Sheikh Kabir, Rangan Sheela, Kielmann Karina, Deshpande Sucheta, Datye Vinita, Porter John
Maharashtra Association of Anthropological Sciences, Pune.
AIDS Care. 2005 Aug;17(6):757-66. doi: 10.1080/09540120412331336742.
We explored HIV testing practices of private medical providers in an urban Indian setting in Pune, western India. 215 private practitioners (PPs) and 36 persons-in-charge of private laboratories were interviewed in separate surveys. 77% of PPs had prescribed HIV tests and 94% of laboratories had performed HIV tests, or collected samples for HIV testing. Among those providers who had prescribed/performed tests, practices which violated national policy guidelines were found to be common. 55% of PPs and 94% of laboratories had not prescribed/performed confirmatory HIV tests, 82% of PPs had conducted routine HIV screening tests, 53% of PPs and 47% of laboratories had never counselled patients before testing, and 39% of laboratories reported breaching confidentiality of test results. PPs' knowledge about HIV tests was also inadequate, with 28% of PPs who had prescribed HIV tests being unable to name the tests they had advised. Prolific HIV testing in the private medical sector is accompanied by inappropriate practices and inadequate knowledge, reflecting deficiencies in the implementation of policy guidelines. The perspectives and needs of private providers, the major source of health care in India, need to be acknowledged. Supportive and regulatory mechanisms can be used to involve private providers in the delivery of better HIV testing services.
我们在印度西部浦那的一个城市环境中，对私立医疗服务提供者的艾滋病毒检测行为进行了调查。分别对215名私人执业医生（PPs）和36名私立实验室负责人进行了访谈。77%的私人执业医生曾开具过艾滋病毒检测处方，94%的实验室进行过艾滋病毒检测，或采集过用于艾滋病毒检测的样本。在那些开具过检测处方/进行过检测的医疗服务提供者中，发现违反国家政策指南的行为很常见。55%的私人执业医生和94%的实验室未开具/进行艾滋病毒确证检测，82%的私人执业医生进行过常规艾滋病毒筛查检测，53%的私人执业医生和47%的实验室在检测前从未对患者进行过咨询，39%的实验室报告存在泄露检测结果保密性的情况。私人执业医生对艾滋病毒检测的知识也不足，28%开具过艾滋病毒检测处方的私人执业医生无法说出他们建议的检测项目。私立医疗部门大量的艾滋病毒检测伴随着不适当的行为和知识不足，这反映出政策指南实施方面的缺陷。印度医疗保健的主要来源——私立医疗服务提供者的观点和需求需要得到认可。可以利用支持和监管机制，让私立医疗服务提供者参与提供更好的艾滋病毒检测服务。
