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首页> 外文期刊>Journal of the International Aids Society >Perspectives on HIV partner notification, partner HIV self‐testing and partner home‐based HIV testing by pregnant and postpartum women in antenatal settings: a qualitative analysis in Malawi and Zambia
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Perspectives on HIV partner notification, partner HIV self‐testing and partner home‐based HIV testing by pregnant and postpartum women in antenatal settings: a qualitative analysis in Malawi and Zambia

机译：产前孕妇和产后妇女对艾滋病毒伴侣通知，伴侣艾滋病毒自我检测和伴侣家庭艾滋病毒检测的观点：马拉维和赞比亚的定性分析

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Introduction HIV testing male partners of pregnant and postpartum women can lead to improved health outcomes for women, partners and infants. However, in sub‐Saharan Africa, few male partners get HIV tested during their partner's pregnancy in spite of several promising approaches to increase partner testing uptake. We assessed stakeholders’ views and preferences of partner notification, home‐based testing and secondary distribution of self‐test kits to understand whether offering choices for partner HIV testing may increase acceptability. Methods Interviewers conducted semi‐structured interviews with HIV‐negative (N?=?39) and HIV‐positive (N?=?41) pregnant/postpartum women, male partners of HIV‐negative (N?=?14) and HIV‐positive (N?=?14) pregnant/postpartum women, healthcare workers (N?=?19) and policymakers (N?=?16) in Malawi and Zambia. Interviews covered views of each partner testing approach and preferred approaches; healthcare workers were also asked about perceptions of a choice‐based approach. Interviews were transcribed, translated and analysed to compare perspectives across country and participant types. Results Most participants within each stakeholder group considered all three partner testing strategies acceptable. Relationship conflict was discussed as a potential adverse consequence for each approach. For partner notification, additional barriers included women losing letters, being fearful to give partners letters, being unable to read and men refusing to come to the clinic. For home‐based testing, additional barriers included lack of privacy or confidentiality and fear of experiencing community‐level HIV stigma. For HIV self‐test kits, additional barriers included lack of counselling, false results and poor linkage to care. Preferred male partner testing options varied. Participants preferred partner notification due to their respect for clinical authority, home‐based testing due to their desire to prioritize convenience and clinical authority, and self‐test kits due to their desire to prioritize confidentiality. Less than half of couples interviewed selected the same preferred male partner testing option as their partner. Most healthcare workers felt the choice‐based approach would be acceptable and feasible, but noted implementation challenges in personnel, resources or space. Conclusions Most stakeholders considered different approaches to partner HIV testing to be acceptable, but concerns were raised about each. A choice‐based approach may allow women to select their preferred method of partner testing; however, implementation challenges need to be addressed.
机译：简介对孕妇和产后妇女的男性伴侣进行HIV检测可以改善女性，伴侣和婴儿的健康状况。但是，在撒哈拉以南非洲地区，尽管有几种有希望的方法可以增加伴侣检测的摄取率，但很少有男性伴侣在伴侣怀孕期间接受艾滋病毒检测。我们评估了利益相关者对合作伙伴通知，家庭测试和二次分发自测工具包的看法和偏好，以了解为合作伙伴HIV测试提供选择是否可以提高可接受性。方法访谈者对孕妇/产后的HIV阴性（N？=？39）和HIV阳性（N？=？41），HIV阴性（N？=？14）的男性伴侣和HIV-进行半结构式访谈马拉维和赞比亚的孕妇（产后阳性）（N = 14），医护人员（N = 19）和决策者（N = 16）。访谈涵盖了每种合作伙伴测试方法和首选方法的观点;还询问医护人员对基于选择的方法的看法。采访被转录，翻译和分析，以比较不同国家和参与者类型的观点。结果每个利益相关者组中的大多数参与者都认为所有三种合作伙伴测试策略都是可以接受的。关系冲突被讨论为每种方法的潜在不利后果。对于伴侣的通知，其他障碍包括女性丢失信件，害怕给伴侣信件，无法阅读以及男性拒绝来诊所。对于家庭测试，其他障碍包括缺乏隐私或机密性以及担心遭受社区级的艾滋病毒污名。对于艾滋病毒自测工具包，其他障碍包括缺乏咨询，错误的结果以及与护理的联系不畅。首选的男性伴侣测试选项多种多样。由于尊重临床权威，希望优先考虑便利性和临床权威而进行家庭测试，以及希望优先考虑机密性的自测工具包，参与者更喜欢选择合作伙伴通知。不到一半的受访夫妇选择了与伴侣相同的首选男性伴侣测试选项。大多数医护人员认为基于选择的方法是可以接受和可行的，但是注意到人员，资源或空间方面的实施挑战。结论大多数利益相关者都认为接受合作伙伴艾滋病毒检测的不同方法是可以接受的，但是对每种方法都提出了担忧。基于选择的方法可以让女性选择自己喜欢的伴侣测试方法;但是，实施挑战需要解决。

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