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传统医疗从业者能否提供艾滋病病毒咨询与检测服务?南非农村地区的一项试点研究。

Can traditional health practitioners deliver HIV counseling and testing services? A pilot study in rural South Africa.

作者信息

Audet Carolyn M, Seabi Tshegofatso, Mabuza Wonderful, Mnisi Praises, Oyekunle Taofik, Hove Jennifer, Carty Taylor, Kahn Kathleen, Wagner Ryan G

机构信息

Carolyn M. Audet PhD, MSc; Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, USA; SA MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.

Tshegofatso Seabi PhD; South African Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, 27 St Andrew Rd, New School of Public Health, South Africa. Email:

出版信息

J Acquir Immune Defic Syndr. 2025 Jun 18. doi: 10.1097/QAI.0000000000003712.


DOI:10.1097/QAI.0000000000003712
PMID:40530889
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12319957/
Abstract

INTRODUCTION: In 2021, 7.2 million South Africans were living with HIV. Uptake of HIV testing is undermined by a combination of factors, including HIV stigma, distrust in the health system, skepticism toward allopathic medicine, preference for traditional medicine, and long distances to the nearest health facility. METHODS: We conducted a single arm pilot trial to determine the acceptability and feasibility of training traditional healers to conduct rapid HIV counseling and testing in rural South Africa. Seventeen healers were enrolled in a nationally recognized training program with the goal of healers recruiting their clients for testing during regular clinical visits. RESULTS: Sixteen healers completed training and began offering HIV counseling and testing services; 14 healers enrolled participants of which four healers accounted for 73% of enrolled (tested) participants. Healers offered testing to 575 clients; 64 (11.1%) self-reported that they were HIV+ so were not eligible to participate and 93 refused. Healers conducted 418 HIV tests (82% uptake) with 20 (4.8%) testing HIV positive. The median age of clients was 30 years (IQR: 23, 40) and 51.1% were female. In total, 34.4% had never completed an HIV test, with significantly more males reported never having tested than females. CONCLUSION: Traditional healers in rural South Africa successfully completed a rapid, point of care HIV counseling and testing training. The clients of trained healers were largely willing to be tested; referral of those with a positive result to treatment proved more difficult to implement, with only 60% of those testing positive enrolling in HIV treatment services.

摘要

引言:2021年,720万南非人感染了艾滋病毒。艾滋病毒检测的普及受到多种因素的影响,包括对艾滋病毒的污名化、对卫生系统的不信任、对西医的怀疑、对传统医学的偏好以及到最近医疗机构的距离较远。 方法:我们进行了一项单臂试点试验,以确定培训传统治疗师在南非农村地区进行快速艾滋病毒咨询和检测的可接受性和可行性。17名治疗师参加了一个全国认可的培训项目,目标是治疗师在常规临床就诊时为其客户招募检测对象。 结果:16名治疗师完成培训并开始提供艾滋病毒咨询和检测服务;14名治疗师招募了参与者,其中4名治疗师的招募(检测)参与者占73%。治疗师为575名客户提供了检测;64人(11.1%)自我报告艾滋病毒呈阳性,因此无资格参与,93人拒绝。治疗师进行了418次艾滋病毒检测(接受率82%),其中20人(4.8%)检测呈艾滋病毒阳性。客户的中位年龄为30岁(四分位距:23,40),51.1%为女性。总体而言,34.4%的人从未完成过艾滋病毒检测,报告从未检测过的男性明显多于女性。 结论:南非农村地区的传统治疗师成功完成了快速即时护理艾滋病毒咨询和检测培训。接受培训的治疗师的客户大多愿意接受检测;将检测呈阳性者转诊接受治疗的实施难度更大,只有60%检测呈阳性的人登记接受艾滋病毒治疗服务。

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本文引用的文献

[1]
A individually randomized controlled trial comparing Healer-led vs. clinician- led training to improve personal protective equipment use among traditional healers in South Africa.

PLOS Glob Public Health. 2024-2-23

[2]
Adaption and pilot testing of a lay HIV supporter program for traditional healers: a mixed methods study in rural Uganda.

Implement Sci Commun. 2023-7-27

[3]
Understanding the role of traditional healers in the HIV care cascade: Findings from a qualitative study among stakeholders in Mwanza, Tanzania.

PLOS Glob Public Health. 2022-8-15

[4]
"If it weren't for my traditional healer, I would be dead": Engaging traditional healers to support people living with HIV in rural Mozambique.

PLoS One. 2022

[5]
A Cluster-Randomized Trial of Traditional Healer-Delivered Counseling and Rapid HIV Testing in Tanzania.

AIDS Behav. 2022-11

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Curr HIV/AIDS Rep. 2022-6

[7]
Traditional healer-delivered point-of-care HIV testing versus referral to clinical facilities for adults of unknown serostatus in rural Uganda: a mixed-methods, cluster-randomised trial.

Lancet Glob Health. 2021-11

[8]
Socio-economic differences in the uptake of HIV testing and associated factors in South Africa.

BMC Public Health. 2021-8-26

[9]
Shortening "the Road" to Improve Engagement with HIV Testing Resources: A Qualitative Study Among Stakeholders in Rural Uganda.

AIDS Patient Care STDS. 2021-2

[10]
Throwing the bones to diagnose HIV: Views of rural South African traditional healers on undertaking HIV counselling and testing.

AIDS Care. 2021-10

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