计划生育门诊医务人员主动提供HIV检测咨询(PITC)服务的探讨

Provider Initiated Testing and Counseling(PITC) for HIV in Family Planning Clinics

目的:探讨在计划生育门诊中开展医务人员主动提供HIV检测咨询(provider-initiated testing and counse-ling,PITC)服务的必要性和可行性及影响因素。方法:随机抽取计划生育门诊就诊者800人进行问卷凋查。结果:就诊者艾滋病总知识知晓率为85.27%,各知识点知晓率差距较大,12个知识点中有7项正确回答率90%以上,有3项正确回答率在70%以下;年轻、初中文化程度和无业人员、工人等人群知晓率偏低。对艾滋病病毒感染者态度有30.0%持"同情并帮助"态度,有38.00%持"同情并疏远"态度。76.75%认为HIV检测咨询可以控制艾滋病的流行和传播。"认为HIV检测的负面影响"的选择中,害怕被歧视29.73%、家庭破裂24.62%、失去工作24.44%、暴露隐私21.21%。在不愿接受HIV检测的就诊者中,81.90%认为没必要。25.62%(人.项)的就诊者知道计生门诊可以提供艾滋病检测咨询服务;35.22%的就诊者会首选到计生门诊检测。分别有86.88%和94.63%的人表示,在计生门诊就诊时,愿意接受医务人员提供HIV检测和HIV方面的知识信息咨询。开展PITC服务1年,门诊检测率从11.64%提高到23.15%,有显著性差异(P<0.01)。结论:计划生育门诊医务人员开展PITC服务是必要的和可行的,能明显提高就诊者的HIV检测率。艾滋病综合知识知晓率低、HIV检测重要性认识不足、社会歧视是阻碍就诊者接受PITC服务的重要影响因素。

Objectives： To discuss the necessity and practicability of PITC for HIV in Family Planning Clinics and the re-lated influencing factors. Methods： A total of 800 patients were randomly chosen to answer the questionnaires who came to family planning clinics for consultation. Results： The subjects who command general HIV knowledge accounted for 85.27% with great differences in different AIDS knowledge range. The subjects who showed lower level of AIDS knowledge were mostly young people with secondary school education who were either unemployed or manual workers. As to the attitude toward HIV infected popula-tion,30% of subjects showed ＂sympathy and support＂ attitude, while 38% chose to have ＂sympathy but detached＂ attitude. A- bout 76.75% of subjects believed that PITC could help to control HIV transmission. Among the subjects unwilling to receive PITC, 81.90% thought there was no need for counselling. 25.62% （person/item） knew Family Planning Clinic could provide PITC for HIV and 35.22% would choose Family Planning Clinic to do the test. The percentage of subjects who were willing to re-ceive HIV test and have HIV education provided by medical professionals were 86.88% and 94.63% respectively. One year after PITC service provision, the clinical HIV test rate increased from 11.64% to 23. 15% , the difference being significant （P 〈0.01 ）. Conclusion： PITC services in the Family Planning Clinic are necessary and feasible. The service can significantly im- prove the detection rate of YIIV in clinics. The underestimation of the value of HIV test and social prejudice are the two factors preventing patients from receiving PITC service.