'If there is joy… I think it can work well': a qualitative study investigating relationship factors impacting HIV self-testing acceptability among pregnant women and male partners in Uganda.
'If there is joy… I think it can work well': a qualitative study investigating relationship factors impacting HIV self-testing acceptability among pregnant women and male partners in Uganda.
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DOI：
10.1136/bmjopen-2022-067172
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发表时间：
2023-02-17
期刊：
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
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作者：
从参加产前保健的孕妇向其男性伴侣二次分发艾滋病毒自我检测（HIV - st）试剂盒显示，这增加了艾滋病毒夫妇的检测和信息披露，并正在撒哈拉以南非洲扩大。了解影响艾滋病毒感染的夫妻层面的障碍和促进因素对于设计优化干预覆盖的策略至关重要。为了调查这些夫妻层面的障碍和促进因素，我们进行了焦点小组讨论和深度访谈。对转录本进行了专题分析，并调整了社区应对和健康行为改变的相互依存模型，以探索影响艾滋病毒感染可接受性的因素。我们招募了2019年4月至2020年2月期间在乌干达坎帕拉两家公立ANC诊所就诊的孕妇，以及孕妇的男性伴侣。我们进行了性别分层的焦点小组讨论（N=14）和深度访谈（N=10），参与者包括参加ANC的感染和未感染艾滋病毒的孕妇以及孕妇的男性伴侣（N=122）。我们利用社区应对和健康行为改变的相互依赖模型，评估了乌干达孕妇和男性伴侣对艾滋病毒传播二次分布的看法。重点领域包括对艾滋病毒感染者的关注和可接受性、对向伙伴披露艾滋病毒状况的看法以及性别角色。与会者认为，包括信任、沟通、对伴侣的恐惧和不忠在内的易感因素将影响妇女向伴侣提供艾滋病毒传播工具包的决定，以及随后的共同应对行为，如夫妻艾滋病毒检测和披露。怀孕被描述为男性接受艾滋病毒感染的一个关键因素，而孕妇的艾滋病毒状况对夫妻共同应对和增进健康的行为有影响。一般来说，参与者认为HIV阴性的女性更有可能传播HIV，而携带HIV的女性由于担心发现血清差异和关系破裂而更加犹豫。与会者强调在整个过程中提供咨询人员的重要性，包括指导妇女如何就艾滋病毒感染问题与伴侣接触，以及在检测结果呈阳性的情况下提供检测后支持。艾滋病毒阴性的妇女在与积极因素的关系中可能最有可能传播艾滋病毒，并利用相互依赖的应对行为。感染艾滋病毒的妇女或那些有负面易感因素的关系的妇女可能受益于有针对性的咨询和披露支持，在分发艾滋病毒传播试剂盒之前和之后。研究结果有助于支持艾滋病毒检测试剂盒分发的政策指南。
Secondary distribution of HIV self-test (HIVST) kits from pregnant women attending antenatal care (ANC) to their male partners is shown to increase HIV couples testing and disclosure, and is being scaled up in sub-Saharan Africa. Understanding couples-level barriers and facilitators influencing HIVST uptake is critical to designing strategies to optimise intervention coverage. To investigate these couples-level barriers and facilitiators, we conducted focus group discussions and in-depth interviews. Transcripts were analysed thematically and the interdependence model of communal coping and health behaviour change was adapted to explore factors impacting HIVST acceptability. We recruited pregnant women attending two public ANC clinics in Kampala, Uganda, and male partners of pregnant women between April 2019 and February 2020. We conducted gender-stratified focus group discussions (N=14) and in-depth interviews (N=10) with pregnant women with and without HIV attending ANC, and male partners of pregnant women (N=122 participants). We evaluated pregnant women’s and male partners’ perceptions of HIVST secondary distribution in Uganda, leveraging the interdependence model of communal coping and health behaviour change. Key areas of focus included HIVST interest and acceptability, perspectives on HIV status disclosure to partners and gender roles. Participants felt that predisposing factors, including trust, communication, fear of partner and infidelity, would influence women’s decisions to deliver HIVST kits to partners, and subsequent communal coping behaviours such as couples HIV testing and disclosure. Pregnancy was described as a critical motivator for men’s HIVST uptake, while HIV status of pregnant women was influential in couples’ communal coping and health-enhancing behaviours. Generally, participants felt HIV-negative women would be more likely to deliver HIVST, while women with HIV would be more hesitant due to concerns about discovery of serodifference and relationship dissolution. Participants stressed the importance of counsellor availability throughout the process including guidance on how women should approach their partners regarding HIVST and post-test support in case of a positive test. HIV-negative women in relationships with positive predisposing factors may be most likely to deliver HIVST and leverage interdependent coping behaviours. Women with HIV or those in relationships with negative predisposing factors may benefit from targeted counselling and disclosure support before and after HIVST kit distribution. Results can help support policy guidelines for HIVST kit distribution.
影响因子：
3.7
作者：
Montgomery CM;Watts C;Pool R
通讯作者：
Pool R