Olaleye Abiola O, Tsibolane Yolisa, Van-Turha Lydia, Monareng Sibongile, Chikobvu Perpetual, Boleme Mohlouoa Sam, Serenata Celicia
a Clinton Health Access Initiative , South Africa.
b School of Health Systems and Public Health , University of Pretoria , South Africa.
AIDS Care. 2016 Mar;28 Suppl 2(sup2):21-8. doi: 10.1080/09540121.2016.1176670.
Although HIV/AIDS constitute a significant health burden among children in South Africa, testing and counselling of exposed children are inadequate. It is therefore imperative that factors relating to paediatric HCT services offered by health workers are examined. This study was conducted to explore and describe the perceptions and experiences of trained professional nurses regarding HIV counselling and testing among children. We conducted six focus group discussions among trained professional nurses in health facilities in a district in Free State Province, South Africa. All verbatim transcripts were analysed with a thematic approach and emergent codes were applied. Forty-seven trained professional nurses participated in the study and two of them were males. The age of the participants ranges from 38 to 60 years while the median age was 50 years. Most participants in the focus groups explained how HCT occurs during regular health talks and that lay counsellors are doing most of the counselling. While a few participants thought that children should not be bothered with HCT, most of them seek consent from caregivers for HIV test for children. While children whose parents are negative are usually not tested, most children are tested only when they become ill. Identified barriers to HCT among children include refusal of consent, work overload, lack of encouragement, and poor record keeping. Participants recommended improvement of issues relating to community mobilization and increasing trained staff strength for optimal paediatric HCT service delivery. Developing guidance and policies with respect to obtaining consent, recruiting more health providers, and addressing structural issues in the society to reduce stigma and discrimination were identified as key priority issues by majority of the participants. The perspectives of these participants who provide paediatric HCT services offer vital insight which may be useful to inform policy interventions.
尽管艾滋病毒/艾滋病给南非儿童带来了沉重的健康负担，但对受感染儿童的检测和咨询服务却不足。因此，必须对卫生工作者提供的儿科艾滋病毒检测服务相关因素进行调查。本研究旨在探索和描述受过培训的专业护士对儿童艾滋病毒咨询和检测的看法及经历。我们在南非自由邦省一个地区的医疗机构中，与受过培训的专业护士进行了六次焦点小组讨论。所有逐字记录都采用主题分析法进行分析，并应用了新出现的编码。47名受过培训的专业护士参与了该研究，其中两名是男性。参与者的年龄在38岁至60岁之间，中位年龄为50岁。焦点小组中的大多数参与者解释了艾滋病毒检测如何在常规健康谈话中进行，并且大部分咨询工作是由非专业顾问完成的。虽然少数参与者认为不应让儿童接受艾滋病毒检测，但大多数人会寻求照顾者对儿童艾滋病毒检测的同意。父母检测结果为阴性的儿童通常不接受检测，大多数儿童只有在生病时才接受检测。已确定的儿童艾滋病毒检测障碍包括拒绝同意、工作负担过重、缺乏鼓励以及记录保存不善。参与者建议改善社区动员相关问题，并增加受过培训的工作人员数量，以实现最佳的儿科艾滋病毒检测服务。制定关于获得同意的指导方针和政策、招募更多卫生服务提供者以及解决社会结构问题以减少耻辱感和歧视，被大多数参与者确定为关键优先事项。这些提供儿科艾滋病毒检测服务的参与者的观点提供了重要见解，可能有助于为政策干预提供参考。
