Department of Pediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda.
Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States of America.
PLoS One. 2021 Jun 29;16(6):e0253616. doi: 10.1371/journal.pone.0253616. eCollection 2021.
HIV status awareness is critical for HIV prevention and care but HIV testing rates remain low in Uganda, especially among men. One suggested approach to increase access and utilisation of HIV testing services is HIV self-testing. We explored perceptions of pregnant and lactating women and their male partners who attended antenatal care, and health care providers in a government hospital in Kampala, Uganda, about HIV self-testing for initial or repeat testing for women and their partners during pregnancy and postpartum We draw implications for scaling-up this new testing approach in Uganda.
This was a qualitative study conducted at Mulago National Referral Hospital, Kampala, Uganda, between April and December 2017. We conducted in-depth interviews with five pregnant or lactating women and their five male partners; five focus group discussions (two with women, two with health workers and one with male partners of women attending antenatal care) and five key informant interviews with health workers providing prevention of mother-to-child HIV transmission (PMTCT) services. Data were analysed using content thematic approach.
There was limited awareness about HIV self-testing especially among pregnant or lactating women and their male partners. Study participants mentioned that HIV self-testing would enable people to know their HIV status faster, they thought the approach would be cost- and time-saving compared to health facility-based HIV testing, improve confidentiality and reduce stigma for those who test HIV positive. They expressed however, a general fear that HIV self-testing would lead to harm to self and others in case one tested HIV positive, including suicide, violence among couples, intentional transmission of HIV, and limited linkage to care due to lack of counselling. The likely misinterpretation of HIV test results especially among those with no or limited education, and possible coercion exerted by male partners on their wives were other potential concerns raised about the use of HIV self-testing.
There was limited knowledge about HIV self-testing among pregnant and lactating women, their partners and health workers. While the self-testing modality was perceived to be critical for helping people, especially those in casual and distant relationships, to know their HIV status and that of their partners, most study participants believed that HIV self-testing could potentially result in a multitude of negative outcomes in the absence of pre- and post-test counselling. Successful scale-up and integration of self-testing in HIV programs requires community education, provision of information materials and making self-test kits accessible and affordable, especially in rural areas.
艾滋病病毒状况意识对于艾滋病病毒预防和护理至关重要，但在乌干达，艾滋病毒检测率仍然很低，尤其是在男性中。增加艾滋病毒检测服务的获取和利用的一种方法是艾滋病毒自检。我们探讨了在坎帕拉的一家政府医院接受产前护理的孕妇和哺乳期妇女及其男性伴侣以及卫生保健提供者对艾滋病毒自检的看法，这种方法是为了在女性及其伴侣怀孕期间和产后期间进行初次或重复检测。我们得出了在乌干达扩大这种新的检测方法的影响。
这是 2017 年 4 月至 12 月在坎帕拉的穆拉戈国家转诊医院进行的一项定性研究。我们对五名孕妇或哺乳期妇女及其五名男性伴侣进行了深入访谈；对五名妇女参加产前护理的五组焦点小组讨论（两组），两组卫生工作者和一组妇女的男性伴侣）和五名关键信息提供者访谈，为预防母婴传播艾滋病毒（PMTCT）服务提供信息。使用内容主题方法分析数据。
对艾滋病毒自检的认识有限，尤其是在孕妇和哺乳期妇女及其男性伴侣中。研究参与者提到，艾滋病毒自检可以使人们更快地了解自己的艾滋病毒状况，他们认为与在卫生机构进行的艾滋病毒检测相比，这种方法将节省成本和时间，提高保密性，并减少对艾滋病毒检测呈阳性的人的污名。然而，他们普遍担心，如果检测出艾滋病毒阳性，艾滋病毒自检可能会对自己和他人造成伤害，包括自杀、夫妻之间的暴力、艾滋病毒的故意传播，以及由于缺乏咨询而导致的联系护理有限。缺乏或有限的教育，以及男性伴侣对妻子的可能强迫，是对艾滋病毒自检使用提出的其他潜在担忧。
孕妇、哺乳期妇女及其伴侣和卫生工作者对艾滋病毒自检的了解有限。尽管自我检测模式被认为对于帮助人们，特别是那些处于偶然和疏远关系中的人，了解自己和伴侣的艾滋病毒状况至关重要，但大多数研究参与者认为，在没有检测前和检测后的咨询的情况下，艾滋病毒自检可能会导致许多负面后果。成功扩大自我检测规模并将其纳入艾滋病毒计划需要社区教育，提供信息材料，并使自我检测工具易于获得和负担得起，尤其是在农村地区。
