Chilean Health Care Providers' Perceived Comfort in Performing Oral Rapid Testing for HIV: A Cross-Sectional Study.

OBJECTIVES: To understand key factors influencing Chilean health care providers' perceived comfort performing oral rapid HIV testing. DESIGN: One hundred and fifty health care providers completed a self-administered questionnaire that included a five-item scale measuring self-perceived comfort in conducting HIV pretest counseling, oral rapid testing, finger-prick testing, and delivering test results. RESULTS: Most participants (60%) envisioned good overall comfort performing oral rapid HIV testing (mean score of 16.21; range 0-20), including doing at least four of the five steps. They perceived least comfort delivering HIV-positive test results during posttest counseling. HIV stigmatizing attitudes reduced self-perceived comfort. CONCLUSIONS: Providing training to counter HIV stigmatization while increasing comfort in performing oral rapid testing would help facilitate its successful implementation.

In-Country Migration and Risk Factors for HIV Acquisition among Pregnant Women in Tijuana, Mexico.

OBJECTIVE: To compare HIV prevalence and HIV acquisition risk behaviors between pregnant women residents and migrants. DESIGN: A cross-sectional study of pregnant women of unknown HIV status seeking care at Tijuana General Hospital, Mexico. METHODS: Pregnant women attending the labor and delivery unit or the prenatal clinic had a rapid HIV test drawn, with positive results confirmed by Western blot. Migrants were defined as women who had resided in Tijuana for less than 5 years. RESULTS: Between 2007 and 2008, a total of 3331 pregnant women consented to participate. The HIV seroprevalence did not differ between Tijuana residents (18 of 2502, 0.72%) and migrants (3 of 829, 0.36%, P = .32). In multivariate regression analyses, HIV acquisition risk behaviors included methamphetamine use (adjusted odds ratio [OR]: 6.03, 95% confidence interval [CI]: 2.3-15.8, P < .001) and first presentation at labor (adjusted OR: 5.0, 95% CI: 1.6-15.3, P = .005), adjusted for migrant status, age, and history of sexually transmitted infections. CONCLUSION: The overall HIV seroprevalence was 0.63% and did not differ between Tijuana residents and migrants.

Aconselhamento na testagem anti-HIV no ciclo gravídico-puerperal: o olhar da integralidade / Counseling in HIV testing in the pre and post labor periods: the look of the integrality

A sorologia para HIV em mulheres no pré-natal e os testes rápidos anti-HIV em maternidade devem ser realizados com aconselhamento pré e pós-teste. Na prática, observa-se que esse nem sempre é realizado, predominando o cumprimento de procedimentos técnicos destinados a prevenir a transmissão vertical. O objetivo deste estudo foi analisar o cuidado profissional a mulheres que tomaram conhecimento da positividade para o HIV durante o trabalho de parto ou puerpério. Trata-se de estudo exploratório de natureza qualitativa, utilizando como categorias analíticas gênero e integralidade. Participaram do estudo doze puérperas usuárias de um centro de referência para HIV/aids, em Salvador (BA). Foi recortado para este artigo o olhar das mulheres sobre o aconselhamento no processo de testagem para o HIV. Os resultados foram produzidos a partir de entrevista semiestruturada e analisados pela técnica de análise de discurso segundo Fiorin. A análise revelou que a testagem anti-HIV foi incorporada à prática clínica sem aconselhamento em nenhuma das etapas da atenção ao ciclo gravídico-puerperal, na realidade investigada. As relações entre profissionais e usuárias refletem mecanismos de poder que comprometem a autonomia das mulheres, distanciando o cuidado da perspectiva da integralidade.

The sorology for HIV in woman and rapid HIV testing in maternity hospitals must be carried with pre and pos-test counseling. However, it has been observed that the counseling has not been accomplished by many health professionals, who give more importance to the prophylactic measures which intend to prevent vertical transmission. The objective of this qualitative study is to investigate how women evaluate the health care received during the HIV testing at pre and post-labor periods. For this paper the look of woman about counseling in the process of HIV testing was cut. We used gender and integrality as analytic categories. The technique used to collect data was the semi-structured interview, carried out in women seen at the CTA for diagnostic conclusion. The testing lost its specificity through its inclusion in the clinical practice as a routine without a counseling in any stages of the care during pre and post labor periods. The relationship between users and professionals reflect power mechanisms that compromise the autonomy of women, distancing the care from the perspective of the integrality.