Shetty Avinash K, Mhazo Miriam, Moyo Sostain, von Lieven Andrea, Mateta Patrick, Katzenstein David A, Maldonado Yvonne, Hill David, Bassett Mary T
Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
Int J STD AIDS. 2005 Nov;16(11):755-9. doi: 10.1258/095646205774763090.
The purpose of this pilot project was to assess the feasibility and acceptability of voluntary counselling and HIV testing (VCT) by pregnant women using community volunteers in Zimbabwe to prevent mother to child transmission (MTCT) of HIV. From July 1999 to June 2001, a short-course zidovudine (ZDV)-based perinatal HIV prevention programme was initiated in two antenatal clinics. Community volunteers, recruited from local community organizations, underwent a two-week training course in VCT, which included HIV/AIDS facts, systematic counselling approach, and practical counselling techniques using scripts and role-play. Rapid HIV testing was performed after informed consent. Lay counsellors conducted individual pre- and post-test counselling for HIV. A total of 35 women community volunteers were trained in VCT; 34 graduated and committed to work four hours per week in the clinic. Of the 6051 pregnant women presenting for antenatal clinics (ANC), 1824 (30%) underwent pre-test counselling and 1547 (26%) were tested, and 429 (28%) were HIV infected. Overall, 1283 (83%) returned for their test results including 406 (95%) of HIV-infected women. Of the 406 HIV-infected women who collected their test results, only 203 (50%) opted for ZDV prophylaxis to prevent MTCT of HIV. Over the two-year study period, two counsellors died and three sought employment at other organizations. Adherence to duty roster was 97% and no breach of confidentiality was reported. Despite many challenges, VCT delivered by community volunteers is feasible and acceptable for pregnant women aiming to reduce their risk of transmitting HIV to their infants. This programme is being implemented at several urban and rural MTCT sites in Zimbabwe and can serve as a model for other resource-poor countries.
该试点项目的目的是评估在津巴布韦利用社区志愿者为孕妇提供自愿咨询与艾滋病毒检测（VCT）以预防艾滋病毒母婴传播（MTCT）的可行性和可接受性。1999年7月至2001年6月，在两家产前诊所启动了一项以齐多夫定（ZDV）为基础的短期围产期艾滋病毒预防项目。从当地社区组织招募的社区志愿者参加了为期两周的VCT培训课程，内容包括艾滋病毒/艾滋病知识、系统咨询方法以及使用脚本和角色扮演的实际咨询技巧。在获得知情同意后进行快速艾滋病毒检测。非专业咨询师为艾滋病毒检测前后的个人提供咨询。共有35名女性社区志愿者接受了VCT培训；34名毕业并承诺每周在诊所工作4小时。在6051名到产前诊所就诊的孕妇中，1824名（30%）接受了检测前咨询，1547名（26%）接受了检测，429名（28%）艾滋病毒呈阳性。总体而言，1283名（83%）返回获取检测结果，其中包括406名（95%）艾滋病毒感染女性。在406名获取检测结果的艾滋病毒感染女性中，只有203名（50%）选择使用ZDV预防措施来预防艾滋病毒母婴传播。在为期两年的研究期间，两名咨询师死亡，三名在其他组织寻求工作。遵守值班表的比例为97%，未报告有违反保密规定的情况。尽管面临诸多挑战，但由社区志愿者提供的VCT对于旨在降低将艾滋病毒传播给婴儿风险的孕妇来说是可行且可接受的。该项目正在津巴布韦的多个城乡艾滋病毒母婴传播地点实施，并可作为其他资源匮乏国家的典范。
