Mmeje Okeoma, Njoroge Betty, Akama Eliud, Leddy Anna, Breitnauer Brooke, Darbes Lynae, Brown Joelle
a Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor , MI , USA.
b Department of Health Behavior and Health Education , University of Michigan , Ann Arbor , MI , USA.
AIDS Care. 2016;28(6):750-7. doi: 10.1080/09540121.2016.1153592. Epub 2016 Mar 9.
Reproduction is important to many HIV-affected individuals and couples and healthcare providers (HCPs) are responsible for providing resources to help them safely conceive while minimizing the risk of sexual and perinatal HIV transmission. In order to fulfill their reproductive goals, HIV-affected individuals and their partners need access to information regarding safer methods of conception. The objective of this qualitative study was to develop a Safer Conception Counseling Toolkit that can be used to train HCPs and counsel HIV-affected individuals and couples in HIV care and treatment clinics in Kenya. We conducted a two-phased qualitative study among HCPs and HIV-affected individuals and couples from eight HIV care and treatment sites in Kisumu, Kenya. We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) to assess the perspectives of HCPs and HIV-affected individuals and couples in order to develop and refine the content of the Toolkit. Subsequently, IDIs were conducted among HCPs who were trained using the Toolkit and FGDs among HIV-affected individuals and couples who were counseled with the Toolkit. HIV-related stigma, fears, and recommendations for delivery of safer conception counseling were assessed during the discussions. One hundred and six individuals participated in FGDs and IDIs; 29 HCPs, 49 HIV-affected women and men, and 14 HIV-serodiscordant couples. Participants indicated that a safer conception counseling and training program for HCPs is needed and that routine provision of safer conception counseling may promote maternal and child health by enhancing reproductive autonomy among HIV-affected couples. They also reported that the Toolkit may help dispel the stigma and fears associated with reproduction in HIV-affected couples, while supporting them in achieving their reproductive goals. Additional research is needed to evaluate the Safer Conception Toolkit in order to support its implementation and use in HIV care and treatment programs in Kenya and other HIV endemic regions of sub-Saharan Africa.
生育对许多受艾滋病毒影响的个人和夫妇来说至关重要，医疗保健提供者（HCPs）有责任提供资源，帮助他们安全受孕，同时将性传播和围产期艾滋病毒传播的风险降至最低。为了实现他们的生育目标，受艾滋病毒影响的个人及其伴侣需要获得有关更安全受孕方法的信息。这项定性研究的目的是开发一个更安全受孕咨询工具包，可用于培训肯尼亚艾滋病毒护理和治疗诊所的医疗保健提供者，并为受艾滋病毒影响的个人和夫妇提供咨询。我们在肯尼亚基苏木的八个艾滋病毒护理和治疗点，对医疗保健提供者以及受艾滋病毒影响的个人和夫妇进行了两阶段的定性研究。我们进行了深入访谈（IDI）和焦点小组讨论（FGD），以评估医疗保健提供者以及受艾滋病毒影响的个人和夫妇的观点，从而制定和完善工具包的内容。随后，对使用该工具包进行培训的医疗保健提供者进行了深入访谈，并对接受该工具包咨询的受艾滋病毒影响的个人和夫妇进行了焦点小组讨论。在讨论过程中，评估了与艾滋病毒相关的耻辱感、恐惧以及提供更安全受孕咨询的建议。106人参与了焦点小组讨论和深入访谈；其中包括29名医疗保健提供者、49名受艾滋病毒影响的女性和男性，以及14对艾滋病毒血清学不一致的夫妇。参与者表示，需要为医疗保健提供者开展一个更安全受孕咨询和培训项目，并且常规提供更安全受孕咨询可能通过增强受艾滋病毒影响夫妇的生殖自主权来促进母婴健康。他们还报告说，该工具包可能有助于消除受艾滋病毒影响夫妇与生育相关的耻辱感和恐惧，同时支持他们实现生育目标。需要进行更多研究来评估更安全受孕工具包，以支持其在肯尼亚和撒哈拉以南非洲其他艾滋病毒流行地区的艾滋病毒护理和治疗项目中的实施和使用。
