INDIVIDUAL- AND COMMUNITY-LEVEL DETERMINANTS OF ANTENATAL HIV TESTING IN ZIMBABWE
INDIVIDUAL- AND COMMUNITY-LEVEL DETERMINANTS OF ANTENATAL HIV TESTING IN ZIMBABWE
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DOI：
10.1017/s002193201800007x
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发表时间：
2019-03-01
影响因子：
1.5
通讯作者：
Magadi, Monica Akinyi
中科院分区：
文献类型：
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作者：
Gazimbi, Martin Marufu;Magadi, Monica Akinyi
这项研究有助于通过使用艾滋病毒和产前护理（ANC）综合服务预防母婴艾滋病毒传播（PMTCT）的对话。探讨了津巴布韦产前艾滋病毒检测的决定因素。多层次逻辑回归模型应用于数据的8471名妇女从406集群谁在5年前在2005/6年和2010/11年进行的津巴布韦人口和健康调查生育。人们发现，产前艾滋病毒检测的接受程度取决于与妇女经济和人口状况有关的各种个人因素，以及艾滋病毒相关因素，包括社区内对艾滋病毒的认识和耻辱感。重要的个人层面的有利因素和感知需要因素包括社会经济地位高，没有观察到与艾滋病毒有关的耻辱和对艾滋病毒状况的了解（基于以前的艾滋病毒检测），因此这些群体的个人在怀孕期间接受艾滋病毒检测的可能性明显高于社会经济地位较低的人，以及观察到与艾滋病毒有关的耻辱或不知道自己的艾滋病毒状况的人。结果进一步显示，社区艾滋病毒意识对于改善产前艾滋病毒检测非常重要，而耻辱感与检测率下降有关。大多数背景社区一级的因素没有发现有很大的影响，产前艾滋病毒检测的吸收。因此，政策应侧重于个人层面的诱发因素和有利因素，以提高津巴布韦产前艾滋病毒检测的接受率。
This study contributes to the dialogue on the prevention of mother-to-child HIV transmission (PMTCT) through the use of HIV and antenatal care (ANC) integrated services. The determinants of antenatal HIV testing in Zimbabwe were explored. Multilevel logistic regression models were applied to data for 8471 women from 406 clusters who gave birth in the 5 years preceding Zimbabwe Demographic and Health Surveys conducted in 2005/6 and 2010/11. The uptake of antenatal HIV testing was found to be determined by a wide range of individual-level factors relating to women's economic and demographic status, as well as HIV-related factors, including HIV awareness and stigma within the community. Important individual-level enabling and perceived need factors included high socioeconomic status, not having observed HIV-related stigma and knowledge of HIV status (based on a previous HIV test), such that these groups of individuals had a significantly higher likelihood of being tested for HIV during pregnancy than their counterparts of lower socioeconomic status, and who had observed HIV-related stigma or did not know their HIV status. The results further revealed that community HIV awareness is important for improving antenatal HIV testing, while stigma is associated with reduced testing uptake. Most contextual community-level factors were not found to have much effect on the uptake of antenatal HIV testing. Therefore, policies should focus on individual-level predisposing and enabling factors to improve the uptake of antenatal HIV testing in Zimbabwe.