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中国预防艾滋病母婴传播服务:医疗保健专业人员与感染艾滋病毒的流动妇女之间的对话

Prevention of mother-to-child transmission of HIV services in China: A conversation between healthcare professionals and migrant women with HIV.

作者信息

Lin Chunqing, Li Li, Ji Guoping

机构信息

Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, Los Angeles, CA, U.S.A.

Epidemiology Department, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA, U.S.A.

出版信息

Int J Healthc Manag. 2018;11(3):202-209. doi: 10.1080/20479700.2017.1330737. Epub 2017 Jun 6.

Abstract

In China, the access to prevention of mother-to-child transmission (PMTCT) of HIV services is particularly low among migrant population, which remains a challenge in the fight against HIV/AIDS. The study is aimed to investigate the PMTCT continuum for migrant women with HIV (MWHIV) and to identify barriers and potential strategies to improve the service delivery. The study started with a first round of focus group discussions with 20 healthcare professionals to map out the local PMTCT service cascade, followed by in-depth interviews with 20 recently delivered MWHIV to explore their perceived barriers along each step of the cascade, and a final round of focus groups with healthcare professionals to identify potential strategies to improve the PMTCT continuum. Lack of knowledge of antenatal care, stigma and discrimination in healthcare settings, inadequate provider-patient communication were major barriers hindering the PMTCT service utilization. Potential strategies to enhance the PMTCT uptake included broaden publicity to the general population and using mobile phone application for health education. The issues of HIV designated hospital and integration of postpartum and neonatal care were also discussed. The study allowed the healthcare professionals to recognize the service gaps along the PMTCT continuum and identified potential solutions for service improvement.

摘要

在中国,流动人口中获得预防艾滋病母婴传播(PMTCT)服务的比例特别低,这仍然是抗击艾滋病毒/艾滋病的一项挑战。该研究旨在调查感染艾滋病毒的流动妇女(MWHIV)的预防艾滋病母婴传播连续过程,并确定改善服务提供的障碍和潜在策略。该研究首先与20名医疗保健专业人员进行了第一轮焦点小组讨论,以绘制当地的预防艾滋病母婴传播服务流程,随后对20名近期分娩的感染艾滋病毒的流动妇女进行了深入访谈,以探讨她们在服务流程每个步骤中所感受到的障碍,最后与医疗保健专业人员进行了一轮焦点小组讨论,以确定改善预防艾滋病母婴传播连续过程的潜在策略。缺乏产前护理知识、医疗环境中的耻辱和歧视、医患沟通不足是阻碍预防艾滋病母婴传播服务利用的主要障碍。提高预防艾滋病母婴传播接受率的潜在策略包括向普通人群扩大宣传以及使用手机应用程序进行健康教育。还讨论了艾滋病指定医院以及产后和新生儿护理整合的问题。该研究使医疗保健专业人员认识到预防艾滋病母婴传播连续过程中的服务差距,并确定了改善服务的潜在解决方案。

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