Pilot study of home-based delivery of HIV testing and counseling and contraceptive services to couples in Malawi
Pilot study of home-based delivery of HIV testing and counseling and contraceptive services to couples in Malawi
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DOI：
10.1186/1471-2458-14-1309
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发表时间：
2014-12-20
影响因子：
4.5
通讯作者：
Tsui, Amy
中科院分区：
文献类型：
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作者：
Becker, Stan;Taulo, Frank O.;Tsui, Amy
背景：对夫妇进行艾滋病咨询和检测是艾滋病预防战略的重要组成部分，特别是在撒哈拉以南非洲地区。本试点研究的目的是估计夫妇艾滋病毒咨询和检测（CHCT）和夫妇计划生育（CFP）服务的一个单一的家访在城市周边的马拉维，并评估相关factors.Methods：本研究涉及提供CHCT和CFP服务的夫妇在他们的家中，180对夫妇抽样家庭在城市周边地区的布兰太尔。基线数据收集自两个合作伙伴，并在一周后收集随访数据。一对男女咨询师分别与每一个伴侣接触，了解艾滋病毒检测、咨询和避孕服务，然后，如果双方同意，提供CHCT和CFP服务（药丸、避孕套和其他方法的推荐）。双变量和多变量logistic回归分析，以检查个人合作伙伴的特点和接受的服务之间的关系。选定的行为报告前和干预后，特别是夫妇报告避孕药具的使用和避孕套的使用，在最后sex.Results的差异进行了测试：89%的夫妇接受至少一个服务（58% CHCT只，29% CHCT + CFP，2% CFP只）。在女性中，先前的测试经验（p < 0.05），产次（p < 0.01）和与伴侣的情感亲密度（p < 0.01）与接受至少一项服务有显著的双变量关联。在接受任何干预措施的夫妇中，报告的最后一次性行为时使用避孕套的比例从6%上升到25%。有史以来第一次艾滋病毒检测交付给25名妇女和69名男子，分别导致4和11个新发现的infections.Conclusions：家庭为基础的CHCT和CFP是非常成功的，在这项试点研究中，以前未经测试的丈夫和妻子接受CHCT的比例很高，有几乎没有负面的结果在一周内。这项研究支持需要进一步研究和测试家庭和夫妇为基础的方法，以扩大获得HCT和避孕服务，以防止性传播感染和意外怀孕的不良后果，通过无保护的性行为。
Background: HIV counseling and testing for couples is an important component of HIV prevention strategies, particularly in Sub Saharan Africa. The purpose of this pilot study is to estimate the uptake of couple HIV counseling and testing (CHCT) and couple family planning (CFP) services in a single home visit in peri-urban Malawi and to assess related factors.Methods: This study involved offering CHCT and CFP services to couples in their homes; 180 couples were sampled from households in a peri-urban area of Blantyre. Baseline data were collected from both partners and follow-up data were collected one week later. A pair of male and female counselors approached each partner separately about HIV testing and counseling and contraceptive services and then, if both consented, CHCT and CFP services (pills, condoms and referrals for other methods) were given. Bivariate and multivariate logistic regression analyses were done to examine the relationship between individual partner characteristics and acceptance of the services. Selected behaviors reported pre- and post-intervention, particularly couple reports on contraceptive use and condom use at last sex, were also tested for differences.Results: 89% of couples accepted at least one of the services (58% CHCT-only, 29% CHCT + CFP, 2% CFP-only). Among women, prior testing experience (p < 0.05), parity (p < 0.01), and emotional closeness to partner (p < 0.01) had significant bivariate associations with acceptance of at least one service. Reported condom use at last sex increased from 6% to 25% among couples receiving any intervention. First-ever HIV testing was delivered to 25 women and 69 men, resulting, respectively, in 4 and 11 newly detected infections.Conclusions: Home-based CHCT and CFP were very successful in this pilot study with high proportions of previously untested husbands and wives accepting CHCT and there were virtually no negative outcomes within one week. This study supports the need for further research and testing of home- and couple-based approaches to expand access to HCT and contraceptive services to prevent the undesired consequences of sexually transmitted infection and unintended pregnancy via unprotected sex.