医务人员主动提供HIV检测咨询策略的SWOT分析

SWOT Analysis on Strategy of Provider-initiated Testing and Counseling

目的:在分析医务人员主动提供HIV检测咨询(PITC)策略的基础上,提出对策与建议。方法:通过文献分析回顾PITC策略的概念背景与实施情况,运用SWOT分析法研究PITC策略的优势、劣势、机会、威胁。结果:PITC策略可以扩大HIV检测,促进早期诊断,有利于后续治疗服务,具有一定成本效益,同时由于其简化的咨询服务也影响HIV相关知晓、高危行为改变、依从性等干预效果,虽然有PITC指南、公众健康需求、适宜性与可行性研究等外部环境支持,但是其实施仍然受到公众防艾意识、卫生资源短缺、政策法规支持缺乏、伦理学争议等影响。结论:宏观层面制定政策法规,加大卫生投入,完善转诊体系;微观层面加强培训督导,建立考核机制,确保实施质量;开展经济学评估,持续关注伦理问题,完善PITC策略。

Objective： To provide the and suggestions on the basis of analyzing the strategy of Provider - Initiated Testing and Counseling （PITC）. Methods： The background, conception and practice of PITC strategy were studied by literature review, while the strength, weakness, opportunity and threat of PITC strategy were studied with SWOT analysis. Results： PITC strategy, with cost - effectiveness, would scale - up HIV testing, improve HIV early diagnosis and be beneficial for subsequent treatment services, but the intervention effect of HIV knowledge, high risk behavior change, adherence would be influenced attributed to simplified counseling. Though there were supporting of PITC guidelines, public health demand, feasibility and applicability study, PITC strategy were influenced by public AIDS awareness, heath resource shortage, lack of laws and policies support, ethical criticize. Conclusion： To formulate the laws and policies in order to increase health input and improve the referral system in macro level, construct the performance mechanism and strengthen the staff training and supervision to improve the PITC service quality in micro level. The economic evaluation and ethical focus will contribute to the PITC strategy improvemem.