社区组织对男男性行为人群HIV抗体检测的促进作用

The impact of community-based organizations in HIV testing mobilization among men who have sex with men

目的分析社区组织对男男性行为人群（MSM）HIV检测及对感染者发现的促进作用。方法自2008年7月至2011年12月，收集全国范围内15个调查地区与社区组织合作开展MSMHIV检测的结果，并与调查地区疫情报告数据进行比较，展示社区组织对MSMHIV感染者发现的促进作用。同时分析MSMHIV筛查后结果告知、确认检测、随访及CD4细胞检测情况，并与调查地区医疗机构来源的感染者进行比较，展示社区组织的参与对HIV筛查后相关服务接受情况的作用。结果调查地区与社区组织合作共动员196075人次MSM接受HIV检测，累计新发现MSMHIV阳性者7704例，占调查地区累计报告MSM感染者人数的51．7％（7704／14914）。社区组织动员新发现的MSM感染者人数占调查地区当年所有新报告MSM感染者人数的比例由2008年的35．4％（609／1722）上升至2010年的63．7％（2371／3722），2011年为58．3％（3024／5189）。社区组织动员所发现的感染者接受筛查结果告知、随访与CD4细胞检测比例[分别为97．3％（4441／4563）、84．6％（2559／3024）、66．1％（1999／3024）]均高于经医疗机构途径发现的感染者[分别为92．8％（13140／14153）、79．8％（5589／7002）、52．9％（3705／7002）]，初筛阳性者接受确认检测比例[78．6％（3588／4563）]低于医疗机构[85．6％（12115／14153）]。结论社区组织能够促进MSMHIV感染者的发现，其所动员发现的MSM感染者已成为项目地区MSM感染者发现的主要来源。

Objective To analyze the impact of efforts of community-based organizations （CBO） in HIV testing mobilization and case finding among men who have sex with men（MSM）. Methods Results of HIV testing mobilization among MSM through CBOs in 15 program areas were collected and compared with corresponding HIV case reporting data to demonstrate the contribution of CBO-bascd HIV testing in HIV case finding among MSM from July 2008 to December 2011. Meanwhile, the proportion of screened HIV positives who received testing results notification, confirmatory test, following up and CD4 cell tests were analyzed and compared with those identified in medical institutions. Results A total of 196 075 HIV tests were performed for MSM, as a result of mobilization efforts of CBOs. Cumulatively 7704 new HIV cases were identified, accounting for 51.7% （7704/14 914 ） of all newly diagnosed HIV cases infected via homosexual sex in the program areas. Among the newly diagnosed MSM HIV infections in the program areas, the proportion of infections detected through the mobilization of CBOs increased from 35.4% （609/1722） in 2008 to 63.7% （2371/3722） in 2010,and 58. 3% （3024/5189） in 2011. Compared with those identified through medical institutions,newly diagnosed MSM infections detected though CBOs testing mobilization have higher rates of receiving screening testing results notification（97.3% （4441/4563） vs 92. 8% （ 13 140/14 153 ） ） , （84. 6% （2559/3024） vs 79. 8% （ 5589/7002 ）） and CD4 cell tests （ 66. 1% （ 1999/3024 ） vs 52. 9% （3705/7002））, and a lower rate of receiving confirmatory test （78.6% （3588/4563） vs 85.6% （ 12 115/14 153） ）. Conclusion CBOs can take their advantages in mobilizing MSM to receive HIV test, and MSM HIV cases detected through CBOs have become the main source of MSM HIV case finding in program areas.