Kurien M, Thomas K, Ahuja R C, Patel A, Shyla P R, Wig N, Mangalani M, Kasthuri A, Vyas B, Brogen A, Sudarsanam T D, Chaturvedi A, Abraham O C, Tharyan P, Selvaraj K G, Mathew J
Coordinating Centre, Christian Medical College, Vellore 632004, Tamil Nadu, India.
Natl Med J India. 2007 Mar-Apr;20(2):59-66.
Stigma and discrimination, particularly in access to healthcare, remains a major problem for people Infected with HIV in most parts of India.
We did a multicentre study (n = 10) with a cross-sectional survey design using a standardized, interviewer-administered questionnaire.
A total of 2200 healthcare providers participated. The knowledge, attitude and practice (KAP) related to HIV service delivery were very poor with a mean overall KAP score of only 49.7% (CI: 49.1-50.3). Only 5%, 5% and 1% of the participants scored more than 75% separately for the dimensions of knowledge, attitude and practice, respectively. Only 24.4% and 36.7% of responders knew that HIV screening was not recommended prior to surgery and pre-employment check-up. Many doctors (19.4%) had refused treatment to people living with HIV/AIDS (PLHA) at least some of the time and nearly half (47.2%) identified and labelled them; 23.9% isolated them in separate care areas and 13.3% postponed or changed treatment based on the patient's HIV status. Screening for HIV prior to elective surgery was done by 67% of providers. While 64.7% of responders were aware of the existence of national guidelines on and recommendations for HIV testing, only 38.4% had read the policy document.
There is a growing need to provide care, support and treatment to a large number of PLHA. The capacity of healthcare providers must be urgently built up so as to improve their knowledge of and attitude to HIV to enable them to deliver evidence-based and compassionate care to PLHA in various healthcare settings.
在印度大部分地区，耻辱感和歧视，尤其是在获得医疗保健方面，仍然是艾滋病毒感染者面临的一个主要问题。
我们采用标准化的、由访谈员管理的问卷进行了一项多中心研究（n = 10），采用横断面调查设计。
共有2200名医疗保健提供者参与。与艾滋病毒服务提供相关的知识、态度和实践（KAP）非常差，总体KAP平均得分仅为49.7%（CI：49.1 - 50.3）。在知识、态度和实践维度上，分别只有5%、5%和1%的参与者得分超过75%。只有24.4%和36.7%的受访者知道手术前和入职前检查不建议进行艾滋病毒筛查。许多医生（19.4%）至少在某些时候拒绝为艾滋病毒/艾滋病患者（PLHA）提供治疗，近一半（47.2%）的医生对他们进行识别和标记；23.9%的医生将他们隔离在单独的护理区域，13.3%的医生根据患者的艾滋病毒状况推迟或改变治疗。67%的提供者在择期手术前进行艾滋病毒筛查。虽然64.7%的受访者知道有关于艾滋病毒检测的国家指南和建议，但只有38.4%的人阅读过该政策文件。
越来越需要为大量的艾滋病毒/艾滋病患者提供护理、支持和治疗。必须紧急增强医疗保健提供者的能力，以提高他们对艾滋病毒的知识和态度，使他们能够在各种医疗环境中为艾滋病毒/艾滋病患者提供基于证据的、富有同情心的护理。
