Testing and Counseling for HIV: A Multi-Site Study

HIV 检测和咨询：多中心研究

• 批准号: 7293522
• 负责人: CARLA M OBERMEYER
• 金额: $ 44.35万
• 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/7293522
• 关键词: Attention; Attitude; Behavior; Burkina Faso; Caring; Characteristics; Classification; Client; Communication; Condition; Confidentiality; Consent; Counseling; Country; Data; Disclosure; Factor Analysis; Gender; Goals; Guidelines; HIV; Health Personnel; Health Services; Health care facility; Human immunodeficiency virus test; Informed Consent; Interview; Kenya; Knowledge; Life; Malawi; Measures; Motivation; Outcome; Patients; Pattern; Perception; Phase; Prevention; Prevention program; Provider; Qualitative Methods; Recommendation; Research Personnel; Risk; Services; Sexually Transmitted Diseases; Shapes; Site; Social Environment; Socioeconomic Status; Statistical Methods; Stigmata; Surveys; Testing; Thinking; Training; Trust; Tuberculosis; Uganda; Work; base; behavior test; comparative; design; experience; improved; programs; residence; response; satisfaction; social; social stigma; success; uptake

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）：拟议的项目是一项针对HIV的测试和咨询（T＆C）的多站点研究，旨在调查阻碍或促进不同情况下吸收的因素。 T＆C的吸收是艾滋病毒治疗和预防计划成功的关键，鉴于目前关于从独立的自愿性T＆C转变为综合常规服务的辩论，了解其决定因素尤为重要。这项研究使各四个站点的系统比较在提供T＆C和提供服务的社会环境方面有所不同。分析的第一阶段是为每个站点进行的，并调查了三组被认为会影响测试吸收的因素：用户和非用户对测试和披露的非用户的行为和动机；提供测试和咨询，包括测试是客户或提供者发起的；以及实施与机密性和同意有关的实践。分析的第二阶段包括跨站点的系统比较，以确定与测试的吸收以及客户之间的积极响应相关的程序和环境的特定特征。比较分析中检查的具体问题包括：污名与测试和披露的关联程度；性别对测试和披露的影响；形成与知情同意和机密性有关的情况；这些实践在多大程度上影响客户的反应。该研究基于与健康提供者，测试服务客户以及非用户（尚未经过测试的人）以及研究站点的观察结果的访谈。数据将在卫生机构中收集，包括：独立的HIV测试和咨询设施，为艾滋病毒携带者提供护理的设施，以及提供艾滋病毒测试和咨询的设施，作为提供其他卫生服务的一部分，例如提供产前护理，治疗结核病或进行性传播感染。分析将结合可量化调查数据的统计方法，以及由开放式响应和观察结果产生的文本数据的定性方法。