艾滋病自愿咨询检测人群特征的病例对照研究

目的对主动参加艾滋病自愿咨询与检测（HIV Voluntary Counseling ＆ Tesing,VCT）人群的特征进行分析比较,了解其特点和规律,为今后改进VCT工作、更好地发挥其作用提供实践依据。方法以2006年1月至2008年12月,参加上海市原南汇区疾病预防控制中心VCT门诊的205名对象为病例组,以同期同地区报告的53名艾滋病病毒感染者/艾滋病病人（HIV/AIDS病人）为对照组,开展病例对照研究,比较两组人群的各种特征。结果 VCT人群中女性（χ2=13.70,P〈0.01）、高中以下学历（χ2=46.20,P〈0.01）和有注射吸毒史（χ2=17.35,P〈0.01）者所占的比例显著低于HIV/AIDS病人群。结论在女性、低学历和吸毒人群中,深入加强艾滋病自愿咨询与检测的宣传,对及早发现HIV/AIDS病人,更好地开展艾滋病防治工作具有十分重要的意义。     

An evaluation of awareness: attitudes and beliefs of pregnant Nigerian women toward voluntary counseling and testing for HIV

The rate of HIV seroprevalence in Nigeria is troublesome because it is one of the highest prevalence rates worldwide. As in most developing countries, vertical transmission from mother to child accounts for most of the HIV infections in Nigerian children. The purpose of this study was to determine the awareness, attitudes, and beliefs of pregnant Nigerian women toward voluntary counseling and testing (VCT) for HIV. Two hundred forty pregnant women in Awka, Nigeria, completed questionnaires aimed at determining their willingness to accept or reject VCT. Furthermore, participants where questioned about their knowledge of HIV infection, routes of transmission, and treatment options. The majority of the women (87%) approved of VCT; of those who approved, 93% were aware that VCT could reduce the risk of transmission of HIV to their babies. All respondents who accepted VCT were willing to be tested if results remained confidential and 89% would accept if they were tested simultaneously with their partners. 69% of the women who refused VCT attribute their refusal to the social and cultural stigmatization associated with HIV. Overall, the acceptance of VCT appears to depend on the understanding that VCT has proven benefits for the unborn child. Sociocultural factors such as stigmatization of HIV-infected individuals appears to be the major barrier toward widespread acceptance of VCT in Nigeria, thus the development of innovative health education strategies is essential for providing women with information regarding the benefits of VCT and other means of prevention of mother-to-child transmission of HIV (PMTCT).     

HIV-related knowledge, attitudes, perceived benefits, and risks of HIV testing among pregnant women in rural Southern India

The rising prevalence of HIV among pregnant women in rural India is of great concern. Prenatal voluntary counseling and HIV testing (VCT) is critical to prevent mother-to-child transmission of HIV (PMTCT). We surveyed 202 pregnant women attending a rural antenatal clinic in Southern India to investigate HIV-related knowledge, attitudes toward infant feeding practices, and perceived benefits and risks of HIV testing. Of the total of 202 women surveyed, 189 women (94%) had heard of HIV/AIDS and 60% of them had relatively good knowledge regarding risk factors for HIV transmission. However, 48% did not know that there are "means to prevent mother-to-child HIV transmission." If women were not to breastfeed her baby, negative attitudes expected from the partner would include 84% thinking that that the mother is harming the baby, 78% thinking she is not a good mother, 74% thinking she has HIV, and 66% thinking she has been unfaithful. Ninety-seven percent of women did not perceive themselves at risk for HIV and only 57% had been tested for HIV. Although, 85% of women expressed their willingness to be tested, most were concerned about confidentiality and disclosing HIV serostatus because of fear of negative reactions from their husbands, parents, and community. Many social and cultural barriers confront pregnant women when they decide to opt for HIV testing. If VCT and PMTCT interventions are to be successful, urgent attention must be focused on education, development of innovative culturally appropriate interventions that empower women to make decisions about HIV testing, involvement of men, and addressing stigma and discriminatory attitudes toward people living with HIV/AIDS.     

Evaluation of 2 techniques of HIV pre-test counselling for pregnant women in west Africa. DITRAME Study Group.

This study compares the effect of group and individual pre-test counselling on uptake of HIV voluntary counselling and testing (VCT) by African pregnant women and knowledge about HIV/AIDS in 2 antenatal clinics of Bobo-Dioulasso, Burkina Faso. Pre-test counselling was offered to 3958 pregnant women, 927 by group counselling and 3031 by individual counselling. Acceptance of the test improved with individual counselling, which was already high with group counselling (93.3% versus 89.4%). The return rate for results was independent of the pre-test counselling technique. At post-test session, knowledge about HIV/AIDS was better after group than individual counselling, except for reporting the existence of an asymptomatic stage of HIV infection. At a public health level, group pre-test counselling can be easily integrated into existing sessions of antenatal care counselling, routinely performed by the current clinic staff. Our findings may help programme managers in the field of maternal and child health to choose optimal options of pre-test counselling adapted to local circumstances in resource-poor settings.     

Comparing Couples’ and Individual Voluntary Counseling and Testing for HIV at Antenatal Clinics in Tanzania: A Randomized Trial

Voluntary counseling and testing (VCT) for couples (CVCT) is an important HIV-prevention effort in sub-Saharan Africa where a substantial proportion of HIV transmission occurs within stable partnerships. This study aimed to determine the acceptance and effectiveness of CVCT as compared to individual VCT (IVCT). 1,521 women attending three antenatal clinics in Dar es Salaam were randomized to receive IVCT during that visit or CVCT with their husbands at a subsequent visit. The proportion of women receiving test results in the CVCT arm was significantly lower than in the IVCT arm (39 vs. 71%). HIV prevalence overall was 10%. In a subgroup analysis of HIV-positive women, those who received CVCT were more likely to use preventive measures against transmission (90 vs. 60%) and to receive nevirapine for themselves (55 vs. 24%) and their infants (55 vs. 22%) as compared to women randomized to IVCT. Uptake of CVCT is low in the antenatal clinic setting. Community mobilization and couple-friendly clinics are needed to promote CVCT.     

Assessing the Efficacy of a Voluntary HIV Counseling and Testing Intervention for Pregnant Women and Male Partners in Urumqi City, China

This study investigated the efficacy of voluntary counseling and testing (VCT) in an educated cohort of pregnant women attending antenatal clinics in Urumqi, China. VCT was given to women and their partners (experimental group) or women alone (control group). Both groups were given pre- and post-intervention questionnaires to assess HIV knowledge and willingness to get HIV testing. Multivariate analysis showed that all women improved significantly in HIV knowledge between baseline and follow-up. Moreover, HIV knowledge was significantly associated with HIV testing willingness. At follow-up, women in the control and experimental groups were 6.8 and 7.9 times more willing to receive HIV testing than at baseline, respectively. VCT seems effective in this cohort of educated pregnant women.     

Mother-to-child HIV transmission in resource poor settings: how to improve coverage?

OBJECTIVES: To review coverage of the current nevirapine prevention model in Coast Provincial General Hospital (CPGH) in Mombasa, Kenya, and to reflect on alternative models to reduce mother-to-child transmission (MTCT) of HIV. METHODS: At the antenatal clinic, health information is provided, followed by pre-test HIV voluntary counselling and testing (VCT). Because many women deliver at home, HIV-infected women are provided with a tablet of 200 mg nevirapine for themselves, and with 0.6 ml (6 mg) nevirapine in a luer lock syringe for the baby. Data on coverage are provided from antenatal records and delivery registers. RESULTS: Out of 3564 first-visit pregnant women receiving health education, 2516 were counselled (71%) and 2483 were tested (97%); 348 were HIV positive (14%), and 106 women took nevirapine in labour, resulting in an overall coverage rate of 20%. In the same period, approximately 6000 women gave birth in CPGH, of whom 21% had attended a facility with VCT services. Assuming an overall HIV prevalence of 14%, 840 mother-infant pairs could have received a preventative intervention with a hospital policy of antepartum as well as intrapartum testing and treatment in place. CONCLUSION: The coverage of perinatal MTCT was low as a result of a variety of programme elements requiring urgent improvement at different levels. Alternative models, including intrapartum testing, should be considered as a safety net for women without access to VCT before delivery, and recommendations for nevirapine should be considered in the light of home deliveries.     

广西南宁市流动建筑民工STD/AIDS的知识态度行为调查分析

目的了解南宁市流动建筑民工对性传播疾病/艾滋病(STD/AIDS)知识、态度、行为,为对流动人口实施预防AIDS干预提供决策参考。方法采取随机抽样方法,抽取南宁市施工期限在6个月以上的2个建筑工地,调查其中从事建筑施工的236名流动工人对STD/AIDS相关知识的掌握及态度、行为特征等。结果236名民工中98.31%听说过AIDS,对4个常见性病病征同时回答正确的仅占1.27%。AIDS传播途径回答正确的占26.70%。对一些保护性知识的知晓率仅达到33%。但对一些消除恐惧、有利于营造社区关怀与支持的非AIDS问题有较高的知晓率。回答曾经患过性病的人数占5.51%。患性病后求医时选择综合医院或专科医院/门诊就医的占85.17%。在综合医院就医时选择性病科和专家门诊就医的占82.21%。首次性行为年龄<15岁占4.24%,有不固定性伴的占16.95%,有吸毒行为的占5.93%。结论南宁市流动建筑民工对STD/AIDS的相关知识的知晓率仍处于较低水平。对STD/AIDS的接纳程度有限。民工求医行为较为理智,对STD/AIDS仍较为脆弱。对其实施干预的重点在普及知识,同时提高和规范综合医院和专科医院医疗服务能力。     

HIV testing in antenatal clinics: the impact on women

One hundred and fifty-five women attending antenatal clinics in an inner city area where the rate of AIDS reporting is high were interviewed to examine the acceptability of different modes and purposes of antenatal HIV testing. Eighty-two per cent of women felt the test should be available in antenatal clinics, but only 48% reported that they themselves would take the test. Seventy-four per cent would accept anonymous testing. Potential anxiety levels surrounding the HIV test were significantly higher than for other (currently routine) tests in antenatal clinics. The implications of these findings for policy are discussed.     

Perceived risks and benefits of HIV testing, and predictors of acceptance of HIV counselling and testing among pregnant women in Zimbabwe

This project evaluated perceived risks and benefits and determined predictors of acceptance of voluntary HIV counselling and testing (VCT) among pregnant women in Zimbabwe. One hundred and seventy pregnant women attending an urban antenatal clinic were surveyed. Implications of a negative or positive HIV test result and of telling a partner or community members that one is HIV positive were queried. Forty women (23.5%) consented to VCT, and 16 (40%) were HIV positive. Women who saw VCT as lower risk (odds ratio [OR] = 2.3, 95% confidence interval [CI] [1.1-5.0]) and women who had had a stillbirth or child die (OR = 0.4, 95% CI [0.16-0.97]) were more likely to consent. Prenatal HIV VCT offers the best opportunity for prevention of mother-to-child transmission of HIV; however, less than 25% of women consented. If such interventions are to be successful, attention must be directed towards developing culturally appropriate strategies to address women's concerns and improve future acceptance of VCT in Zimbabwe.     

湖州市2011年艾滋病自愿咨询检测结果分析

目的了解湖州市接受艾滋病自愿咨询检测（VCT）服务人群的现状,为艾滋病防治措施的制定提供科学依据。方法对2011年在湖州市接受VCT服务的人员的人口学状况、求询原因、危险行为等进行统计学分析。结果3 778名求询者中,3 759人（99.5%）接受了HIV抗体检测,检出阳性9例,HIV检出率为0.24%。求询者男女性别比为0.8∶1;年龄主要集中在20～49岁,占90.3%;初中学历占38.6%。各类高危行为中,有性乱史者占58.8%。结论青壮年和性接触是湖州市艾滋病传播的高危人群及方式;加强艾滋病知识宣传和VCT服务、提高求询者阳性者转介率,是今后VCT工作的重点。     

Effectiveness of antenatal group HIV voluntary counseling and testing services in rural India.

This study assessed HIV attitudes among pregnant women attending antenatal clinics in the Namakkal district of Tamilnadu, India, as well as HIV knowledge before and after group counseling sessions. Two hundred thirteen women (97%) attending five antenatal clinics in July 2004 accepted HIV counseling and testing and completed precounseling and postcounseling questionnaires. Although the majority of women had heard of HIV, precounseling knowledge was low (mean precounseling score; 6.9/18, SD: 4.53), with scores correlating with the women's educational level and the number of sources from which they had received information about HIV. Posttest scores increased by 21%, however, understanding of modalities to prevent HIV infection remained poor. Group counseling sessions achieve small gains in HIV knowledge, but there is a continued need for ongoing and multifaceted HIV education in rural India.     

Consent and antenatal HIV testing: the limits of choice and issues of consent in HIV and AIDS

The mood of nihilism that affected HIV is now changing. The availability of new therapies allows for cautious optimism--especially in relation to mother-to-child transmission of HIV and preventative interventions. This has prompted a widespread policy shift towards HIV testing in pregnancy. In this context, informed consent is an ethical issue which needs to be addressed. This study reports on two sets of data exploring consent policy and practices in UK antenatal clinics. The first is derived from an audit of obstetric clinics in the UK and Eire (n = 288), with a 91% response rate. The second provided the views on consent and testing of a cohort of pregnant women attending four London antenatal clinics (n = 697). It was found that written consent was more likely to be obtained in units with a universal HIV testing offer (p = 0.0005); 77.8% of women believed consent would be requested, but 17.7% believed they could not refuse an HIV test. Their views were contrasted with those held about other antenatal screening tests. The data show that the generally haphazard method of giving information and obtaining consent in antenatal HIV provision is probably counterproductive in terms of test uptake and the ultimate goal of minimizing maternal-fetal HIV transmission.     

Effectiveness of HIV counseling services on knowledge, attitude, behavior and practice (KABP) among pregnant women attending PPTCT program

Counseling services is an important component of National AIDS Control Program which aims at creating awareness and promoting changes in reducing high risk behavior against HIV/AIDS. Pregnant women attending antenatal clinics are being counseled about HIV/AIDS under prevention of parent to child transmission (PPTCT) program. The objective of this study was to assess (KABP) regarding HIV/AIDS among pregnant women attending PPTCT program before and after counseling at Lok Nayak Hospital, New Delhi. A Quasi-experimental study was conducted. Data was collected by interviewing 600 pregnant women attending ANC clinic during May 2006 to May 2007 using a pre-test and post-test interview schedule. About 69.2% of the pregnant women had heard about AIDS before the counseling. Knowledge regarding mother to child transmission of HIV was 53.5%. 38.2% knew that mother to child transmission can be reduced by drugs. The knowledge of pregnant women about AIDS was significantly different in pre-test (mean score = 15.3) and post test (mean score = 35.6) (P < 0.0001). Attitude of study participants towards people living with HIV/AIDS (PLWHA) indicated that individuals with HIV should be allowed to work (79.9%) and all commercial sex workers should compulsorily be tested for HIV (55.1%). There was significant difference between in pre-test and post-test attitude about PLWHA and HIV testing (p < 0.0001). The condom use among the study participants significantly improved after counseling (1.2% in pre-test and 58.6% after counseling) (p < 0.0001). Counseling services were effective in increasing knowledge and changes in attitude and behavior among pregnant women and the efforts needs to be sustained.     

兰州市孕妇AIDS/STI健康教育及相关知识分析

目的 了解兰州市孕妇艾滋病病毒(HIV)感染情况和艾滋病／性传播感染(AIDS／STI)及相关知识的现状。方法 对2所妇幼保健医院的孕妇进行匿名问券调查，同时进行HIV抗体检测。结果 共调查300名孕妇，未检出HIV阳性者。孕妇平均年龄27岁，以汉族、高中及以上文化程度、本地户口、工人和干部占大多数，安全套为首选避孕措施。对一般性AIDS／STI知识及性、血液、母婴三个传播途径知晓率较高。但对游泳、同厕、蚊虫叮咬认识有偏差。部分调查对象及配偶有吸毒、有偿供血、患过性病、流动性等高危行为存在。绝大多数未参加过AIDS／STD知识的宣传，其相关知识的获得以广播、电视等大众传媒为主。结论 HIV已由特殊人群向一般人群扩散蔓延，应有针对性的加强宣传，提高认识，改善检测条件，并进行大样本调查以明确事实。     

Mother-to-child transmission of HIV and its prevention: awareness and knowledge in Uganda and Tanzania

Awareness and knowledge about HIV mother-to-child transmission (MTCT) and preventive measures in different population groups and health personnel were analysed in future intervention areas in western Uganda and south-western Tanzania. In Uganda, a total of 751 persons (440 clients of antenatal and outpatient clinics, 43 health workers, 239 villagers, 29 traditional birth attendants) and in Tanzania, 574 persons (410 clients, 49 health workers, 93 villagers, 18 traditional birth attendants) were interviewed. When given options, knowledge on transmission during pregnancy and delivery in women was 93% and 67% in Uganda and Tanzania respectively, and 86% and 78% for transmission during breastfeeding. In Uganda 59% of male interviewees did not believe that HIV is transmitted during breastfeeding. Expressed acceptance of HIV testing was above 90% in men and women in both countries, but only 10% of the clients in Uganda and 14% in Tanzania had been tested for HIV infection. Health workers' knowledge regarding MTCT was acceptable, while traditional birth attendants' knowledge on both MTCT and preventive measures was extremely poor. Recommendations on infant feeding were not compatible with WHO recommendations for HIV-infected women. If prevention of MTCT (PMTCT) interventions are to be accepted by the population and promoted by health personnel, thorough orientation and training are mandatory.     

Oral health-care workers and HIV infection control practices in Nigeria

The first case of HIV infection was reported in Nigeria in 1986. Since then, the prevalence has risen from less than 0.1% in 1987 to 5.8% in 2002, and an estimated 3.6 million Nigerians now live with HIV/AIDS. More than 40 oral manifestations of HIV infection have been recorded and between 70% and 90% of persons with HIV infection will have at least one oral manifestation at sometime during the course of their disease. Oral health-care workers (OHCWS) are expected to play active roles in the prevention and control of HIV/AIDS. In this study, a one-day workshop was organized for 64 oral health workers in Ile-Ife, Nigeria, focusing on the epidemiology of HIV/AIDS, the oral manifestations, control and prevention of HIV in a dental environment, oral care of the infected patient and the ethical, legal and social aspects of HIV/AIDS. Participants' knowledge and practices of infection control were assessed with an infection control checklist administered pre- and post-workshop. Sixty (90.8%) respondents believed that HIV/AIDS was not yet a problem in Nigeria, and 58 (90.6%) believed that drugs have been developed which can cure HIV infection and AIDS. The men complied more with waste disposal regulations than women (P = 0.010). Twenty-nine of 58 (50.0%) did not discard gloves which were torn, cut or punctured. Seven (12.1%) did not change gloves between patients' treatment. Conscious efforts should be made to train OHCWS on all aspects of HIV/AIDS prevention and care. It must never be assumed that adequate information will be acquired through tangential sources.     

Correlates of women's knowledge of mother-to-child transmission of HIV and its prevention in Tanzania: a population-based study

Studies that explored women's knowledge on mother-to-child transmission (MTCT) of HIV and its prevention (PMTCT) in the general population are currently lacking. This paper examined factors associated with having adequate knowledge of MTCT of HIV and PMTCT among a nationally representative sample of women in Tanzania. We conducted a cross-sectional analysis including 10,299 women from the 2011–2012 Tanzania HIV/AIDS and Malaria Indicator Survey. The outcome of interest was the presence of adequate knowledge on MTCT and PMTCT of HIV. We used multivariable logistic regression to identify factors associated with having adequate knowledge on MTCT and PMTCT of HIV. Results revealed that the overall prevalence of having adequate knowledge on MTCT and PMTCT of HIV was low (46%). We found a statistically significant difference in the proportions of having adequate knowledge between HIV-negative and HIV-positive women (45% vs. 56%; p?相似文献