Cartoux M, Rouamba O, Meda N, Dabis F, Durand G, Salamon R
Université de Bordeaux II, Inserm U 330, France.
Sante. 1996 Jan-Feb;6(1):7-10.
Two approaches, a questionnaire administered to pregnant women and interviews independently with selected individuals in posts of responsibility, were used to assess (i) the perception of HIV screening among patients attending a Maternal and Child Health Clinic and (ii) the attitudes of health staff and local authorities. One hundred and thirty five pregnant women were individually interviewed in their native language at the Farakan Maternal and Child Health Clinic, Bobo Dioulasso. Ninety six percent accepted the principle of being screened for HIV, and 91% wanted to be given the result, 46% in the presence of a family member. The person most often chosen to share the announcement of the result was the regular partner. Three physicians, two midwives, a hospital director, a parish priest and a politician were interviewed. One midwife did not approve of offering screening tests in the absence of available treatment. Four of these individuals suggested that the presence of a member of the family during counselling would be valuable to promote a sense of partnership. Many reasons were given to explain the difficulties associated with announcing the results of tests. They included: the absence of treatment; the cost of the test; the lack of confidentiality; psychosocial consequences; the reaction, particularly fear, of the patient; difficulties associated with communication and with changing behavior. These observations contribute to a basis for analysis to develop a local and national consensus about HIV testing and counselling for pregnant woman.
一是向孕妇发放调查问卷,二是分别与选定的责任岗位人员进行访谈。评估内容包括:(i)妇幼保健诊所患者对艾滋病毒筛查的认知;(ii)医护人员和地方当局的态度。在博博迪乌拉索的法拉坎妇幼保健诊所,用当地语言对135名孕妇进行了单独访谈。96%的孕妇接受艾滋病毒筛查原则,91%的孕妇希望得知检测结果,46%的孕妇希望在家庭成员在场时得知结果。最常被选择来分享检测结果的人是固定伴侣。对三名医生、两名助产士、一名医院院长、一名教区牧师和一名政治家进行了访谈。一名助产士不赞成在没有可用治疗方法的情况下提供筛查检测。其中四人建议在咨询过程中有家庭成员在场,这将有助于促进伙伴关系意识。人们给出了许多理由来解释公布检测结果所面临的困难。这些理由包括:缺乏治疗方法;检测费用;缺乏保密性;心理社会后果;患者的反应,尤其是恐惧;沟通困难以及行为改变困难。这些观察结果为分析奠定了基础,以便就孕妇艾滋病毒检测和咨询形成地方和国家层面的共识。