亚的斯亚贝巴门诊部门中具有HIV感染可能临床体征的患者接受医疗机构发起的HIV咨询与检测(PICT)的情况。

Uptake of provider initiated HIV counseling and testing (PICT) among out patient department (OPD) clients with possible clinical signs of HIV infection in Addis Ababa.

作者信息

Girma Selamawit, Enquselassie Fikre

机构信息

School of Public Health, Addis Ababa University.

出版信息

Ethiop Med J. 2009 Oct;47(4):245-54.

DOI:
Abstract

BACKGROUND

Developments have been seen in recent years in global efforts to address the AIDS epidemnic. HIV counseling and testing (VCT) is the key entry point to prevention, care, treatment and support services. To improve the slow uptake besides VCT different alternatives have been proposed, namely provider-initiated HIV counseling and testing (PICT).

OBJECTIVES

To assess uptake of provider initiated HIV counseling and testing among out patient department (OPD) clients with possible clinical signs of HIV infection and factors associated with it.

METHODS

Facility based cross sectional study was conducted on 423 OPD clients with possible clinical signs of HIV infection in 12 government health centers in Addis Ababa. Once the health facilities were selected randomly from each sub cities, study subjects who came to the health centers were interviewed consecutively.

RESULT

The pre-test and post-test acceptability rates among those who showed willingness to PICT, were 0.98 and 0.96 respectively where as the overall acceptability rate of all study participants was 0.67. Compared with age group 15-24, subjects 25-34 years old have higher rate of willingness (Adj.OR = 8.98, 95% CI = 1.2-66.5) and acceptability (Adj.OR = 6.4 CI = 1.2-33.6). On the other hand those who had "less" support for PITC were less likely to be willing (AOR = 0.03; CI = 0.002-0.43) and accept the test (AOR = 0.02; 95% CI = 0.02-0.3) than who supported it "extremely".

CONCLUSION

Though knowledge about PICT among the study subjects was not satisfactory the relatively high willingness and acceptability identified in this study is promising for wider application towards strengthened prevention and control of HIV/AIDS. We recommend that PICT needs to be implemented at all levels of health facilities in Ethiopia.

摘要

背景

近年来,全球在应对艾滋病流行方面已取得进展。HIV咨询与检测(VCT)是预防、护理、治疗及支持服务的关键切入点。为改善VCT接受率较低的情况,人们提出了不同的替代方案,即由医护人员主动提供HIV咨询与检测(PICT)。

目的

评估门诊(OPD)中可能有HIV感染临床症状的患者对医护人员主动提供HIV咨询与检测的接受情况及其相关因素。

方法

在亚的斯亚贝巴的12家政府卫生中心,对423名可能有HIV感染临床症状的门诊患者开展了基于机构的横断面研究。从每个子城市随机选择卫生机构后,对前来卫生中心的研究对象进行连续访谈。

结果

表示愿意接受PICT的患者中,检测前和检测后的接受率分别为0.98和0.96,而所有研究参与者的总体接受率为0.67。与15 - 24岁年龄组相比,25 - 34岁的受试者有更高的意愿率(调整后比值比=8.98,95%置信区间=1.2 - 66.5)和接受率(调整后比值比=6.4,置信区间=1.2 - 33.6)。另一方面,对PITC“支持较少”的人比“极其支持”的人更不愿意接受检测(优势比=0.03;置信区间=0.002 - 0.43),接受检测的可能性也更低(优势比=0.02;95%置信区间=0.02 - 0.3)。

结论

尽管研究对象对PICT的了解并不理想,但本研究中发现的相对较高的意愿和接受度有望在更广泛应用中加强对HIV/AIDS的预防和控制。我们建议在埃塞俄比亚各级卫生机构实施PICT。

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