。
定性访谈研究。
在科特迪瓦阿比让一家公共产前诊所开展的一项旨在预防母婴传播HIV的项目。
选取27名有目的抽样的女性，她们HIV-1检测结果呈阳性，在妊娠36周开始使用齐多夫定进行预防用药前被邀请每月回来进行随访，但她们要么拒绝要么中断了随访。这些女性均未开始预防用药。
大多数女性将她们未参与随访归因于与项目工作人员互动时的负面经历或她们对该项目的看法。其他原因包括她们对HIV检测呈阳性结果的怀疑以及个人因素。
女性在与预防项目工作人员接触时遇到的困难以及她们对该项目的负面看法可能导致她们不参与预防用药。对项目工作人员的培训和监督可能会增加工作人员与服务对象之间积极互动的可能性，从而促进女性参与预防母婴传播HIV。在预防项目所服务的社区进行外展和动员，可通过增强社会对女性预防母婴传播HIV努力的支持，在项目层面补充这些措施。
