Lolekha Rangsima, Kullerk Nareeluck, Wolfe Mitchell I, Klumthanom Kanyarat, Singhagowin Thapanaporn, Pattanasin Sarika, Sombat Potjaman, Naiwatanakul Thananda, Leartvanangkul Chailai, Voramongkol Nipunporn
Global AIDS Program, Thailand MOPH-U.S. CDC Collaboration (TUC), Mail: P.O. Box 139, Nonthaburi, 11000, Thailand.
Department of Health (DOH), Ministry of Public Health, Nonthaburi, Thailand.
BMC Int Health Hum Rights. 2014 Dec 24;14:39. doi: 10.1186/s12914-014-0039-2.
Couples HIV testing and counseling (CHTC) at antenatal care (ANC) settings allows pregnant women to learn the HIV status of themselves and their partners. Couples can make decisions together to prevent HIV transmission. In Thailand, men were tested at ANC settings only if their pregnant partners were HIV positive. A CHTC program based in ANC settings was developed and implemented at 16 pilot hospitals in 7 provinces during 2009-2010.
Cross-sectional data were collected using standard data collection forms from all pregnant women and accompanying partners who presented at first ANC visit at 16 hospitals. CHTC data for women and partners were analyzed to determine service uptake and HIV test results among couples. In-depth interviews were conducted among hospital staff of participating hospitals during field supervision visits to assess feasibility and acceptability of CHTC services.
During October 2009-April 2010, 4,524 women initiating ANC were enrolled. Of these, 2,435 (54%) women came for ANC alone; 2,089 (46%) came with partners. Among men presenting with partners, 2,003 (96%) received couples counseling. Of these, 1,723 (86%) men and all pregnant women accepted HIV testing. Among 1,723 couples testing for HIV, 1,604 (93%) returned for test results. Of these, 1,567 (98%) were concordant negative, 6 (0.4%) were concordant positive and 17 (1%) were HIV discordant (7 male+/female- and 10 male-/female+). Nine of ten (90%) executive hospital staff reported high acceptability of CHTC services.
CHTC implemented in ANC settings helps identify more HIV-positive men whose partners were negative than previous practice, with high acceptability among hospital staff.
在产前保健（ANC）机构开展夫妻艾滋病毒检测与咨询（CHTC），可让孕妇了解自己及其伴侣的艾滋病毒感染状况。夫妻双方能够共同做出预防艾滋病毒传播的决定。在泰国，只有当男性的怀孕伴侣艾滋病毒呈阳性时，才会在产前保健机构对其进行检测。2009年至2010年期间，在7个省份的16家试点医院开展并实施了一项基于产前保健机构的夫妻艾滋病毒检测与咨询项目。
使用标准数据收集表，收集了在16家医院首次进行产前保健就诊的所有孕妇及其陪同伴侣的横断面数据。对女性及其伴侣的夫妻艾滋病毒检测与咨询数据进行分析，以确定夫妻双方的服务接受情况和艾滋病毒检测结果。在现场监督访问期间，对参与项目医院的工作人员进行了深入访谈，以评估夫妻艾滋病毒检测与咨询服务的可行性和可接受性。
在2009年10月至2010年4月期间，共有4524名开始接受产前保健的女性登记入组。其中，2435名（54%）女性独自前来接受产前保健；2089名（46%）女性与伴侣一同前来。在与伴侣一同前来的男性中，2003名（96%）接受了夫妻咨询。其中，1723名（86%）男性和所有孕妇接受了艾滋病毒检测。在1723对接受艾滋病毒检测的夫妻中，1604对（93%）返回获取检测结果。其中，1567对（98%）检测结果一致为阴性，6对（0.4%）检测结果一致为阳性，17对（1%）艾滋病毒检测结果不一致（7名男性阳性/女性阴性，10名男性阴性/女性阳性）。十名执行医院工作人员中有九名（90%）报告称夫妻艾滋病毒检测与咨询服务的可接受性很高。
在产前保健机构实施夫妻艾滋病毒检测与咨询，比以往做法能发现更多伴侣为阴性的艾滋病毒阳性男性，且医院工作人员对其接受度很高。
