Marwa Rose, Anaeli Amani
Department of Public Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar-es- Salaam, Tanzania.
HIV AIDS (Auckl). 2020 Mar 31;12:141-150. doi: 10.2147/HIV.S235818. eCollection 2020.
According to Provider-Initiated HIV Testing and Counseling (PITC), healthcare providers recommend HIV testing and counseling to persons attending health care facilities as a standard component of medical care. In order to reduce the morbidity and mortality of late Human Immunodeficiency Virus (HIV) diagnosis, timely diagnosis and initiation of ARVs is necessary. This aims to accelerate universal access to HIV prevention, treatment, care, and support services for people living with HIV/AIDS. The present study aimed to explore perceived barriers toward PITC provision in pediatric clinics.
The study had a cross-sectional exploratory study design. In-depth interviews were used to collect data from the informants in Mwananyamala and Temeke hospitals in Dar-es-Salaam. Nineteen informants were recruited purposely for in-depth interviews. All the interviews were audio recorded, transcribed verbatim, and translated from Swahili to English. Lastly, data were analyzed using a thematic analysis approach.
The study findings showed six barriers including inadequate training on PITC among healthcare providers, little practice of PITC provision, inability to properly counsel patients due to little knowledge, poor attitude of healthcare providers in providing PITC, shortage of healthcare providers, and little motivation and incentives among healthcare providers. Patient barriers included little understanding of PITC among parents/guardians of children and its importance in terms of their children's health, absence of parents, overcrowding at clinics, HIV/AIDS stigma, lack of privacy at clinics, and harsh language of some of the healthcare providers. Health facility barriers included inadequate space to provide PITC and shortage of medical equipment and medical supplies for HIV testing. Policy-related barriers included the absence of PITC guidelines in each consultation room.
Perceived barriers toward PITC must be understood for effective implementation of PITC to reach 90-90-90 goal. The study identified several barriers which need to be addressed in order to improve PITC provision.
根据医疗服务提供者发起的艾滋病毒检测与咨询（PITC），医疗服务提供者向前往医疗机构就诊的人员推荐艾滋病毒检测与咨询，将其作为医疗服务的标准组成部分。为了降低晚期人类免疫缺陷病毒（HIV）诊断的发病率和死亡率，及时诊断并启动抗逆转录病毒药物治疗是必要的。这旨在加速为艾滋病毒/艾滋病感染者普及艾滋病毒预防、治疗、护理和支持服务。本研究旨在探讨儿科诊所提供PITC时存在的可感知障碍。
本研究采用横断面探索性研究设计。通过深入访谈收集达累斯萨拉姆的姆瓦纳尼亚马拉医院和特梅克医院的 informant 的数据。特意招募了19名 informant 进行深入访谈。所有访谈均进行了录音，逐字转录，并从斯瓦希里语翻译成英语。最后，使用主题分析方法对数据进行分析。
研究结果显示了六个障碍，包括医疗服务提供者对PITC的培训不足、PITC提供的实践较少、由于知识不足无法正确为患者提供咨询、医疗服务提供者在提供PITC时态度不佳、医疗服务提供者短缺，以及医疗服务提供者的积极性和激励措施不足。患者方面的障碍包括儿童的父母/监护人对PITC及其对孩子健康的重要性了解甚少、父母不在场、诊所人满为患、艾滋病毒/艾滋病污名化、诊所缺乏隐私，以及一些医疗服务提供者使用 harsh 语言。医疗机构方面的障碍包括提供PITC的空间不足，以及用于艾滋病毒检测的医疗设备和医疗用品短缺。与政策相关的障碍包括每个咨询室都没有PITC指南。
为了有效实施PITC以实现90-90-90目标，必须了解对PITC的可感知障碍。该研究确定了几个需要解决的障碍，以改善PITC的提供。
