Kebaabetswe P M
Botswana Harvard Aids Institute Partnership for HIV Research and Education, Gaborone, Botswana.
AIDS Care. 2007 Mar;19(3):355-60. doi: 10.1080/09540120600942407.
The existing belief that if money and free antiretroviral drugs were offered to developing countries, people would flock to use the services does seem to hold for the Prevention of Mother-to-Child Transmission of HIV Program (PMTCT) in Botswana. The government offers free counseling, testing, free antiretroviral drugs and free infant formula for babies born to infected mothers and yet some women are reluctant to enroll in this program to protect their infants. A qualitative study on factors that motivated and hindered pregnant women from participating in the PMTCT program was conducted in Gaborone, Botswana. Forty subjects (ten HIV-positive pregnant women who accepted the program, eleven who rejected the program, nine PMTCT health workers and ten key informants) participated in in-depth interviews. Thematic content analysis yielded the following barriers to participation in the program: fear of knowing one's own HIV status, infant feeding distribution stigma, lack of male partners' support and negative attitudes of health workers. Reinforcing factors were: availability of free antiretroviral drugs and free infant formula. In conclusion, stigma and discrimination are still the main impediments to women's participation in the PMTCT program. Mitigating these barriers could reduce AIDS-related infant mortality in this country.
现有的一种观点认为，要是向发展中国家提供资金和免费抗逆转录病毒药物，人们就会蜂拥而至使用这些服务，这种观点在博茨瓦纳的预防母婴传播艾滋病毒项目（PMTCT）中似乎确实成立。政府为感染艾滋病毒的母亲所生婴儿提供免费咨询、检测、免费抗逆转录病毒药物和免费婴儿配方奶粉，但仍有一些妇女不愿加入该项目来保护自己的婴儿。在博茨瓦纳哈博罗内开展了一项关于促使和阻碍孕妇参与PMTCT项目的因素的定性研究。40名受试者（10名接受该项目的艾滋病毒呈阳性孕妇、11名拒绝该项目的孕妇、9名PMTCT医护人员和10名关键信息提供者）参与了深度访谈。主题内容分析得出了参与该项目的以下障碍：害怕知晓自己的艾滋病毒感染状况、婴儿喂养分配方面的污名、缺乏男性伴侣的支持以及医护人员的负面态度。强化因素包括：免费抗逆转录病毒药物和免费婴儿配方奶粉的可获得性。总之，污名和歧视仍是妇女参与PMTCT项目的主要障碍。减轻这些障碍可降低该国与艾滋病相关的婴儿死亡率。
