Mistrust in marriage-Reasons why men do not accept couple HIV testing during antenatal care- a qualitative study in eastern Uganda
Mistrust in marriage-Reasons why men do not accept couple HIV testing during antenatal care- a qualitative study in eastern Uganda
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DOI：
10.1186/1471-2458-10-769
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发表时间：
2010-12-17
影响因子：
4.5
通讯作者：
Ekstrom, Anna Mia
中科院分区：
文献类型：
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作者：
Larsson, Elin C.;Thorson, Anna;Ekstrom, Anna Mia
背景资料：2006年，乌干达出台了一项夫妇艾滋病毒咨询和检测政策，敦促孕妇及其配偶在产前护理期间一起接受艾滋病毒检测。该政策旨在查明感染艾滋病毒的孕妇，通过预防性抗逆转录病毒治疗防止母婴传播艾滋病毒，提供咨询，并将艾滋病毒感染者与护理联系起来。然而，夫妇检测的采用率仍然很低。本研究探讨了男性的意见，夫妇艾滋病毒检测在ANC.Methods的经验：这项研究是在两个时间点，在2008年和2009年，在乌干达东部的农村伊甘加和Mayuge区。我们进行了九次焦点小组讨论，每次约有10名参与者，并对13名男性进行了深入采访，他们都是父亲。数据收集在当地语言，Lusoga，录音，此后翻译和转录成英语和分析使用content analysis.Results：男子充分意识到夫妇艾滋病毒检测的可用性，但列举了几个障碍，他们使用这些服务。这些男性认为他们的婚姻不稳定且不信任，这使得夫妻测试的想法没有吸引力，因为它可能会引发冲突。此外，他们不明白为什么他们应该测试，如果他们没有症状。最后，艾滋病毒护理被认为是一种耻辱，保健设施的保健工作者态度粗鲁，使他们认为提供产前护理的保健设施不受欢迎。我们研究中的男性对如何改进现行政策提出了几项建议：提高男性的同伴敏感性，减少卫生设施的污名化，使其对男性更加友好，培训卫生工作者以满足男性的需求，以及在卫生工作者和社区成员之间进行讨论。总之，将夫妇艾滋病毒检测作为使男子更愿意为妻子进行检测和支持防止母婴传播的主要途径，在这个地区似乎不起作用。艾滋病毒服务必须更好地适应当地的性别制度，同时考虑到男女之间的激励措施、寻求健康的行为和卫生系统障碍不同。
Background: A policy for couple HIV counseling and testing was introduced in 2006 in Uganda, urging pregnant women and their spouses to be HIV tested together during antenatal care (ANC). The policy aims to identify HIV-infected pregnant women to prevent mother-to-child transmission of HIV through prophylactic antiretroviral treatment, to provide counseling, and to link HIV-infected persons to care. However, the uptake of couple testing remains low. This study explores men's views on, and experiences of couple HIV testing during ANC.Methods: The study was conducted at two time points, in 2008 and 2009, in the rural Iganga and Mayuge districts of eastern Uganda. We carried out nine focus group discussions, about 10 participants in each, and in-depth interviews with 13 men, all of whom were fathers. Data were collected in the local language, Lusoga, audio-recorded and thereafter translated and transcribed into English and analyzed using content analysis.Results: Men were fully aware of the availability of couple HIV testing, but cited several barriers to their use of these services. The men perceived their marriages as unstable and distrustful, making the idea of couple testing unappealing because of the conflicts it could give rise to. Further, they did not understand why they should be tested if they did not have symptoms. Finally, the perceived stigmatizing nature of HIV care and rude attitudes among health workers at the health facilities led them to view the health facilities providing ANC as unwelcoming. The men in our study had several suggestions for how to improve the current policy: peer sensitization of men, make health facilities less stigmatizing and more male-friendly, train health workers to meet men's needs, and hold discussions between health workers and community members.Conclusions: In summary, pursuing couple HIV testing as a main avenue for making men more willing to test and support PMTCT for their wives, does not seem to work in its current form in this region. HIV services must be better adapted to local gender systems taking into account that incentives, health-seeking behavior and health system barriers differ between men and women.