Successful introduction of routine opt-out HIV testing in antenatal care in Botswana
Successful introduction of routine opt-out HIV testing in antenatal care in Botswana
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DOI：
10.1097/qai.0b013e318047df88
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发表时间：
2007-05-01
影响因子：
3.6
通讯作者：
Kilmarx, Peter H.
中科院分区：
文献类型：
--
作者：
Creek, Tracy L.;Ntumy, Raphael;Kilmarx, Peter H.
背景资料：博茨瓦纳的孕妇艾滋病毒感染率很高（2003年为37.4%），并提供预防艾滋病毒母婴传播的免费服务。从1999年到2003年，产前艾滋病毒检测的接受率很低。2004年，博茨瓦纳总统宣布，艾滋病毒检测应是“例行的，但不是强制性的”在医疗settings.Methods：卫生工作者接受培训，提供集体教育，并建议艾滋病毒检测作为常规ANC服务的一部分。ANC出勤，艾滋病毒检测，并采取预防母婴传播干预措施的日志数据进行了审查之前和之后的常规检测培训，和ANC客户进行了interviewed.Results：常规检测开始后，所有艾滋病毒感染的妇女在区域医院谁知道自己的艾滋病毒状况的百分比从47%增加到78%，并接受预防母婴传播干预措施的百分比从29%增加到56%。产前护理的出勤率和向他人透露艾滋病毒感染状况的艾滋病毒抗体阳性妇女的百分比保持稳定。访谈表明，ANC客户支持policy.Conclusions：常规艾滋病毒检测比自愿检测在这种情况下更容易接受，并导致大量增加的测试和PMTCT干预措施的摄取没有检测到的不良后果。在其他环境中进行常规检测可能会加强艾滋病毒护理和预防工作。
Background: Botswana has high HIV prevalence among pregnant women (37.4% in 2003) and provides free services for prevention of mother-to-child transmission (PMTCT) of HIV Nearly all pregnant women (> 95%) have antenatal care (ANC and deliver in hospital. Uptake of antenatal HIV testing was low from 1999 through 2003. In 2004, Botswana's President declared that HIV testing should be " routine but not compulsory" in medical settings.Methods: Health workers were trained to provide group education and recommend HIV testing as part of routine ANC services. Logbook data on ANC attendance, HIV testing, and uptake of PMTCT interventions were reviewed before and after routine testing training, and ANC clients were interviewed.Results: After routine testing started, the percentage of all HIV-infected women delivering in the regional hospital who knew their HIV status increased from 47% to 78% and the percentage receiving PMTCT interventions increased from 29% to 56%. ANC attendance and the percentage of HIV-positive women who disclosed their HIV status to others remained stable. Interviews indicated that ANC clients supported the policy.Conclusions: Routine HIV testing was more accepted than voluntary testing in this setting and led to substantial increases in the uptake of testing and PMTCT interventions without detectable adverse consequences. Routine testing in other settings may strengthen HIV care and prevention efforts.