Matoy Leila S, Tarimo Felista S, Kosia Efraim M, Mkunda Josephine J, Weisser Maja, Mtenga Sally
Interventions and Clinical Trials, Ifakara Health Institute, Morogoro, Tanzania.
The Nelson Mandela, African Institution of Science and Technology, Tengeru, Arusha, Tanzania.
HIV AIDS (Auckl). 2024 Jul 11;16:275-287. doi: 10.2147/HIV.S438672. eCollection 2024.
Healthcare workers (HCW) play an important role in managing women living with HIV (WLHIV) with gender-based violence (GBV) experience, but little is known about their experience in screening and managing GBV among WLHIV. This study explored the perceptions and experience of the HCWs on screening and managing GBV cases among WLHIV.
We performed a descriptive phenomenological qualitative study to elicit the views and experience of HCW on GBV screening and management for WLHIV. The study was conducted in the semi-urban setting in Morogoro Region, Tanzania. Ten in-depth interviews (IDIs) were administered to HCW selected purposefully based on their roles at an HIV care and treatment center. Data were transcribed using patterns matching study aim and then merged into relevant themes for analysis and interpretation. NVIVO software version 12 was used for data coding and analysis.
We found that HCW experienced multiple challenges in GBV screening and management, including limited capacity for GBV screening and management; inadequate training on assessment and handling GBV cases, limited resources (time, GBV guidelines and screening tools), inadequate GBV referral and monitoring systems; referral forms for GBV survivors to social support centers and follow-up mechanisms to trace survivors, mental aspects; HCWs' fear of being stressed by listening to women's' GBV traumatic experiences, HCWs' fear of causing problems to the women's families and HCW biased notions on women disclosure of GBV; the believes that women will not report their GBV experiences.
We identified context-specific challenges preventing HCW to deliver optimal services of GBV to WLHIV, stressing the necessity to strengthen HCW capacity and resources for GBV services and to integrate psychosocial services into HIV care. Policy and programs should be developed to support GBV screening and management for WLHIV.
医护人员在管理有基于性别的暴力（GBV）经历的感染艾滋病毒的女性（WLHIV）方面发挥着重要作用，但对于他们在筛查和管理WLHIV中的GBV方面的经验知之甚少。本研究探讨了医护人员对筛查和管理WLHIV中GBV病例的看法和经验。
我们进行了一项描述性现象学定性研究，以了解医护人员对WLHIV的GBV筛查和管理的观点和经验。该研究在坦桑尼亚莫罗戈罗地区的半城市环境中进行。基于他们在艾滋病毒护理和治疗中心的角色，有目的地选择了10名医护人员进行深入访谈（IDI）。数据使用与研究目标匹配的模式进行转录，然后合并到相关主题中进行分析和解释。使用NVIVO软件版本12进行数据编码和分析。
我们发现医护人员在GBV筛查和管理中面临多重挑战，包括GBV筛查和管理能力有限；对评估和处理GBV病例的培训不足，资源有限（时间、GBV指南和筛查工具），GBV转诊和监测系统不足；GBV幸存者转介到社会支持中心的转诊表格以及追踪幸存者的后续机制，心理方面；医护人员担心因听取女性的GBV创伤经历而感到压力，医护人员担心给女性家庭带来问题以及医护人员对女性披露GBV的偏见观念；认为女性不会报告她们的GBV经历。
我们确定了阻碍医护人员为WLHIV提供最佳GBV服务的特定背景挑战，强调有必要加强医护人员提供GBV服务的能力和资源，并将心理社会服务纳入艾滋病毒护理。应制定政策和计划以支持对WLHIV的GBV筛查和管理。
