Testing and Counseling for HIV: A Multi-Site Study

HIV 检测和咨询：多中心研究

• 批准号: 7121347
• 负责人: CARLA M OBERMEYER
• 金额: $ 45.09万
• 依托单位: WORLD HEALTH ORGANIZATION
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7121347
• 关键词: AIDS education /prevention; Africa; HIV infections; behavior; behavioral /social science research tag; clinical research; counseling; diagnosis; evaluation /testing; health care personnel performance; health care service evaluation; human population study; international cooperation; interview; medical records; motivation; sex

DESCRIPTION (provided by applicant): The proposed project is a multisite study of testing and counseling (T&C) for HIV, designed to investigate the factors that hinder or facilitate uptake in different settings. The uptake of T&C is key to the success of HIV treatment and prevention programs, and it is especially important to understand its determinants in view of current debates regarding the shift from stand-alone voluntary T&C to integrated routine services. The study makes systematic comparisons across four sites that differ in terms of the provision of T&C and the social context in which services are provided. The first phase of the analysis is carried out for each site separately, and investigates three sets of factors thought to influence the uptake of testing: the behaviors and motivations of users and non-users of services towards testing and disclosure; the provision of testing and counseling, including whether testing is client- or provider-initiated; and the implementation of practices related to confidentiality and consent. The second phase of the analysis consists of systematic comparisons across sites to identify the particular characteristics of programs and context that are associated with the uptake of testing and with positive responses among clients. Among the specific questions examined in comparative analyses are: the extent of the association of stigma with testing and disclosure; the influence of gender on testing and disclosure; the circumstances that shape practices related to informed consent and confidentiality; and the extent to which these practices influence clients' responses. The study is based on interviews with health providers, with clients of testing services, and with non- users (people who have not been tested), as well as on observations at study sites. Data will be collected at health facilities, including: stand-alone HIV testing and counseling facilities, facilities that provide care to people living with HIV, and facilities that provide HIV testing and counseling as part of providing other health services, such as antenatal care, care for tuberculosis, or for sexually transmitted infections. Analyses will combine statistical methods for quantifiable survey data, and qualitative methods for the textual data resulting from open-ended responses and observations.

描述（由申请人提供）：拟议项目是一项针对艾滋病毒检测和咨询（T&C）的多地点研究，旨在调查在不同环境下阻碍或促进艾滋病毒感染的因素。 T&C 的采用是 HIV 治疗和预防计划成功的关键，鉴于当前关于从独立自愿 T&C 向综合常规服务转变的争论，了解其决定因素尤为重要。该研究对四个在条款和条件的提供以及提供服务的社会背景方面有所不同的网站进行了系统比较。第一阶段的分析是针对每个站点分别进行的，并调查了三组被认为影响测试采用率的因素：服务的用户和非用户对测试和披露的行为和动机；提供测试和咨询，包括测试是由客户还是提供商发起；以及实施与保密和同意相关的做法。分析的第二阶段包括跨站点的系统比较，以确定与测试的采用和客户的积极反应相关的项目和背景的特定特征。比较分析中审查的具体问题包括：耻辱与测试和披露的关联程度；性别对测试和披露的影响；影响知情同意和保密相关实践的情况；以及这些做法在多大程度上影响客户的反应。该研究基于对卫生服务提供者、检测服务客户和非用户（未接受检测的人）的访谈以及研究地点的观察。数据将在卫生设施中收集，包括：独立的艾滋病毒检测和咨询设施、为艾滋病毒感染者提供护理的设施以及作为提供其他卫生服务（如产前保健、护理结核病或性传播感染。分析将结合可量化调查数据的统计方法和开放式回答和观察产生的文本数据的定性方法。