艾滋病毒检测中的公平性：来自十个南部非洲国家的横断面研究证据。
Equity in HIV testing: evidence from a cross-sectional study in ten Southern African countries.
机构信息
CIETcanada, 1 Stewart Street, Ottawa, Ontario, Canada.
出版信息
BMC Int Health Hum Rights. 2010 Sep 13;10:23. doi: 10.1186/1472-698X-10-23.
BACKGROUND
HIV testing with counseling is an integral component of most national HIV and AIDS prevention strategies in southern Africa. Equity in testing implies that people at higher risk for HIV such as women; those who do not use condoms consistently; those with multiple partners; those who have suffered gender based violence; and those who are unable to implement prevention choices (the choice-disabled) are tested and can have access to treatment.
METHODS
We conducted a household survey of 24,069 people in nationally stratified random samples of communities in Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Zambia, and Zimbabwe. We asked about testing for HIV in the last 12 months, intention to test, and about HIV risk behaviour, socioeconomic indicators, access to information, and attitudes related to stigma.
RESULTS
Across the ten countries, seven out of every ten people said they planned to have an HIV test but the actual proportion tested in the last 12 months varied from 24% in Mozambique to 64% in Botswana. Generally, people at higher risk of HIV were not more likely to have been tested in the last year than those at lower risk, although women were more likely than men to have been tested in six of the ten countries. In Swaziland, those who experienced partner violence were more likely to test, but in Botswana those who were choice-disabled for condom use were less likely to be tested. The two most consistent factors associated with HIV testing across the countries were having heard about HIV/AIDS from a clinic or health centre, and having talked to someone about HIV and AIDS.
CONCLUSIONS
HIV testing programmes need to encourage people at higher risk of HIV to get tested, particularly those who do not interact regularly with the health system. Service providers need to recognise that some people are not able to implement HIV preventive actions and may not feel empowered to get themselves tested.
背景
在南部非洲，艾滋病毒检测和咨询是大多数国家艾滋病毒和艾滋病预防战略的一个组成部分。检测公平性意味着那些感染艾滋病毒风险较高的人群，如女性；那些不经常使用避孕套的人；那些有多个性伴侣的人；那些遭受性别暴力的人；以及那些无法实施预防措施的人（选择受限者）都需要接受检测，并能够获得治疗。
方法
我们在博茨瓦纳、莱索托、马拉维、莫桑比克、纳米比亚、南非、斯威士兰、坦桑尼亚、赞比亚和津巴布韦的全国分层随机社区样本中进行了一项 24069 人的家庭调查。我们询问了他们在过去 12 个月中是否进行了艾滋病毒检测、检测意愿以及艾滋病毒风险行为、社会经济指标、信息获取情况和与污名相关的态度。
结果
在这 10 个国家中，每 10 人中就有 7 人表示他们计划进行艾滋病毒检测，但在过去 12 个月中实际接受检测的比例从莫桑比克的 24%到博茨瓦纳的 64%不等。一般来说，感染艾滋病毒风险较高的人并不比感染艾滋病毒风险较低的人更有可能在过去一年中接受检测，尽管在六个国家中，女性接受检测的比例高于男性。在斯威士兰，经历过伴侣暴力的人更有可能接受检测，但在博茨瓦纳，选择受限者更不可能接受检测。在这些国家中，与艾滋病毒检测最相关的两个因素是从诊所或卫生中心听说过艾滋病毒/艾滋病，以及与他人谈论过艾滋病毒/艾滋病。
结论
艾滋病毒检测方案需要鼓励感染艾滋病毒风险较高的人接受检测，特别是那些不经常与卫生系统互动的人。服务提供者需要认识到，有些人无法实施艾滋病毒预防措施，可能也没有能力让自己接受检测。
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