Barriers to the implementation of programs for the prevention of mother-to-child transmission of HIV: a cross-sectional survey in rural and urban Uganda.
Barriers to the implementation of programs for the prevention of mother-to-child transmission of HIV: a cross-sectional survey in rural and urban Uganda.
复制标题
DOI：
10.1186/1742-6405-2-10
复制
发表时间：
2005-10-28
影响因子：
2.2
通讯作者：
Muzoora, Michael
中科院分区：
文献类型：
--
作者：
Bajunirwe, Francis;Muzoora, Michael
背景：实施预防艾滋病毒母婴传播（PMTCT）方案面临各种障碍和挑战。对这些挑战的评估一般在大型城市卫生设施中进行。随着方案扩展到农村地区，也需要评估可能遇到的潜在障碍。本研究探讨了潜在的障碍，可能会影响的可接受性的干预PMTCT在农村和城市setting.RESULTS：四百四名妇女在一个大型城市医院和三个农村诊所，最近开始实施PMTCT进行了采访。两个地区的母婴传播知识水平和对艾滋病毒快速检测的偏好同样高，但农村妇女更倾向于认为她们在检测前应咨询丈夫，具有边缘统计学意义（72%对64%，p = 0.09）。与城市相比，农村地区的母亲在保健设施分娩的比例明显较低。总体而言，愿意检测艾滋病毒的重要预测因素是小学后教育（OR = 3.1，95%CI 1.2，7.7）和对快速艾滋病毒检测的了解（OR = 1.8，95%CI 1.01，3.4）。愿意接受艾滋病毒检测的最强预测因素是妇女认为她的丈夫会同意她进行艾滋病毒检测。妇女谁认为他们的丈夫会批准几乎6倍的可能性报告愿意进行测试相比，那些谁认为他们的丈夫不会批准（OR = 5.6，95%CI 2.8，11.2）。结论：在大型城市医院的经验教训可以推广到农村设施，但在农村地区的设施为基础的分娩比例较低，需要加以解决。当天结果很可能确保艾滋病毒检测服务的高利用率，但应考虑男性配偶的参与，特别是在农村地区。普及初等教育将有助于防止母婴传播方案取得成功。
BACKGROUND: Implementation of programs for the prevention of mother-to-child transmission (PMTCT) of HIV faces a variety of barriers and challenges. The assessment of these challenges has generally been conducted in large urban health facilities. As programs expand into rural areas, the potential barriers that may be encountered there also need to be assessed. This study examines potential barriers that might affect the acceptability of interventions for PMTCT in rural and urban settings.RESULTS: Four hundred and four women at a large urban hospital and three rural clinics that had recently started implementing PMTCT were interviewed. Level of knowledge of MTCT and preference for rapid HIV testing were equally high in both areas, but rural women had a higher tendency to think that they should consult their husbands before testing, with borderline statistical significance (72% vs. 64% p = 0.09). Health facility-based deliveries were significantly lower among mothers in rural areas compared to those in the urban setting. Overall, significant predictors of willingness to test for HIV were post-primary education (OR = 3.1 95% CI 1.2, 7.7) and knowledge about rapid HIV tests (OR = 1.8, 95% CI 1.01, 3.4). The strongest predictor of willingness to accept an HIV test was the woman's perception that her husband would approve of her testing for HIV. Women who thought their husbands would approve were almost six times more likely to report a willingness to be tested compared to those who thought their husbands would not approve (OR = 5.6, 95% CI 2.8, 11.2).CONCLUSION: Lessons learned in large urban hospitals can be generalized to rural facilities, but the lower proportion of facility-based deliveries in rural areas needs to be addressed. Same-day results are likely to ensure high uptake of HIV testing services but male spousal involvement should be considered, particularly for rural areas. Universal Primary Education will support the success of PMTCT programs.