Qiao Shan, Zhang Yao, Li Xiaoming, Menon J Anitha
Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America.
School of Information, Kent State University, Kent, OH, United States of America.
PLoS One. 2018 Feb 7;13(2):e0192327. doi: 10.1371/journal.pone.0192327. eCollection 2018.
It was estimated that 1.2 million people live with HIV/AIDS in Zambia by 2015. Zambia has developed and implemented diverse programs to reduce the prevalence in the country. HIV-testing is a critical step in HIV treatment and prevention, especially among all the key populations. However, there is no systematic review so far to demonstrate the trend of HIV-testing studies in Zambia since 1990s or synthesis the key factors that associated with HIV-testing practices in the country. Therefore, this study conducted a systematic review to search all English literature published prior to November 2016 in six electronic databases and retrieved 32 articles that meet our inclusion criteria. The results indicated that higher education was a common facilitator of HIV testing, while misconception of HIV testing and the fear of negative consequences were the major barriers for using the testing services. Other factors, such as demographic characteristics, marital dynamics, partner relationship, and relationship with the health care services, also greatly affects the participants' decision making. The findings indicated that 1) individualized strategies and comprehensive services are needed for diverse key population; 2) capacity building for healthcare providers is critical for effectively implementing the task-shifting strategy; 3) HIV testing services need to adapt to the social context of Zambia where HIV-related stigma and discrimination is still persistent and overwhelming; and 4) family-based education and intervention should involving improving gender equity.
据估计，到2015年赞比亚有120万人感染艾滋病毒/艾滋病。赞比亚制定并实施了各种方案以降低该国的患病率。艾滋病毒检测是艾滋病毒治疗和预防的关键步骤，尤其是在所有重点人群中。然而，迄今为止，尚无系统评价来证明自20世纪90年代以来赞比亚艾滋病毒检测研究的趋势，或综合该国与艾滋病毒检测行为相关的关键因素。因此，本研究进行了一项系统评价，以检索六个电子数据库中2016年11月之前发表的所有英文文献，并检索到32篇符合我们纳入标准的文章。结果表明，高等教育是艾滋病毒检测的常见促进因素，而对艾滋病毒检测的误解和对负面后果的恐惧是使用检测服务的主要障碍。其他因素，如人口特征、婚姻动态、伴侣关系以及与医疗服务的关系，也极大地影响了参与者的决策。研究结果表明：1）需要为不同的重点人群制定个性化策略和提供全面服务；2）医疗服务提供者的能力建设对于有效实施任务转移策略至关重要；3）艾滋病毒检测服务需要适应赞比亚的社会环境，在该国与艾滋病毒相关的耻辱和歧视仍然持续且严重；4）基于家庭的教育和干预应包括改善性别平等。
