Baiden F, Baiden Rita, Williams J, Akweongo Patricia, Clerk Christine, Debpuur C, Philips J, Hodgson A
Navrongo Health Research Center, Ghana Health Service, Upper East Region, Ghana.
Ghana Med J. 2005 Mar;39(1):8-13. doi: 10.4314/gmj.v39i1.35974.
SummaryVoluntary counselling and HIV testing has become an integral part of HIV prevention and care programs in many countries in sub-Saharan Africa. A number of interventions offer potential to reduce mother-to-child HIV transmission. These interventions, including antenatal and or intrapartum administration of antiretroviral drugs require the integration of voluntary counselling and HIV testing for pregnant women into antenatal care. Ghana's strategic framework for HIV control calls for the integration of voluntary counselling and HIV testing to antenatal care nationwide. It sets as target, the year 2005 when VCT would be widely available and accessible in the country. This paper reviews medline-indexed publications on antenatal-linked VCT programs of sub-Saharan Africa. Four critical themes were used in the medline search. These are acceptability, rates of return for test, disclosure of results vis-à-vis confidentiality and cost effectiveness. The growing consensuses on these issues are discussed in relations to the findings of a recent study conducted among 270 pregnant women in Navrongo in the Kassena-Nankana district of northern Ghana. Suggestions are made to guide the on-going pilot VCT and prevention of mother-to-child programs in Ghana. It is also suggested on the basis of the review and the findings of the Navrongo study that Ghana should explore options likely to promote universal access and overall acceptability. These include couple counselling, guarantee of confidentiality, free testing and continuum of care for mothers who are test positive.
摘要
在撒哈拉以南非洲的许多国家，自愿咨询和艾滋病毒检测已成为艾滋病毒预防和护理计划的一个组成部分。一些干预措施有可能减少母婴艾滋病毒传播。这些干预措施，包括产前和（或）产时抗逆转录病毒药物的使用，要求将孕妇的自愿咨询和艾滋病毒检测纳入产前护理。加纳的艾滋病毒控制战略框架要求在全国范围内将自愿咨询和艾滋病毒检测纳入产前护理。它设定了一个目标，即在2005年该国将广泛提供和普及自愿咨询和检测服务。本文回顾了撒哈拉以南非洲与产前相关的自愿咨询和检测项目的医学索引出版物。在医学索引搜索中使用了四个关键主题。这些主题是可接受性、检测回访率、结果披露与保密性以及成本效益。结合最近在加纳北部卡塞纳-南卡纳区纳夫龙戈对270名孕妇进行的一项研究结果，讨论了在这些问题上日益达成的共识。提出了一些建议，以指导加纳正在进行的自愿咨询和检测试点以及母婴预防项目。根据该综述和纳夫龙戈研究的结果，还建议加纳应探索可能促进普遍获得服务和总体可接受性的选项。这些选项包括夫妇咨询、保密保证、免费检测以及为检测呈阳性的母亲提供持续护理。
