Adeneye A K, Brieger W R, Mafe M A, Adeneye A A, Salami K K, Titiloye M A, Adewole T A, Agomo P U
Public Health Division, Nigerian Institute of Medical Research, Lagos, Nigeria.
Int Q Community Health Educ. 2006;26(4):337-53. doi: 10.2190/IQ.26.4.c.
HIV counseling and testing (CT) is slowly being introduced as one of several key components of the comprehensive package of HIV/AIDS prevention and care in Nigeria, particularly in the prevention of mother-to-child transmission of HIV (PMTCT). A cross-sectional survey of 804 women attending antenatal clinics (ANC) in Ogun State, Nigeria was done using questionnaires to assess their willingness to seek and undergo CT and know the determinants. Focus group discussions were also held in the general community: 84.3% of respondents believed in AIDS reality, while 24.3% thought they were at risk of HIV infection. Only 27% knew about MTCT, while 69.7% of 723 who had heard of HIV/AIDS did not know about CT. Only 71 (8.8%) had thought about CT and 33 (4.5%) mentioned HIV testing as one of antenatal tests. After health education on CT, 89% of the women expressed willingness to be tested. Their willingness for CT was positively associated with education (p < 0.05), ranging from 77% (no education) to 93% (post-secondary). More of those with self-perceived risk expressed willingness to test for HIV (p < 0.05). Those willing to be tested had a higher knowledge score on how HIV spreads than those not willing. Multiple regressions identified four key factors that were associated with willingness for CT: increasing educational level; not fearing a blood test; perception that the clinic offered privacy; and perceptions of higher levels of social support from relatives and peers. Those unwilling or undecided about CT expressed strong fear of social stigma/rejection if tested positive. The results provided insights for planning promotional programs and showed that not only are IEC efforts needed to boost knowledge about HIV/AIDS, but that change in clinic setting and community are imperative in creating supportive environment to encourage uptake of CT services.
在尼日利亚，艾滋病毒咨询与检测（CT）正作为艾滋病毒/艾滋病综合预防与护理一揽子计划的几个关键组成部分之一被逐步引入，尤其是在预防艾滋病毒母婴传播（PMTCT）方面。在尼日利亚奥贡州，对804名到产前诊所（ANC）就诊的妇女进行了一项横断面调查，通过问卷调查来评估她们寻求并接受CT检测的意愿以及了解相关决定因素。同时还在普通社区进行了焦点小组讨论：84.3%的受访者相信艾滋病的存在，而24.3%的人认为自己有感染艾滋病毒的风险。只有27%的人了解母婴传播，在723名听说过艾滋病毒/艾滋病的人中，69.7%的人不知道CT检测。只有71人（8.8%）考虑过CT检测，33人（4.5%）将艾滋病毒检测列为产前检查项目之一。在接受关于CT检测的健康教育后，89%的妇女表示愿意接受检测。她们接受CT检测的意愿与教育程度呈正相关（p<0.05），范围从77%（未受过教育）到93%（大专以上）。更多自认为有风险的人表示愿意接受艾滋病毒检测（p<0.05）。愿意接受检测的人在艾滋病毒传播方式方面的知识得分高于不愿意接受检测的人。多元回归确定了与接受CT检测意愿相关的四个关键因素：教育水平提高；不害怕血液检测；认为诊所提供隐私；以及认为从亲属和同龄人那里能获得更高水平的社会支持。那些不愿意或对CT检测犹豫不决的人表示，如果检测呈阳性，非常害怕社会耻辱/被排斥。研究结果为规划宣传项目提供了见解，表明不仅需要开展信息、教育和宣传（IEC）工作来提高对艾滋病毒/艾滋病的认识，而且诊所环境和社区的改变对于营造支持性环境以鼓励人们接受CT服务至关重要。
