School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia.
Mzuzu University, Mzuzu, Malawi.
BMC Health Serv Res. 2018 Jul 11;18(1):540. doi: 10.1186/s12913-018-3354-9.
In 2011 the World Health Organisation recommended that children with a diagnosis of HIV be gradually informed about their HIV status between the ages of 6 and 12 years. However, to date, literature has focused mainly on primary caregiver and child experiences with HIV disclosure, little is known about healthcare workers' perspectives and practices of HIV status disclosure to children. The aim of this study was to assess healthcare workers' perspectives and practices regarding the disclosure of HIV status to children aged between 6 and 12 years in Malawi.
A cross-sectional survey was used to collect data from 168 healthcare providers working in antiretroviral clinics in all government District and Tertiary Hospitals in Malawi. Participants were asked questions regarding their knowledge, practice, and barriers to HIV disclosure. Data were analysed using binary logistic regression.
Almost all healthcare workers (98%) reported that it was important to disclose HIV status to children. A significant proportion (37%) reported that they had never disclosed HIV status to a child and about half estimated that the rate of HIV disclosure at their facility was 25% or less. The main barriers to disclosure were lack of training on disclosure (85%) and lack of a standard tool for disclosure (84%). Female healthcare workers (aOR) 2.4; 95% CI: 1.1-5.5) and lack of training on disclosure (aOR 7.7; 95% CI: 3.4-10.7) were independently associated with never having disclosed HIV status to a child.
This study highlights the need for providing appropriate training in HIV disclosure for healthcare workers and the provision of standardised disclosure materials.
2011 年,世界卫生组织建议在 6 至 12 岁之间逐步向诊断出 HIV 的儿童告知其 HIV 状况。然而,迄今为止,文献主要集中在初级照顾者和儿童对 HIV 披露的经验上,对于医疗保健工作者向儿童披露 HIV 状况的观点和实践知之甚少。本研究旨在评估马拉维卫生保健工作者在向 6 至 12 岁儿童披露 HIV 状况方面的观点和做法。
采用横断面调查,从马拉维所有政府区和三级医院的抗逆转录病毒诊所收集了 168 名医疗保健提供者的数据。参与者被问及有关他们的知识,实践和 HIV 披露障碍的问题。使用二元逻辑回归分析数据。
几乎所有卫生保健工作者(98%)都表示向儿童披露 HIV 状况很重要。相当一部分(37%)报告说他们从未向儿童透露过 HIV 状况,大约一半的人估计他们所在机构的 HIV 披露率为 25%或更低。披露的主要障碍是缺乏披露培训(85%)和缺乏披露标准工具(84%)。女性卫生保健工作者(优势比,aOR)2.4;95%置信区间:1.1-5.5)和缺乏披露培训(aOR 7.7;95%置信区间:3.4-10.7)与从未向儿童透露过 HIV 状况独立相关。
这项研究强调了为医疗保健工作者提供适当的 HIV 披露培训以及提供标准化的披露材料的必要性。