Rapid Testing May Not Improve Uptake of HIV Testing and Same Day Results in a Rural South African Community: A Cohort Study of 12,000 Women
Rapid Testing May Not Improve Uptake of HIV Testing and Same Day Results in a Rural South African Community: A Cohort Study of 12,000 Women
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DOI：
10.1371/journal.pone.0003501
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发表时间：
2008-10-23
期刊：
影响因子：
3.7
通讯作者：
Bland, R. M.
中科院分区：
文献类型：
--
作者：
Mkwanazi, Ntombizodumo B.;Patel, Deven;Bland, R. M.
背景：孕妇快速检测的目的是增加艾滋病毒检测和结果的吸收，从而优化护理。我们报告艾滋病毒咨询和检测的可接受性，以及在这一领域引入快速检测前后对结果的吸收。方法和主要发现：艾滋病毒顾问在参加一项检查婴儿喂养和产后艾滋病毒传播的研究之前，向参加8个产前诊所的妇女提供咨询和检测。从2001年8月至2003年4月，根据该地区预防母婴传播（PMTCT）方案，送血进行艾滋病毒ELISA检测。从2003年5月到2004年9月，作为预防母婴传播方案的一部分，向妇女提供了快速艾滋病毒检测，但也继续进行酶联免疫吸附试验，用于研究目的。在接受咨询的12,323名妇女中，5,879人在2003年5月之前到诊所就诊，6,444人在2003年5月之后接受了快速检测；其中分别有4324人（74.6%）和4810人（74.6%）同意接受艾滋病毒检测。在接受艾滋病毒快速检测的4,810名妇女中，只有166名（3.4%）要求在检测当天收到结果，其余的人选择在以后的预约中返回获得结果。受过中等教育的女性比没有受过教育的女性更不愿意接受检测（AOR为0.648,p < 0.001）， 2135岁（AOR为0.762,p < 0.001）和35岁（AOR为0.756,p < 0.01）的女性与20岁以下的女性相比也更不愿意接受检测。结论：与其他报告相反，接受快速检测的妇女很少在同一天接受艾滋病毒检测结果。制定战略以提高孕妇了解其艾滋病毒检测结果的比例至关重要，这样才能提供适当的护理。
Background: Rapid testing of pregnant women aims to increase uptake of HIV testing and results and thus optimize care. We report on the acceptability of HIV counselling and testing, and uptake of results, before and after the introduction of rapid testing in this area.Methods and Principal Findings: HIV counsellors offered counselling and testing to women attending 8 antenatal clinics, prior to enrolment into a study examining infant feeding and postnatal HIV transmission. From August 2001 to April 2003, blood was sent for HIV ELISA testing in line with the Prevention of Mother-to-Child Transmission (PMTCT) programme in the district. From May 2003 to September 2004 women were offered a rapid HIV test as part of the PMTCT programme, but also continued to have ELISA testing for study purposes. Of 12,323 women counselled, 5,879 attended clinic prior to May 2003, and 6,444 after May 2003 when rapid testing was introduced; of whom 4,324 (74.6%) and 4,810 (74.6%) agreed to have an HIV test respectively. Of the 4,810 women who had a rapid HIV test, only 166 (3.4%) requested to receive their results on the same day as testing, the remainder opted to return for results at a later appointment. Women with secondary school education were less likely to agree to testing than those with no education (AOR 0.648, p < 0.001), as were women aged 2135 (AOR 0.762, p < 0.001) and > 35 years (AOR 0.756, p < 0.01) compared to those < 20 years.Conclusions: Contrary to other reports, few women who had rapid tests accepted their HIV results the same day. Finding strategies to increase the proportion of pregnant women knowing their HIV results is critical so that appropriate care can be given.