Asampong Emmanuel, Glozah Franklin N, Nwameme Adanna, Hornuvo Ruby, Kamau Edward Mberu, Tabong Philip Teg-Nefaah
Department of Social and Behavioural Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) at World Health Organisation, Geneva, Switzerland.
PLoS Negl Trop Dis. 2025 Jun 2;19(6):e0012469. doi: 10.1371/journal.pntd.0012469. eCollection 2025 Jun.
In Sub-Saharan Africa (SSA), HIV remains the leading cause of adult premature death. The rising prevalence of Female Genital Schistosomiasis (FGS) in SSA, including Ghana, has led to a growing dual burden of HIV-FGS cases. This trend has prompted the WHO to advocate for integrated HIV and FGS services. This study examined stakeholder perspectives on integrating FGS prevention and control with HIV care in endemic areas of Ghana.
The study took place in Ga South Municipality, Greater Accra Region, Ghana. A qualitative approach combining narrative and phenomenological designs was used. Data collection included Focus Group Discussions with Community Health Officers (CHOs) (n = 9), and Key Informant Interviews with healthcare providers at regional, district, and community levels (n = 13). In-depth interviews were also conducted with individuals affected by FGS and HIV (n = 13), female household members (n = 10), Community Health Management Committee members, and community leaders (n = 7). Participants were purposively selected. Audio-recorded interviews were transcribed, coded, and thematically analyzed using NVivo version 13.
There was a notable knowledge gap on FGS among CHOs and community members. Many health workers mistook FGS for sexually transmitted infections, while community members primarily recognized it through gynecological symptoms. Healthcare was sought from a mix of formal health facilities, herbalists, and spiritual centers, often delaying accurate diagnosis and management. Barriers to integrating HIV and FGS services included limited awareness, stigma, cultural beliefs, provider attitudes, and resource shortages.
Both CHOs and community members lacked sufficient knowledge about FGS, hindering regular screening and timely diagnosis. While integrating FGS and HIV care could support Ghana's HIV eradication goals, success depends on addressing stigma, improving awareness, ensuring drug availability, and equipping health facilities. Collaboration among healthcare professionals and developing standardized clinical protocols are essential. Training community health workers on these protocols is urgently needed to support effective integration.
在撒哈拉以南非洲地区（SSA），艾滋病毒仍然是成年人过早死亡的主要原因。包括加纳在内的撒哈拉以南非洲地区女性生殖器血吸虫病（FGS）患病率不断上升，导致艾滋病毒 - FGS病例的双重负担日益加重。这一趋势促使世界卫生组织倡导将艾滋病毒和FGS服务整合起来。本研究调查了加纳流行地区利益相关者对将FGS预防控制与艾滋病毒护理相结合的看法。
该研究在加纳大阿克拉地区的加南区进行。采用了结合叙事和现象学设计的定性方法。数据收集包括与社区卫生官员（CHOs）进行焦点小组讨论（n = 9），以及与区域、地区和社区层面的医疗服务提供者进行关键信息访谈（n = 13）。还对受FGS和艾滋病毒影响的个人（n = 13）、女性家庭成员（n = 10）、社区卫生管理委员会成员和社区领袖（n = 7）进行了深入访谈。参与者是有目的地挑选的。对录音访谈进行转录、编码，并使用NVivo 13版本进行主题分析。
社区卫生官员和社区成员对FGS存在明显的知识差距。许多卫生工作者将FGS误认为性传播感染，而社区成员主要通过妇科症状认识到它。人们会从正规医疗机构、草药医生和宗教中心等多种渠道寻求医疗服务，这常常延误了准确的诊断和治疗。整合艾滋病毒和FGS服务的障碍包括认识有限、耻辱感、文化信仰、提供者态度和资源短缺。
社区卫生官员和社区成员对FGS都缺乏足够的了解，这阻碍了定期筛查和及时诊断。虽然整合FGS和艾滋病毒护理可以支持加纳的艾滋病毒消除目标，但成功与否取决于消除耻辱感、提高认识、确保药物供应以及为卫生设施配备人员。医疗专业人员之间的合作以及制定标准化临床方案至关重要。迫切需要对社区卫生工作者进行这些方案的培训，以支持有效的整合。
