Katirayi Leila, Akuno Job, Kulukulu Bright, Masaba Rose
Research Department, Elizabeth Glaser Pediatric AIDS Foundation, Washington, D.C, USA.
Elizabeth Glaser Pediatric AIDS Foundation, Nairobi, Kenya.
BMC Public Health. 2021 Feb 25;21(1):398. doi: 10.1186/s12889-021-10391-x.
HIV testing among adolescents is significantly lower than among adults and many adolescents living with HIV do not know their status. Adolescent perceptions of HIV testing are poorly understood and may negatively affect testing uptake. Using a qualitative design, this study sought to explore perceptions about HIV testing and treatment among adolescents living with HIV and adolescents of unknown HIV status in Lusaka, Zambia and Kenya.
Study participants were adolescents aged 15-19 years old. The adolescents living with HIV were recruited from HIV support groups at health facilities. Adolescents of unknown HIV status were recruited from existing adolescent groups within the community. In both Zambia and Kenya, four focus group discussions (FGDs) were conducted with adolescents living with HIV and four FGDs were conducted with adolescents whose HIV status was unknown, for a total of 16 FDGs. FGDs consisted of 6-12 participants, a moderator, and a note-taker. FGDs were audio-recorded, transcribed, and translated into transcripts. Transcripts were coded in the qualitative analysis software program MAXQDA v. 12. Data reduction and summary tables were generated to help identify themes across the two study population groups. Data were interpreted within the health belief model.
Adolescents discussed the challenges of facing a positive HIV test result, including fear of a positive result and need to change their lifestyle, fear of social isolation, and perception of the lost opportunity to achieve future dreams. Most adolescents of unknown status were not as aware of the benefits of learning their HIV status, nor were they aware of the ability to live a long and healthy life on ART. HIV-positive adolescents reported that the messages targeted towards adolescents focus on the need to remain HIV-negative, as opposed to the benefits of knowing one's status. Adolescents described age and requirements for parental permission as a significant limitation in their ability to access HIV testing.
Adolescents require more information about the benefits of testing early and the ability to live a long and healthy life on ART. Educating adolescents that HIV testing is a normative behavior among their peers could strengthen HIV testing among adolescents.
青少年中的艾滋病毒检测率显著低于成年人，许多感染艾滋病毒的青少年并不知道自己的感染状况。青少年对艾滋病毒检测的认知尚不清楚，可能会对检测接受度产生负面影响。本研究采用定性设计，旨在探索赞比亚卢萨卡和肯尼亚感染艾滋病毒的青少年以及艾滋病毒感染状况未知的青少年对艾滋病毒检测和治疗的认知。
研究参与者为15至19岁的青少年。感染艾滋病毒的青少年从医疗机构的艾滋病毒支持小组中招募。艾滋病毒感染状况未知的青少年从社区现有的青少年群体中招募。在赞比亚和肯尼亚，分别与感染艾滋病毒的青少年进行了四次焦点小组讨论（FGD），与艾滋病毒感染状况未知的青少年进行了四次焦点小组讨论，总共进行了16次焦点小组讨论。焦点小组讨论由6至12名参与者、一名主持人和一名记录员组成。焦点小组讨论进行了录音、转录，并翻译成文字记录。文字记录在定性分析软件程序MAXQDA v. 12中进行编码。生成数据简化和汇总表，以帮助识别两个研究人群组中的主题。数据在健康信念模型中进行解释。
青少年讨论了面对艾滋病毒检测呈阳性结果所面临的挑战，包括对阳性结果的恐惧以及改变生活方式的必要性、对社会孤立的恐惧，以及对失去实现未来梦想机会的认知。大多数感染状况未知的青少年并不了解了解自己艾滋病毒感染状况的好处，也不了解通过抗逆转录病毒治疗可以过上长寿健康生活的能力。艾滋病毒呈阳性的青少年报告说，针对青少年的信息侧重于保持艾滋病毒阴性的必要性，而不是了解自身状况的好处。青少年将年龄和父母许可要求描述为他们进行艾滋病毒检测能力的重大限制。
青少年需要更多关于早期检测的好处以及通过抗逆转录病毒治疗过上长寿健康生活的能力的信息。教育青少年艾滋病毒检测在同龄人中是一种规范行为，可以加强青少年中的艾滋病毒检测。
