The Necessity, Feasibility And Influencing Factors Of Couducting HIV Testing And Counseling In Gynaecological Clinics

BackgroundAs an element of HIV/AIDS prevention and control,HIV testing and counseling plays an important role in stopping the expansion of HIV/AIDS epidemic.A new type of HIV testing and counseling,provider-initiated testing and counseling,has been conducting in many countries because of its positivity,pertinency and convenience to provide clinical treatment.ObjectiveTo explore the necessity,feasibility and associated factors of conducting HIV testing and counseling in gynaecological clinics1.To learn the current basic service condition and the status of HIV testing and counseling in the gynaecological clinics2.To learn the cognition of health facilitiy rulers,gynaecologists and patients of conducting HIV testing and counseling in gynaecoly clinics.3.To identify the influencing factors associated with conducting HIV testing and counseling in gynaecoly clinics.MethodsTwo counties are selected in Guizhou and Jilin province as study sites.Both qualitative and quantitative methodologies were employed in the field investigation. Qualitative methodologies,including observation,referring to associated files and key-person interviews,were used to leam the current basic service condition and the status of HIV testing and counseling in the gynaecological clinics.11 managers and 20 gynaecologists were interviewed to learn the cognition of the HIV/AIDS prevention and control and HIV testing and counseling.Quantitative methodologies used a structured questionnaire designed to obtain information on patients' understanding of HIV/AIDS knowledge,the past testing and counseling history,and the cognation of HIV testing and counseling,and 381 patients were interviewed. Through the combination of both qualitative and quantitative methodologies,the necessity,feasibility and associated factors of comducting HIV testing and counseling in gynaecological clinics were identified.All qualitative data were coded,sorted and conceptualized by different themes. Deductive analysis was then applied based on the descriptive analysis.The quantitative data were inputted into a database established with Epidata 3.0 software, and analyzed through SPSS 13.0 software.Results1.The health facilities conducting toll HIV testing are in the majority;the contents of pre- and post-testing counseling are simple,minority of patients received the testing and counseling services;Most gynaecologists received HIV/AIDS correlative training,but less did normal counseling training;gynaecologists can provide referral services to high-risk patients,however,they are not familiar with the concrete contact information.2.Viewing the weakness of local HIV/AIDS prevention and control,the health facility rulers support to carry out HIV testing and counseling in gynaeclogical clinics;but the services may affected by low acceptability of patients, unaffordable testing fees,inadequate counseling capacity of gynaecologists,lack of clinical guideline and other factors.3.Most gynaecologists are eager to receive HIV/AIDS training,but few of them received HIV counseling training.Though they would like to provide high-risk patients with testing and counseling services,it were hindered by patients' low acceptability,high workload,lack of service time;majority gynaecologists support real-name testing,clearly notification,and supply of security measures. 4.58.0%patients know the HIV/AIDS knowledge,and few of them know the issues related with daily life;65.4%know the HIV testing and counseling spots,and 41.0%select general hospital as the favourite testing and counseling spot.22.6% thought about having a HIV testing,but only 8.7%received the testing,with 90.9%learning the results.89.2%of none-testing thought "it is unnecessary" to receive testing;the major factors influencing the patients' acceptability include the patient's knowledge about HIV/AIDS,the testing fee,and the usage of real-name in testing.Conclusions1.Based on many STIs sufferers are included in the gynaecological clinic patients and the patients' consciousnesses of seeking HIV testing are weak,it's necessary to carry out HIV testing and counseling services in the gynaecological clinic.2.The health facility manager,gynaecologists and patients are willing to provide/receive HIV testing and counseling services,most health facility can provide HIV testing now,so it is feasible to conduct HIV testing and counseling services in the gynaecological clinic through providing training to the gynaecologists and strengthening the monitoring of the service.3.There are many factors influencing conducting HIV testing and counseling services in the gynaecological clinic,such as lack of clinical guideline, gynaecologist's high workload and inadequate counseling capacity,unable to get the same day results,low confidentiality during the attendance,the significant influencing factors are being unaware of the HIV/AIDS knowledge,toll HIV testing,usage of real-name to test.