妇幼保健医院门诊实施艾滋病PITC策略效果

An analysis on PITC pilot in maternal and child care service centre

目的了解在妇幼保健医院实施医务人员提供艾滋病检测咨询（PITC）策略的可行性，探讨艾滋病检测率的影响因素，为在艾滋病防治工作中推广实施PITC策略提供参考。方法2010年6月-2011年8月，选择广州市番禺区妇幼保健医院作为临床医疗机构试点，共选择3个门诊量较大的门诊科室作为试点，收集试点工作报表和访谈结果等资料进行分析。结果项日周期内，共计为57309人提供PITC服务，其中19809人（34．57％）接受艾滋病检测，婚检科、产科和妇科的艾滋病检测人数分别为9817人（100．00％）、6157人（35．63％）和3569人（12.37％）。产科艾滋病检测率高于妇科，差异有统计学意义（X^23514．72，P〈0．01）。在接受检测的19809人中，确认HIV阳性者3人（0．15％。1。产科和妇科调查对象拒绝艾滋病检测的主要原因均为认为自身没有感染艾滋病的可能性，分别占41．00％和59．00％。产科和妇科检测率与前15个月相比，差异均有统计学意义（P〈0．01）。结论在妇幼保健医院实施PITC策略具有可行性，政策支持、检测费用等对PITC的开展有重要影响。

Objective To evaluate the feasibility of the provider initiated HIV testing and coun seling （PITC） pilot in maternal and child care service centre and to find out problems and solutions in implementing PITC, so as to provide evidence for making strategies and policies for acquired immune deficiency syndrome （AIDS） control and prevention. Methods The Maternal and Children Health Care Service Centre of Panyu District in Guangzhou was selected as a clinical trial of medical institution, 3 out patient departments for the pilot were chosen, pilot work report and interview results and other information were collected for analysis. Results During the project cycle, 57, 309 provider-initiated HIV tests were recommended, and 19, 809 （34.57%） were accepted. The number of HIV testing rates in pre marital check up, obstetrics and gynecology clients were 9,817（100.00%）, 6,157（35.63%） and 3, 569（12.37%）respectively. The HIV testing rates of obstetric were higher than those of gynecological, there were significant differences （X^2 = 3514.723, P〈 0.01）. 19,809 people accepted test, 3 persons con firmed HIV-positive （0.15%）. The main cause of rejecting HIV testing of the patients in obstetrical and gyneeological was ＂think they have no possibility of HIV infection＂, with proportion of 41% and 59% respectively. Obstetrics and gynecology HIV testing rates were compared to those 15 months before, there were significant differences （P 〈 O.O1）.Conclusions It is feasible to implement PITC in maternal and child care service centre, policy support and testing fee are key factors that influence the implementation of PITC.