一项基于学校的流动艾滋病毒检测服务——它对年轻人友好吗？

A mobile school-based HCT service - is it youth friendly?

作者信息

Lawrence Estelle, Struthers Patricia, Van Hove Geert

机构信息

a PhD student, School of Public Health , University of the Western Cape , Cape Town , South Africa.

b PhD, Associate Professor at School of Public Health , University of the Western Cape , Cape Town , South Africa.

出版信息

SAHARA J. 2016 Dec;13(1):123-35. doi: 10.1080/17290376.2016.1222597.

DOI:10.1080/17290376.2016.1222597

PMID:27576352

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5642433/

Abstract

BACKGROUND

Despite an increase in HIV Counselling and Testing (HCT), few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided) are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS) as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly.

METHODS

The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions.

KEY RESULTS

The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and non-judgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care.

CONCLUSION

Providing HCT in the school setting may make HCT more accessible for students, but it needs to be provided in an equitable, accessible, acceptable, and effective way.

摘要

背景

尽管艾滋病毒咨询与检测（HCT）有所增加，但接受检测的年轻人却很少。有人认为他们不进行检测是因为提供HCT的正规医疗服务通常对年轻人不友好。世界卫生组织将对年轻人友好的医疗服务（YFHS）描述为一种可及、公平、可接受、恰当且有效的服务。开普敦的一个非政府组织实施了一种基于学校的流动模式，试图使HCT对年轻人更友好且更易获得。本研究的目的是探讨这种基于学校的流动HCT服务是否对年轻人友好。

方法

该研究为描述性研究，采用了三种定性数据收集方法：观察两所中学的HCT场所；访谈六名服务提供者；直接观察21次HCT咨询过程。

主要结果

基于学校的流动HCT服务满足了成为YFHS的部分标准。该服务是公平的，因为所有学生，无论种族、性别、年龄或社会经济地位如何，都可免费使用该服务。就地点和费用而言，它是可及的，但学生在使用该服务的决策方面信息不足。该服务是可接受的，因为保证了保密性且服务提供者友好且不评判，但由于隐私有限，它并不被认为是完全可接受的。该服务是恰当的，因为基于证据和专家意见，HCT被推荐作为减少艾滋病毒传播的干预措施；然而，在这种情况下，HCT是作为一项独立服务提供的，而不是一整套服务的一部分。此外，研究表明年轻人想知道自己的艾滋病毒感染状况。该服务在识别艾滋病毒呈阳性的学生方面是无效的；然而，这些学生并未得到获得护理的帮助。