云南省医务人员主动提供艾滋病检测咨询服务现状

摘要:目的　从医务人员角度了解云南省医务人员主动提供艾滋病检测咨询服务现状及存在问题，探讨PITC工作开展的影响因素。方法　采用问卷调查的方法，对云南省2个市（区）的14家医疗机构186名PITC医生进行调查。结果　47.5%的医院还未将PITC工作纳入内部考核；96.8%的医务人员认为PITC工作有必要开展，主要原因有:可扩大检测，提高感染者的发现率（95.6%）、可减少院内职业暴露（73.3%）、可避免院内感染（67.2%）；仅69.9%表示接受过PITC培训，98.4%认为培训对PITC工作有帮助；50.7%的调查对象表示告知患者HIV检测结果有困难，主要体现在:不知道如何告诉患者结果（28.6%）、患者不接受检测结果（91.4%）、不知如何处理患者的过激情绪（60.0%）、对患者的有些问题回答不了（34.3%）。结论　为保证PITC工作的有效开展，需建立医院领导负责制和PITC工作考核、奖励机制；加强医务人员PITC培训；建立有效转介机制。

The status of provider-initiated HIV testing and counseling in Yunnan Province

Abstract: Objective This work was to learn how medical care workers incorporate provider-initiated HIV testing and counseling (PITC) into their regular practice, and what challenges they faced in implementing PITC, and to explore the impact factors associated with PITC. Methods 186 respondents from 14 medical institutions in two counties of Yunnan were selected to do the anonymous questionnaire, and 186 valid questionnaires were collected. Results Nearly 47.5% of medical institutions has not put PITC in the internal assessment. However, 96.8% of respondents thought PITC was necessary. The main reasons were that it could expand the coverage of HIV testing, improve the detection of HIV/AIDS (95.6%), reduce occupational exposure to HIV (73.3%), and avoid nosocomial infections (67.2%). 69.9% of respondents had received PITC training, and 98.4% thought training was helpful to PITC work. 50.7% of respondents said that would be difficult to notify patients about the results because they do not know how to tell the patient the results (28.6%), how to deal with patients' extreme emotional behavior (60%), how to answer some questions of patients (34.3%), and how to handle the situation when patients do not accept test results (91.4%). Conclusion To ensure the effective implementation of PITC, a leadership responsibility and PITC assessment and rewarding system should be established, PITC training among medical care workers should be strengthened, and effective referral mechanisms should be established.