Oosterhoff P, Hardon A P, Nguyen T A, Pham N Y, Wright P
Medical Committee Netherlands Vietnam, Hanoi, Vietnam.
AIDS Care. 2008 Jul;20(6):654-9. doi: 10.1080/09540120701687026.
HIV testing is an essential component of PMTCT. It can be offered to pregnant women through different testing models, ranging from voluntary counseling and testing (VCT) to routine and mandatory testing. This study was conducted in Hanoi, Vietnam, where HIV-prevalence is low among the general population, but high among young, urban, sexually active, male intravenous drug users. Women who want to deliver in a state hospital are routinely tested for HIV in the absence of well-defined opt-out procedures. In-depth interviews with a convenience sample of 38 seropositive pregnant women and mothers and 53 health workers explored the acceptability of routine testing. Patients and healthcare workers appeared to accept routine 'blood' tests (including HIV tests) because they feel uncomfortable discussing issues specific to HIV/AIDS. To avoid having to inform women directly about their HIV status, health workers at routine testing sites rely on the official notification system, shifting the responsibility from the hospitals to district and commune health staff. The notification system in Hanoi informs these local officials about the HIV status of people living in their catchment area without patients' consent. Our study shows that this non-confidential process can have serious social, economic and health consequences for the HIV-positive women and their children.
艾滋病毒检测是预防母婴传播的重要组成部分。可以通过不同的检测模式为孕妇提供检测，从自愿咨询检测（VCT）到常规和强制检测。本研究在越南河内进行，该国普通人群中的艾滋病毒感染率较低，但在年轻、城市、性活跃的男性静脉吸毒者中感染率较高。在没有明确的退出程序的情况下，想要在国立医院分娩的妇女会被常规检测艾滋病毒。对38名血清阳性孕妇和母亲以及53名医护人员进行的便利抽样深入访谈，探讨了常规检测的可接受性。患者和医护人员似乎接受常规的“血液”检测（包括艾滋病毒检测），因为他们在讨论艾滋病毒/艾滋病的具体问题时会感到不舒服。为了避免直接告知女性她们的艾滋病毒感染状况，常规检测点的医护人员依赖官方通知系统，将责任从医院转移到地区和社区卫生工作人员身上。河内的通知系统在未经患者同意的情况下，将居住在其辖区内的人员的艾滋病毒感染状况告知这些地方官员。我们的研究表明，这种非保密程序可能会给艾滋病毒阳性女性及其子女带来严重的社会、经济和健康后果。
