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首页> 外文期刊>AIDS care. >'I did not see a need to get tested before, everything was going well with my health': a qualitative study of HIV-testing decision-making in KwaZulu-Natal, South Africa
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'I did not see a need to get tested before, everything was going well with my health': a qualitative study of HIV-testing decision-making in KwaZulu-Natal, South Africa

机译：“我没有看到以前需要进行测试，一切都与我的健康顺利进行”：南非夸祖鲁 - 纳塔尔艾滋病毒检测决策的定性研究

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Few studies have examined HIV-testing decision-making since the South African national HIV counseling and testing campaign in 2010-2011 and subsequent expansion in antiretroviral therapy (ART) eligibility in 2012. We describe HIV-testing decision-making and pathways to testing among participants in Pathways to Care, a cohort study of newly-diagnosed HIV-positive adults in KwaZulu-Natal. Our analysis is embedded within a theoretical framework informed by Arthur Kleinman's work on pluralistic healthcare systems, and the concept of diagnostic itineraries (i.e., the route taken to HIV testing). We conducted 26 semi-structured interviews in 2012, within one month of participants' diagnosis. Most (n=22) deferred testing until they had developed symptoms, and then often sought recourse in non-biomedical settings. Of the eleven symptomatic participants who accessed professional medical services prior to testing, only three reported that a healthcare professional had offered or recommended an HIV test. Although ART emerged as an important motivator, offering hope of health and normalcy, fear of death and HIV-related stigma remained key barriers. Despite national policy changes in testing and treatment, health system and individual factors contributed to ongoing high levels of late diagnosis of HIV in this study population. Encouraging local health systems to direct clients toward HIV testing, and continuing to raise awareness of the benefits of routine testing remain important strategies to reduce delayed diagnoses.
机译：自2010 - 2011年南非国家艾滋病毒咨询和检测活动以来，少数研究检测了艾滋病毒检测决策，并在2012年进行了抗逆转录病毒治疗（艺术）资格的随后扩增。我们描述了艾滋病毒检测决策和途径来测试关怀的途径参与者，是夸祖鲁 - 纳尔新诊断的艾滋病毒阳性成年人的队列研究。我们的分析嵌入了Arthur Kleinman在多元医疗保健系统上的工作，以及诊断行程的概念（即艾滋病毒检测所需的途径）。我们在2012年在参与者诊断的一个月内进行了26层半结构化访谈。大多数（n = 22）延迟测试，直到它们发生了症状，然后经常在非生物医学环境中寻求求助。在测试前访问专业医疗服务的11个症状参与者中，只有三个报告的医疗保健专业人员提供或推荐了HIV测试。虽然艺术被出现为一个重要的动机，但提供健康和正常的希望，害怕死亡和艾滋病毒相关的耻辱仍然是关键障碍。尽管检测和治疗的国家政策变化，但卫生系统和个人因素导致本研究人口中持续高水平的艾滋病毒诊断。鼓励当地卫生系统直接客户对艾滋病毒检测，并继续提高对日常检测的益处的认识，仍然是减少延迟诊断的重要策略。

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