Institute for Global Health, University College London, London, United Kingdom.
PLoS One. 2024 May 31;19(5):e0300581. doi: 10.1371/journal.pone.0300581. eCollection 2024.
Despite improvements, the prevalence of HIV, syphilis, and hepatitis B remains high in Asia. These sexually transmitted infections (STIs) can be transmitted from infected mothers to their children. Antenatal screening and treatment are effective interventions to prevent mother-to-child transmission (MTCT), but coverage of antenatal screening remains low. Understanding factors influencing antenatal screening is essential to increase its uptake and design effective interventions. This systematic literature review aims to investigate barriers and facilitators to antenatal screening for HIV, syphilis, and hepatitis B in Asia.
We conducted a systematic review by searching Ovid (MEDLINE, Embase, PsycINFO), Scopus, Global Index Medicus and Web of Science for published articles between January 2000 and June 2023, and screening abstracts and full articles. Eligible studies include peer-reviewed journal articles of quantitative, qualitative and mixed-method studies that explored factors influencing the use of antenatal screening for HIV, syphilis or hepatitis B in Asia. We extracted key information including study characteristics, sample, aim, identified barriers and facilitators to screening. We conducted a narrative synthesis to summarise the findings and presented barriers and facilitators following Andersen's conceptual model.
The literature search revealed 23 articles suitable for inclusion, 19 used quantitative methods, 3 qualitative and one mixed method. We found only three studies on syphilis screening and one on hepatitis B. The analysis demonstrates that antenatal screening for HIV in Asia is influenced by many barriers and facilitators including (1) predisposing characteristics of pregnant women (age, education level, knowledge) (2) enabling factors (wealth, place of residence, husband support, health facilities characteristics, health workers support and training) (3) need factors of pregnant women (risk perception, perceived benefits of screening).
Knowledge of identified barriers to antenatal screening may support implementation of appropriate interventions to prevent MTCT and help countries achieve Sustainable Development Goals' targets for HIV and STIs.
尽管有所改善，但亚洲的艾滋病毒、梅毒和乙型肝炎的流行率仍然很高。这些性传播感染（STIs）可从受感染的母亲传播给她们的孩子。产前筛查和治疗是预防母婴传播（MTCT）的有效干预措施，但产前筛查的覆盖率仍然很低。了解影响产前筛查的因素对于提高其接受度和设计有效的干预措施至关重要。本系统文献综述旨在调查亚洲地区产前筛查艾滋病毒、梅毒和乙型肝炎的障碍和促进因素。
我们通过搜索 Ovid（MEDLINE、Embase、PsycINFO）、Scopus、全球索引医学和 Web of Science，检索了 2000 年 1 月至 2023 年 6 月期间发表的文章，并对摘要和全文进行了筛选。符合条件的研究包括定量、定性和混合方法研究的同行评议期刊文章，这些研究探讨了影响亚洲地区使用产前筛查艾滋病毒、梅毒或乙型肝炎的因素。我们提取了关键信息，包括研究特征、样本、目的、筛查的障碍和促进因素。我们进行了叙述性综合分析，以总结研究结果，并根据安德森的概念模型呈现障碍和促进因素。
文献检索共发现 23 篇适合纳入的文章，其中 19 篇采用定量方法，3 篇采用定性方法，1 篇采用混合方法。我们只发现了三项关于梅毒筛查的研究和一项关于乙型肝炎的研究。分析表明，亚洲的 HIV 产前筛查受到许多障碍和促进因素的影响，包括（1）孕妇的倾向特征（年龄、教育水平、知识）；（2）促进因素（财富、居住地、丈夫支持、医疗机构特征、卫生工作者支持和培训）；（3）孕妇的需求因素（风险认知、对筛查的益处的感知）。
了解产前筛查的障碍可能有助于实施适当的干预措施，以预防母婴传播，并帮助各国实现艾滋病毒和性传播感染的可持续发展目标。
