以妇幼保健网络为基础的健康教育对孕妇接受HIV抗体检测的干预效果评价

Evaluation of the effectiveness of a health education program based on the three-level maternal and child health care network on HIV-testing in pregnant women

目的评价以妇幼保健网络为基础的预防艾滋病母婴传播(Prevention of mother to child transmission,PMTCT)健康教育干预措施,对孕妇孕期艾滋病病毒(HIV)抗体检测率的影响。方法现场干预研究。选择社会特征相近的两个地区分别作为干预地区和对照地区,在基线调查的基础上,对干预地区的孕妇开展为期一年的预防艾滋病母婴传播健康教育干预活动。干预前后分别对两地区孕妇进行问卷调查,比较调查对象孕期HIV抗体检测率的变化,评价健康教育的干预效果。结果共调查1541名孕妇,其中干预地区933人,对照地区组608人。干预后,干预地区孕妇孕期HIV抗体检测率,由干预前的34.27%提高至干预后的72.49%;对照地区孕妇孕期HIV抗体检测则由5.83%提高到20.38%。干预地区孕妇孕期HIV抗体检测率高于对照区52.11%,差异有显著的统计学意义(χ2=24.60,P<0.01)。多因素分析结果显示,预防艾滋病母婴传播健康教育干预措施有效,干预效应OR值为2.01(95%CI:1.60,2.49)。结论依托妇幼县、乡、村三级保健网络,由基层妇幼保健工作人员具体实施,针对育龄妇女(包括孕妇)的预防艾滋病母婴传播健康教育,可有效提高孕妇对HIV抗体检测服务的接受和利用。

Objective To evaluate the effectiveness of a health education program based on the three level maternal and child health care networks in terms of acceptability of HIV tests in pregnant women. Methods A field study approach was adopted. Pregnant women in two sites who were similar in their social features were selected as intervention group and control group, respectively. Based on the baseline survey, the intervention group was exposed to one-year long health education activities on prevention of HIV related MTCT via lectures, broadcasting and educational materials etc. The effectiveness of the interventions was evaluated by interviewing the pregnant women in the two groups via questionnaires and comparing change of HIV test rates pre-and post-interventions. Results A total of 1 541 pregnant women were interviewed, with 933 women in the intervention group and 618 women in the control group. After one year intervention, the rate of HIV-testing during pregnancy in the intervention group was raised from 34.27% to 72.49%, while 5.83 % to 20.38 % in the control group. The rate of HIV-testing during pregnancy in the intervention group was 52.11% higher than in the control group （X^2 = 24.60, P 〈 0. 001）. Multi factor analysis showed that the health education program was effective in raising HIV-testing rate, with intervention effect of OR - 2.01 （95 % CI ： 1.60,2.49） . Conclusions The PMTCT health education intervention based on the three-level（county, township, and village）networks of maternal and child health care units could work well by involving primary MCH workers and targeting to women of child bearing age including pregnant women, and is effective in improving acceptability and utility of HIV testing among them.