运用SEX2．0模型分析云南德宏州暗娼人群干预的成本效果

Cost-effectiveness of female sex worker interventions by using SEX 2. 0 Tool in Dehong prefecture, Yunnan province

目的了解德宏州暗娼人群干预的成本及其效果，并对其进行成本效果分析，为今后合理配置暗娼人群干预资源提供依据。方法对德宏州2005-2007年暗娼人群干预经费使用情况进行问卷调查并收集德宏州2004年基线调查、暗娼哨点监测、2007年经性途径传播现场调查等相关资料，干预效果分析采用联合国艾滋病规划署（UNAIDS）推荐的SEX2．0模型计算，成本效果比为总成本／干预所避免的人类免疫缺陷病毒（HIV）感染者人数。结果2005-2007年全州用于暗娼干预的经费累计支出91．64万元，3年共有效干预暗娼3297名，平均每干预1名暗娼的实际单位成本为277．9元。在完成全部暗娼干预要求的工作内容情况下，暗娼干预的预算单位成本为500．5元。2005-2007年因采取暗娼人群干预措施共避免了69名暗娟感染HIV。暗娼人群干预的成本效果比为13282元。结论德宏州开展的暗娼人群干预具有良好的成本效果。

Objective To perform cost-effectiveness analysis of interventions in female sex workers in Dehong prefecture in China, with an aim of providing evidence for rational resource allocation in female sex worker interventions in the future. Methods The data of expenses for female sex worker interventions in Dehong from 2005--2007 were obtained through questionnaire survey. Meanwhile, the data from baseline survey in 2004, from surveillance of female sex workers from 2005 through 2007 as well as from the special survey on sexual transmission in 2007 were collected. Intervention effectiveness was estimated by using SEX 2. 0 Tool recommended by UNAIDS. The cost-effectiveness ratio is calculated as the total cost divided by the number of estimated non-HIV patients due to these interventions. Results The total cost for female sex worker interventions is 916 400 RMB from 2005 through 2007, and a total of 3297 female sex workers were effectively intervened in these three years. Thus, the actual intervention cost for each female sex worker （ unit cost） is 277.9 RMB. If all the intervention work is performed as required, the predicted unit cost for female sex worker intervention would be 500. 5 RMB. During the period of 2005 through 2007,69 female sex workers had been successfully prevented from HIV infection; therefore, the cost-effectiveness ratio is 13 282 RMB. Conclusion Intervention among female sex workers is highly cost-effective.