Using lay counsellors to promote community-based voluntary counselling and HIV testing in rural northern Ghana: A baseline survey on community acceptance and stigma
Using lay counsellors to promote community-based voluntary counselling and HIV testing in rural northern Ghana: A baseline survey on community acceptance and stigma
复制标题
DOI：
10.1017/s0021932006001829
复制
发表时间：
2007-09-01
影响因子：
1.5
通讯作者：
Binkat, F.
中科院分区：
文献类型：
--
作者：
Baiden, F.;Akanlu, G.;Binkat, F.
加纳大部分地区获得自愿咨询和艾滋病毒检测 (VCT) 的机会仍然有限，农村人口获得的服务最少。服务仍然以设施为基础，并使用越来越少的卫生工作者作为顾问。这项研究评估了加纳北部农村卡塞纳-南卡纳地区对使用非专业咨询师促进基于社区的艾滋病毒自愿咨询和检测以及与艾滋病毒/艾滋病相关的耻辱程度的批准情况。进行了横断面问卷调查。逻辑回归用于确定侮辱艾滋病毒/艾滋病患者（PLWHA）倾向的预测因素。举行了焦点小组讨论并对数据进行了分析编码。 403 名受访者中的大多数（91.1%）表示希望了解自己的艾滋病毒状况。大多数 (88.1%) 受访者认为医疗机构以外的地点是 VCT 的首选地点。大多数（98.7%）受访者赞成使用非专业辅导员。大约四分之一（24%）的受访者认为，与艾滋病病毒感染者共用饮水杯有可能感染艾滋病毒。约一半（52.1%）的受访者认为不应允许感染艾滋病毒/艾滋病的教师教书，而77.2%的受访者则不会向感染者购买蔬菜。认为与感染者共用水杯可能传播艾滋病毒感染的受访者（OR 2.50，95% CI 1.52-4.11）和未受过正规教育的受访者（OR 2.94，95% CI 1.38-6.27）更有可能污蔑感染者。相比之下，了解抗逆转录病毒 (ARV) 药物可用性的受访者不太可能这样做（OR 0.40，95%CI 0.22-0.73）。十三个焦点小组讨论的结果加强了对基于社区的 VCT 和非专业顾问的认可，但也暴露了对耻辱和保密性的担忧。总之，基于社区的 VCT 和使用非专业顾问可能是促进获取的可接受的选择。需要进行干预性研究来评估可行性和成本效益。
Access to voluntary counselling and HIV testing (VCT) remains limited in most parts of Ghana with rural populations being the least served. Services remain facility-based and employ the use of an ever-dwindling number of health workers as counsellors. This study assessed approval for the use of lay counsellors to promote community-based voluntary counselling and testing for HIV and the extent of HIV/AIDS-related stigma in the Kassena-Nankana district of rural northern Ghana. A cross-sectional questionnaire survey was conducted. Logistic regression was used to identify predictors of the tendency to stigmatize people living with HIV/AIDS (PLWHAs). Focus group discussions were held and analytical coding of the data performed. The majority (91.1%) of the 403 respondents indicated a desire to know their HIV status. Most (88.1%) respondents considered locations outside of the health facility as preferred places for VCT. The majority (98.7%) of respondents approved the use of lay counsellors. About a quarter (24%) of respondents believed that it was possible to acquire HIV through sharing a drinking cup with a PLWHA. About half (52.1%) of the respondents considered that a teacher with HIV/AIDS should not be allowed to teach, while 77.2% would not buy vegetables from a PLWHA. Respondents who believed that sharing a drinking cup with a PLWHA could transmit HIV infection (OR 2.50, 95%CI 1.52-4.11) and respondents without formal education (OR 2.94, 95%CI 1.38-6.27) were more likely to stigmatize PLWHAs. In contrast, respondents with knowledge of the availability of antiretroviral (ARV) drugs were less likely to do so (OR 0.40, 95%CI 0.22-0.73). Findings from the thirteen focus group discussions reinforced approval for community-based VCT and lay counsellors but revealed concerns about stigma and confidentiality. In conclusion, community-based VCT and the use of lay counsellors may be acceptable options for promoting access. Interventional studies are required to assess feasibility and cost-effectiveness.