河南省基于农村社区的艾滋病综合防治模式探讨

Study on community-based integrated AIDS prevention and treatment model in rural areas of Henan province

目的探索河南省以社区为依托的艾滋病(AIDS)综合防治(艾防)模式,为制定艾防工作提供科学依据。方法依据并完善现有的县-乡-村医疗卫生体系,科学地开展艾滋病病毒(HIV)感染者管理、患者追踪、实验室检测、母婴阻断、高危干预、健康教育和医疗救治。结果截至2008年底,河南省艾滋病病死率下降至4.57%,母婴传播率降为4.16%,单阳性配偶阳转率为1.13/100人年,病人治疗12个月后仍坚持治疗的比例达到85.2%,大众人群艾滋病防治知识知晓率为82.3%,暗娼中艾滋病预防服务覆盖率为96.98%,娱乐场所暗娼在最近一次商业性性行为时使用安全套的比例为89.54%,暗娼中能够正确识别艾滋病经性传播的途径并摒弃艾滋病传播主要错误观点的比例达81.17%,HIV感染者和AIDS病人(HIV/AIDS病人)安全套坚持使用率达92.57%。结论河南省基于农村社区的艾滋病综合防治模式效果显著,建议在HIV/AIDS病人相对较为集中的地区推广应用。

Objective To summarize the practice of AIDS prevention and treatment in rural areas of Henan province and to explore a community-based integrated AIDS prevention and treatment model.Methods In the context of the existing 3 tier（county-township-village）rural health care systems,several approaches were adopted including scientific management of HIV-infected persons,patient tracking,laboratory testing,maternal-to-child transmission block,high-risk intervention,health education and medical treatment.Results By the end of 2008,AIDS mortality rate dropped to 4.57 %,the rate of mother-to-child transmission reduced to 4.16%,and the sero-conversion rate among HIV positive single spouses was 1.13/100 person per year;the proportion of persons who continued to receive medical care after 12 month therapy was 85.2%;the rate of HIV related knowledge among the public was 82.3%;the coverage of HIV preventive service among CSWs was as high as 96.98%;the rate of condom use among institution-based CSWs in the last sex trade was 89.54%;the proportion of CSWs who had correct understanding of sex route of HIV transmission was 81.17%,and the rate of persistent use of condom among HIV infected persons and AIDS patients reached 92.57%.Conclusion The community-based integrated AIDS prevention and control model in rural areas of Henan province has achieved remarkable outcomes and it is suggested that such a model should be employed in areas where HIV/AIDS is relatively prevalent.