William and Flora Hewlett Foundation Postdoctoral Fellow, African Population Research and Training Program, Institute of BehavioralScience, University of Colorado, Boulder, USA.
Health Policy Plan. 2011 Jul;26(4):307-15. doi: 10.1093/heapol/czq066. Epub 2010 Nov 2.
International organizations promote provider-initiated, 'routine' HIV testing of pregnant women seeking antenatal care as an effort to curb mother-to-child transmission. We offer an account of the perceptions of HIV testing at antenatal clinics in rural Malawi. Although it is both international and Government of Malawi policy that women must be explicitly informed of their right to refuse testing, analysis of in-depth interviews, focus group discussions and evidence from observational field journals show that rural Malawians do not perceive HIV testing as a choice, but rather as compulsory in order to receive antenatal care. This study illustrates dissonance between global expectations and local realities of the delivery of HIV-testing interventions.
国际组织提倡由医务人员主动提供的、针对接受产前护理的孕妇的“常规”艾滋病毒检测，以此努力遏制母婴传播。我们对马拉维农村地区产前诊所的艾滋病毒检测的看法进行了说明。虽然国际社会和马拉维政府都有政策规定，必须明确告知妇女有权拒绝检测，但对深入访谈、焦点小组讨论和实地观察日志的分析表明，农村马拉维人并不认为艾滋病毒检测是一种选择，而是认为这是获得产前护理的必要条件。这项研究说明了全球对艾滋病毒检测干预措施的期望与当地实际情况之间存在的不和谐。
