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首页> 美国卫生研究院文献>Taylor Francis Open Select >Burden of HIV among primary school children and feasibility of primary school-linked HIV testing in Harare Zimbabwe: A mixed methods study
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Burden of HIV among primary school children and feasibility of primary school-linked HIV testing in Harare Zimbabwe: A mixed methods study

机译：津巴布韦哈拉雷小学生的艾滋病毒负担和与小学相关的艾滋病毒检测的可行性：混合方法研究

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Population-based surveys in Southern Africa suggest a substantial burden of undiagnosed HIV-infected long-term survivors of mother-to-child transmission. We conducted an HIV prevalence survey of primary school pupils in Harare, Zimbabwe, and evaluated school-linked HIV counselling and testing (HCT) for pupils, their families and schoolteachers. Population-weighted cluster sampling was used to select six primary schools. Randomly selected class-grade pupils underwent anonymous HIV testing, with concurrent school-linked family HCT offered during the survey. Focus group discussions and interviews were conducted with pupils, parents/ guardians, counsellors, and schoolteachers. About 4386 (73%) pupils provided specimens for anonymous HIV testing. Median age was 9 years (IQR 8–11), and 54% were female. HIV prevalence was 2.7% (95% CI: 2.2–3.1) with no difference by gender. HIV infection was significantly associated with orphanhood, stunting, wasting, and being one or more class grades behind in school due to illness (p <0.001). After adjusting for covariates, orphanhood and stunting remained significantly associated with being HIV positive (p <0.001). Uptake of diagnostic HIV testing by pupils was low with only 47/4386 (1%) pupils undergoing HCT. The HIV prevalence among children under 15 years who underwent HIV testing was 6.8%. The main barrier to HIV testing was parents’ fear of their children experiencing stigma and of unmasking their own HIV status should the child test HIV positive. Most guardians believed that a child's HIV-positive result should not be disclosed and the child could take HIV treatment without knowing the reason. Increased recognition of the high burden of undiagnosed HIV infection in children is needed. Despite awareness of the benefits of HIV testing, HIV-related stigma still dominates parents/guardians' psychological landscape. There is need for comprehensive information and support for families to engage with HIV testing services.
机译：南部非洲基于人口的调查表明，未经诊断的艾滋病毒感染的母婴传播长期幸存者的负担很大。我们对津巴布韦哈拉雷的小学生进行了艾滋病毒患病率调查，并针对学生，他们的家庭和教师评估了学校相关的艾滋病毒咨询和检测（HCT）。人口加权整群抽样被用来选择六所小学。随机选择的班级学生接受了匿名的HIV测试，并在调查期间同时提供了与学校相关的家庭HCT。与学生，父母/监护人，辅导员和学校老师进行了焦点小组讨论和访谈。约有4386名学生（73％）提供了用于匿名HIV检测的标本。中位年龄为9岁（IQR 8-11），女性为54％。 HIV患病率为2.7％（95％CI：2.2-3.1），性别无差异。 HIV感染与孤儿，发育迟缓，消瘦以及由于疾病而在学校落后一个或多个班级成绩显着相​​关（p <0.001）。调整协变量后，孤儿和发育迟缓仍与HIV阳性呈显着相关性（p <0.001）。学生接受HCT诊断性HIV检测的比例很低，只有47/4386（1％）名学生。接受HIV检测的15岁以下儿童的HIV患病率为6.8％。艾滋病毒检测的主要障碍是父母担心孩子遭受耻辱，如果孩子检测出HIV阳性，他们会掩盖自己的HIV状况。大多数监护人认为，不应透露儿童的HIV阳性结果，并且儿童可以在不知道原因的情况下接受HIV治疗。需要增加对儿童未经诊断的艾滋病毒感染高负担的认识。尽管意识到艾滋病毒检测的好处，但与艾滋病毒有关的污名仍然主导着父母/监护人的心理状况。需要全面的信息和支持，以使家庭参与艾滋病毒检测服务。

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