Low male partner participation in antenatal HIV counselling and testing in northern Tanzania: implications for preventive programs
Low male partner participation in antenatal HIV counselling and testing in northern Tanzania: implications for preventive programs
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DOI：
10.1080/09540120701687059
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发表时间：
2008-01-01
影响因子：
1.7
通讯作者：
Stray-Pedersen, B.
中科院分区：
文献类型：
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作者：
Msuya, S. E.;Mbizvo, E. M.;Stray-Pedersen, B.
本研究旨在描述坦桑尼亚Moshi市两家初级卫生保健诊所男性伴侣参与艾滋病毒自愿咨询和检测（VCT）的流行率和预测因素，以及伴侣参与对艾滋病毒围产期干预措施的影响。在2002年6月至2004年3月期间参加预防母婴传播（PMTCT）项目的妊娠晚期孕妇（n = 2654）被鼓励告知并邀请其伴侣进行HIV-VCT。训练有素的护士对参与研究的妇女及其伴侣进行测试前咨询、面谈、临床检查和血液采样。根据参与者的意愿，提供测试结果，并进行单独或夫妻的测试后咨询。332名男性伴侣（12.5%）为HIV-VCT而来。较高比例（131;40%）发生在妇女分娩后。有伴侣参加的艾滋病毒血清阳性妇女使用奈韦拉平预防的可能性是没有伴侣参加的妇女的三倍，避免母乳喂养的可能性是没有伴侣参加的妇女的四倍，坚持所选择的婴儿喂养方法的可能性是没有伴侣参加的妇女的六倍。如果妇女自己收集检测结果，与伴侣住在一起，月收入高，并在报名时表示有意与伴侣分享艾滋病毒检测结果，她们更有可能带伴侣参加VCT。虽然预防母婴传播项目可能是男性参与预防性和围产期艾滋病毒传播的一个很好的切入点，但这种传统的以诊所为基础的方法很少能接触到男性。鉴于男性参与对接受围产期干预的积极影响，迫切需要一种不同的方法来促进男性参与VCT。在预防母婴传播项目中，咨询人员应强调伴侣参与的优势，鼓励女性告知并说服男性伴侣来进行VCT。此外，应优先考虑在男性友好和无障碍的产前环境之外促进夫妻VCT。
This study aimed to describe the prevalence and predictors for male partner participation in HIV voluntary counselling and testing (VCT) at two primary healthcare clinics in Moshi urban, Tanzania as well as the effect of partner participation on uptake of HIV perinatal interventions. Pregnant women (n = 2654) in their third trimester, participating in a prevention of mother to child tranmission (PMTCT) program between June 2002 and March 2004 were encouraged to inform and invite their partners for HIV-VCT. Trained nurses conducted pre-test counselling, interviews, clinical examinations and blood sampling from the participating women and their partners. Test results were presented and post-test counselling was conducted individually or in couples, depending on the wishes of the participants. Three-hundred-and-thirty-two male partners (12.5%) came for HIV-VCT. A high proportion (131; 40%) came after the woman had delivered. HIV-seropositive women whose partners attended were three times more likely to use Nevirapine prophylaxis, four times more likely to avoid breastfeeding and six times more likely to adhere to the infant feeding method selected than those whose partners didn't attend. Women were more likely to bring their partner for VCT if they collected their own test results, were living with their partner, had a high monthly income and had expressed at enrolment the intention to share HIV results with their partner. Although PMTCT programs are presumably a good entry point for male involvement in prevention of sexual and perinatal HIV transmission, this traditional clinic-based approach reaches few men. Given the positive influence male participation has on the acceptance of perinatal interventions, a different approach for promoting male participation in VCT is urgently required. Within PMTCT programs, counseling should emphasize the advantages of partner participation to encourage women to inform and convince male partners to come for VCT. Also, promotion of couple VCT outside antenatal settings in male friendly and accessible settings should be given priority.