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影响南非某卫生区初级卫生保健机构中艾滋病毒阳性个体生殖选择的因素。

Factors influencing reproductive choices of HIV positive individuals attending primary health care facilities in a South African health district.

作者信息

Agbo Samuel, Rispel Laetitia C

机构信息

Department of Family Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

BMC Public Health. 2017 Jun 2;17(1):540. doi: 10.1186/s12889-017-4432-3.

Abstract

BACKGROUND

There is global recognition of the reproductive health rights of people living with HIV (PLHIV). The aim of this research study was to explore the reproductive choices, and the factors influencing these choices, of HIV positive patients attending primary health care (PHC) facilities in the Ekurhuleni health district of the Gauteng Province of South Africa.

METHODS

During 2013, a cross-sectional survey was conducted in the Ekurhuleni health district. At each of three randomly selected community health centres, a random sample of HIV positive patients was selected. After informed consent was obtained, trained fieldworkers administered a structured questionnaire that elicited information on socio-demographics, reproductive choices and knowledge of reproductive options. Survey data were analysed using STATA® 13.

RESULTS

The majority of survey participants (n = 430) were female (70%) and unemployed (57%). The mean age of participants was 36.4 years (SD 8.6): 40.8 years (SD 8.7) for men and 34.5 years (SD7.8) for women. Among survey participants, 46% expressed a desire for children (95% CI: 41.4-50.9). In the multiple logistic regression analysis, predictors of desire for children were age less than 49 years, marriage or living together, and no biological children. The odds of wanting children was 16.48 [95% CI: 5.94-45.74] times higher for PLHIV without children, compared with those with two or more children, while for those less than 25 years, the odds of wanting children was 0.78 [95% CI: 0.23-2.59] compared with those older than 50 years. The PLHIV knowledge on the available reproductive options was limited, with the majority relying on the guidance of the health workers.

CONCLUSION

Health care providers at PHC level should be educated to address the reproductive health needs of PLHIV. These aspects should be reflected in provincial and national health policies.

摘要

背景

全球都认可艾滋病毒感染者(PLHIV)的生殖健康权利。本研究的目的是探讨在南非豪登省埃库鲁莱尼卫生区初级卫生保健(PHC)机构就诊的艾滋病毒阳性患者的生殖选择及其影响因素。

方法

2013年期间,在埃库鲁莱尼卫生区进行了一项横断面调查。在三个随机选择的社区卫生中心,分别随机抽取艾滋病毒阳性患者样本。在获得知情同意后,经过培训的现场工作人员发放一份结构化问卷,收集有关社会人口统计学、生殖选择和生殖选项知识的信息。调查数据使用STATA® 13进行分析。

结果

大多数调查参与者(n = 430)为女性(70%)且失业(57%)。参与者的平均年龄为36.4岁(标准差8.6):男性为40.8岁(标准差8.7),女性为34.5岁(标准差7.8)。在调查参与者中,46%表示想要孩子(95%置信区间:41.4 - 50.9)。在多元逻辑回归分析中,想要孩子的预测因素为年龄小于49岁、已婚或同居以及没有亲生孩子。与有两个或更多孩子的艾滋病毒感染者相比,没有孩子的艾滋病毒感染者想要孩子的几率高出16.48倍[95%置信区间:5.94 - 45.74],而与50岁以上的人相比,25岁以下的人想要孩子的几率为0.78[95%置信区间:0.23 - 2.59]。艾滋病毒感染者对现有生殖选项的了解有限,大多数人依赖医护人员的指导。

结论

应培训初级卫生保健层面的医疗服务提供者,以满足艾滋病毒感染者的生殖健康需求。这些方面应反映在省级和国家卫生政策中。

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