Understanding attitudes, barriers and challenges in a small island nation to disease and partner notification for HIV and other sexually transmitted infections: a qualitative study
Understanding attitudes, barriers and challenges in a small island nation to disease and partner notification for HIV and other sexually transmitted infections: a qualitative study
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DOI：
10.1186/s12889-015-1794-2
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发表时间：
2015-05-02
影响因子：
4.5
通讯作者：
Redwood-Campbell, Lynda
中科院分区：
文献类型：
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作者：
Adams, O. Peter;Carter, Anne O.;Redwood-Campbell, Lynda
背景资料：在巴巴多斯，包括艾滋病毒在内的性传播感染是不应报告的疾病，也没有正式的伴侣通知方案。目标是了解可能的态度，障碍，并引入强制性疾病通知（DN）和合作伙伴通知（PN）的HIV和其他STIs在一个小岛屿state.Methods的挑战：六个关键的知情人确定研究参与者。访谈进行，记录，转录和分析的内容使用标准的methods.Results：参与者（16名男性，13名女性，中位年龄59岁）包括医生，护士，和政府，青年，艾滋病毒，男子，妇女，教会和私营部门组织的代表。社会对HIV/STI DN的可接受性的中位数估计为3，评分范围为1（不可接受）至5（完全可接受）。挑战包括;在一个小岛上保密;公众认为保密性不好;恐惧和耻辱;检测可能会被阻止;报告可能不会发生;立法将很困难;以及一些意见领袖的反对。合同转介与提供者转介不同，并不是“完全中止权利”，同时考虑到“人们有时需要一点温和的压力”。需要额外的咨询，以引起接触或让病人通知合作伙伴。在一个小社会中，羞耻、耻辱和歧视可能使PN不可接受，并阻止检测。患者转诊可能会出现拖延，伴侣可能会反应激烈，而不是来护理。在提供者转诊的情况下，患者可能会担心保密问题，包括如果将家访作为联系方法，邻居会产生怀疑。成功追踪接触者需要时间和精力。与合同转介的人可能既不通知联系人，也不说，他们没有。战略，克服障碍DN和PN包括公众教育，制定适当的立法，使DN和PN，良好的病人咨询和维护保密性。Conclusions：有两个关注，强制性DN和PN将阻止测试和承认的好处。有必要对公众和从业人员进行教育，并制定授权立法，而且需要让公众相信保密工作将得到维护。
Background: In Barbados sexually transmitted infections (STIs) including HIV are not notifiable diseases and there is not a formal partner notification (PN) programme. Objectives were to understand likely attitudes, barriers, and challenges to introducing mandatory disease notification (DN) and partner notification (PN) for HIV and other STIs in a small island state.Methods: Six key informants identified study participants. Interviews were conducted, recorded, transcribed and analysed for content using standard methods.Results: Participants (16 males, 13 females, median age 59 years) included physicians, nurses, and representatives from governmental, youth, HIV, men's, women's, church, and private sector organisations. The median estimated acceptability by society of HIV/STI DN on a scale of 1 (unacceptable) to 5 (completely acceptable) was 3. Challenges included; maintaining confidentiality in a small island; public perception that confidentiality was poorly maintained; fear and stigma; testing might be deterred; reporting may not occur; enacting legislation would be difficult; and opposition by some opinion leaders.For PN, contract referral was the most acceptable method and provider referral the least. Contract referral unlike provider referral was not "a total suspension of rights" while taking into account that "people need a little gentle pressure sometimes". Extra counselling would be needed to elicit contacts or to get patients to notify partners. Shame, stigma and discrimination in a small society may make PN unacceptable and deter testing. With patient referral procrastination may occur, and partners may react violently and not come in for care. With provider referral patients may have concerns about confidentiality including neighbours becoming suspicious if a home visit is used as the contact method. Successful contact tracing required time and effort. With contract referral people may neither inform contacts nor say that they did not.Strategies to overcome barriers to DN and PN included public education, enacting appropriate legislation to allow DN and PN, good patient counselling and maintaining confidentiality.Conclusions: There was both concern that mandatory DN and PN would deter testing and recognition of the benefits. Public and practitioner education and enabling legislation would be necessary, and the public needed to be convinced that confidentiality would be maintained.