Busza J, Zaba B, Urassa M
Centre for Population Studies, London School of Hygiene & Tropical Medicine, 50 Bedford Square, London WC1B 3DP, UK.
Sex Transm Infect. 2009 Jun;85(3):212-5. doi: 10.1136/sti.2008.029835. Epub 2008 Aug 6.
OBJECTIVE(S): We piloted an innovative community-based recruitment approach to contact known HIV+ individuals for referral to treatment without endangering their confidentiality.
Nested within an HIV cohort study, operations research to monitor and improve rural uptake of antiretroviral therapy (ART) was conducted alongside the introduction of Tanzania's national treatment programme. We confronted the challenge of recruiting participants without inadvertently disclosing their HIV status to family or other community members. During post-test counselling, nurses compiled a list of HIV+ persons who expressed interest in being contacted when ART became available. Study numbers, but not names, of 12 "seeds" were added to a randomly generated list of residents, matched by age group and sex, and all were invited to participate in focus-group discussions on community perceptions of treatment. After the discussion, the original counsellors met each participant in private, inviting the "seed" for ART referral and offering VCT to others.
Ten "seeds" were successfully located and attended the local focus-group discussion; all subsequently volunteered to undergo clinical tests in advance of receiving antiretroviral therapy. They also agreed to participate in a study of barriers to ART access. The other focus-group members contributed useful information on levels of understanding and support for treatment, and several came forward for HIV testing.
The "seeded" focus group is a very straightforward and easily arranged method of recruiting HIV+ people for research or service delivery within a wider context of engaging with local community perceptions.
我们试点了一种创新的基于社区的招募方法,以联系已知的HIV阳性个体并将其转介接受治疗,同时不危及他们的隐私。
在一项HIV队列研究中,随着坦桑尼亚国家治疗计划的引入,开展了运营研究以监测和改善农村地区抗逆转录病毒疗法(ART)的使用情况。我们面临着在不无意中向家人或其他社区成员透露参与者HIV感染状况的情况下招募参与者的挑战。在检测后咨询期间,护士编制了一份对ART可用时被联系表示感兴趣的HIV阳性者名单。将12名“种子”的研究编号而非姓名添加到按年龄组和性别匹配的随机生成的居民名单中,并邀请所有人参加关于社区对治疗看法的焦点小组讨论。讨论结束后,原来的咨询员与每位参与者私下会面,邀请“种子”接受ART转介,并为其他人提供自愿咨询检测服务。
成功找到了10名“种子”并参加了当地的焦点小组讨论;随后所有人都自愿在接受抗逆转录病毒治疗之前接受临床检测。他们还同意参与一项关于ART获取障碍的研究。其他焦点小组成员提供了关于对治疗的理解和支持程度的有用信息,还有几人前来接受HIV检测。
“种子”焦点小组是一种非常直接且易于安排的方法,可在更广泛地了解当地社区看法的背景下,招募HIV阳性者参与研究或服务提供。