Lincoln International Institute for Rural Health (LIIRH), University of Lincoln, Brayford Pool, Lincoln, Lincolnshire, LN6 7TS, UK.
Centre Population et Développement (UMR 196 Paris Descartes - IRD), SageSud (ERL INSERM 1244), Institut de Recherche Pour Le Développement, Paris, France.
AIDS Behav. 2020 Dec;24(12):3491-3500. doi: 10.1007/s10461-020-02923-0.
Practices of Provider-Initiated HIV Testing and Counseling (PITC) remains suboptimal in Côte d'Ivoire. The aim of this survey was to identify the practices and obstacles to PITC among healthcare professionals in Côte d'Ivoire. A nationally representative cross-sectional survey was conducted in 2018 by telephone among three separate samples of midwives, nurses and physicians practicing in Côte d'Ivoire. The number of HIV tests proposed during consultation in the month preceding the survey was collected for each professional. Factors associated with the number of proposed tests were identified through ordinal logistic regression models. A total of 298 midwives, 308 nurses and 289 physicians were interviewed. Midwives proposed the test more frequently, followed by nurses and physicians. Among midwives, a higher number of proposed tests was associated with the perception that HIV testing does not require specific consent compared to other diseases (aOR 4.00 [95% CI 1.37-14.29]). Among nurses, having received HIV training and the presence of community HIV counselors were associated with a higher number of proposed tests (aOR 2.01 [1.31-3.09] and aOR 1.75 [1.14-2.70], respectively). For physicians, the presence of a voluntary testing center was associated with a higher number of proposed tests (aOR 1.69 [1.01-2.86]). PITC practices and barriers differed across professions. Beyond improving environmental opportunities such as dedicated staff or services, strengthening the motivations and capabilities of healthcare professionals to propose testing could improve PITC coverage.
提供者主导的 HIV 检测和咨询（PITC）在科特迪瓦仍然不尽如人意。本调查的目的是确定科特迪瓦医疗保健专业人员实施 PITC 的做法和障碍。2018 年，通过电话对三个不同样本的助产士、护士和医生进行了全国代表性的横断面调查。收集了每位专业人员在调查前一个月咨询期间提出的 HIV 检测数量。通过有序逻辑回归模型确定与提出的检测数量相关的因素。共采访了 298 名助产士、308 名护士和 289 名医生。助产士提出的检测最多，其次是护士和医生。在助产士中，与认为 HIV 检测不需要特定同意相比，与其他疾病相比，提出更多检测的可能性与更高的检测数量相关（优势比 4.00 [95%置信区间 1.37-14.29]）。在护士中，接受过 HIV 培训和社区 HIV 顾问的存在与更多的检测数量相关（优势比 2.01 [1.31-3.09]和优势比 1.75 [1.14-2.70]）。对于医生，自愿检测中心的存在与更多的检测数量相关（优势比 1.69 [1.01-2.86]）。PITC 的做法和障碍因专业而异。除了改善环境机会，如专门的工作人员或服务外，还可以通过增强医疗保健专业人员提出检测的动机和能力来提高 PITC 的覆盖面。
