坦桑尼亚伊林加地区 HIV 阳性母亲接受 HIV 早期婴儿诊断服务的影响因素分析。

Predictors of Mothers Living with HIV Uptake of HIV Early Infant Diagnosis Services in Iringa District, Tanzania.

机构信息

School of Public Health and Social Sciences (SPHSS), Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Health Economics and Health Technology Assessment (HEHTA), School of Health and Wellbeing, University of Glasgow, Glasgow, UK.

出版信息

J Int Assoc Provid AIDS Care. 2024 Jan-Dec;23:23259582241272007. doi: 10.1177/23259582241272007.

DOI:10.1177/23259582241272007

PMID:39228204

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11406656/

Abstract

BACKGROUND

Uptake of HIV early infant diagnosis (HEID) among HIV-exposed infants is the key to timely initiation of Antiretroviral Treatment (ART). However, despite the availability of HEID services in Tanzania, its uptake is low. We aimed to determine predictors of mothers living with HIV' with HIV-exposed infants' uptake of HEID services in Iringa District, Tanzania

METHODS

A health facility-based cross-sectional study was conducted in Iringa District from May to June 2023. Mothers with HIV-exposed infants were recruited in the study through a multistage sampling technique and interviewed using pre-tested structured questions. Logistic regression analysis was employed to determine potential predictors of HEID uptake.

RESULTS

A total of 309 mothers with HIV-exposed infants participated in the study. About 78.3% of the HIV-exposed infants had initial DNA PCR for HEID within 6 weeks of age and 86.1% within 8 weeks. Most mothers had high perceived benefits on uptake of HEID with a mean score of 4.3, high perceived self-efficacy with a mean score of 3.8 and 2.7 perceived risk of HIV infection on their HIV-exposed infants on the 5 scale Likert scale with 5 showing the highest perceived benefit, self-efficacy and risk. High perceived self-efficacy and being a businesswoman were the predictors of uptake of HEID. The odds of self-efficacy on the uptake of HEID by 2.4 times (aOR 2.4 95% CI 1.6-3.2) within 6 weeks of age and 1.9 (aOR 1.9 95% CI 1.3-2.7) within 8 weeks. The odds of being a businesswoman were 0.4 for 6 weeks and 0.3 for 8 weeks (aOR 0.4 95% CI 0.2-0.8) and (aOR 0.3 95% CI 0.1-0.8) respectively.

CONCLUSION

Over three-quarters of the HIV-exposed infants had initial DNA PCR for HEID testing as recommended. Perceived self-efficacy was the main factor influencing HEID uptake. These findings highlight the need for strengthening HIV-positive mother's self-efficacy for improved uptake of HEID services.

摘要

背景

艾滋病毒暴露婴儿的艾滋病毒早期诊断（HEID）的采用是及时启动抗逆转录病毒治疗（ART）的关键。然而，尽管坦桑尼亚提供了 HEID 服务，但采用率仍然很低。我们旨在确定伊林加区艾滋病毒阳性母亲所生的艾滋病毒暴露婴儿采用 HEID 服务的预测因素。

方法

2023 年 5 月至 6 月在伊林加区进行了一项基于卫生机构的横断面研究。通过多阶段抽样技术招募了携带 HIV 暴露婴儿的母亲，并使用预先测试的结构化问题对其进行了访谈。采用逻辑回归分析确定 HEID 采用的潜在预测因素。

结果

共有 309 名携带 HIV 暴露婴儿的母亲参与了研究。约 78.3%的 HIV 暴露婴儿在出生后 6 周内和 86.1%在 8 周内进行了初始 DNA PCR 检测以确定 HEID。大多数母亲对采用 HEID 的感知益处较高，平均得分为 4.3，感知自我效能感较高，平均得分为 3.8，对其 HIV 暴露婴儿的 HIV 感染风险感知为 2.7，5 分表示最高的感知益处、自我效能感和风险。高感知自我效能感和经商是采用 HEID 的预测因素。自我效能感对 6 周内 HEID 的采用几率增加了 2.4 倍（优势比 2.4，95%置信区间 1.6-3.2），8 周内增加了 1.9 倍（优势比 1.9，95%置信区间 1.3-2.7）。作为商人的几率分别为 6 周时的 0.4 和 8 周时的 0.3（优势比 0.4，95%置信区间 0.2-0.8）和（优势比 0.3，95%置信区间 0.1-0.8）。