BARRIERS TO PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV SERVICES IN UGANDA
BARRIERS TO PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV SERVICES IN UGANDA
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DOI：
10.1017/s002193200999040x
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发表时间：
2010-03-01
影响因子：
1.5
通讯作者：
Magnussen, P.
中科院分区：
文献类型：
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作者：
Mbonye, A. K.;Hansen, K. S.;Magnussen, P.
了解寻求护理的做法和预防艾滋病毒母婴传播的障碍，对于设计有效的方案以解决乌干达艾滋病毒/艾滋病造成的高疾病负担是必要的。这项研究探讨了年轻和艾滋病毒抗体阳性妇女对防止母婴传播的看法、寻求护理的做法和障碍。2009年1月至4月，在乌干达中部的Wakiso区进行了一次家庭调查（10 706名14-49岁的妇女）、12次重点小组讨论和66次关键的信息提供者访谈。结果表明，获得预防母婴传播服务（计划生育、艾滋病毒咨询和检测以及在保健单位提供服务）的机会很小。决策是获得预防母婴传播服务的一个重要因素。社会经济因素（财富五分位数、年龄、教育水平）和体制做法也影响到获得预防母婴传播的机会。总体而言，当男女共同做出决定或妇女有权做出自己的决定时，接受艾滋病毒检测的比例最高。这在财富五分位数（P=0.0001）、年龄组（P=0.0001）和教育水平（P=0.0001）之间具有显著性。艾滋病毒检测水平最低的是男子为其配偶做决定的时候;在卫生单位进行计划生育和分娩的情况也是如此。防止母婴传播的其他障碍是害怕妇女和男性配偶进行艾滋病毒检测，以及认为产前诊所必须进行艾滋病毒检测。最后，为了增加妇女，特别是年轻、贫穷和受教育程度最低的妇女获得预防母婴传播的机会，有必要增强她们在寻求保健方面作出决定的能力，也有必要增强男子支持其配偶作出正确决定的能力。其他障碍，如害怕进行艾滋病毒检测，应通过对客户的适当咨询加以解决。
Understanding care-seeking practices and barriers to prevention of mother-to-child transmission (PMTCT) of HIV is necessary in designing effective programmes to address the high disease burden due to HIV/AIDS in Uganda. This study explored perceptions, care-seeking practices and barriers to PMTCT among young and HIV-positive women. A household survey (10,706 women aged 14-49 years), twelve focus group discussions and 66 key informant interviews were carried out between January and April 2009 in Wakiso district, central Uganda. Results show that access to PMTCT services (family planning, HIV counselling and testing and delivery at health units) was poor. Decision making was an important factor in accessing PMTCT services. Socioeconomic factors (wealth quintile, age, education level) and institutional practices also influenced access to PMTCT. Overall, having had an HIV test was highest when both men and women made decisions together or when women were empowered to make their own decisions. This was significant across wealth quintiles (P=0.0001), age groups (p=0.0001) and education levels (p=0.0001). The least level of HIV testing was when men made decisions for their spouses; and this was the case with family planning and deliveries at health units. Other barriers to PMTCT were fear of women and male spouses to have an HIV test and the perception that HIV testing is compulsory in antenatal clinics. In conclusion, to increase access to PMTCT among women, especially the young, poor and least educated, there is a need to empower them to make decisions on health seeking, and also to empower men to support their spouses to make good decisions. Other barriers like fear of having an HIV test should be addressed through appropriate counselling of clients.