基层医疗卫生机构开展艾滋病防控工作的模式和效果分析

A Pilot Study on Strategy and Effect Analysis of AIDS Prevention and Control in Primary Health Care Institutions

目的分析不同类型基层医疗卫生机构开展艾滋病防控工作的效果和可行性。方法对相关人员进行定量和定性调查。结果社区卫生服务机构的模式扩大了干预覆盖面,目标人群对此"满意"的占81.3%,"不满意"的仅占0.7%;乡镇卫生院和村卫生室的模式提高了外出务工人员的艾滋病知识知晓率,由试点前的54.2%提高到试点后的94.4%,发生商业性行为的比例由36.8%下降至21.6%,安全套使用比例由67.7%提高到81.6%;劳动场所医务室的模式提高了务工人员的知识知晓率,扩大了干预覆盖面,目标人群的知识知晓率由68.3%提高到89.6%,没接受过防艾宣传的比例由66.9%下降到2.8%,接受过安全套的比例由5.8%上升到45.6%。结论不同类型基层医疗卫生机构开展艾滋病防控工作的模式具有明显效果,同时,在经费、人员培训和督导考核等保障机制方面需要创新。

OBJECTIVE To summarize and analyze the effect and feasibility of different types of primary health care institutions to carry out AIDS prevention and control strategy. METHODS Questionnaire survey and qualitative interviews were conducted among work staffs and service objects. RESULTS The community-based AIDS prevention and control mode expanded service coverage. The satisfaction of target population towards this mode was 81.3%, while the dissatisfaction rate was only 0.7%. The strategy carried out by township hospitals and village clinics improved the subjects＇ AIDS knowledge. Among those migrant workers after the pilot, correct answer rate of AIDS knowledge increased from 54.2% to 94.4%, the proportion of having commercial sex decreased from 36.8% to 21.6%, the proportion of condom use increased from 67.7% to 81.6%. The strategy based on mproving the migrant workers＇ AIDS knowledge, expanded the intervention coverage. Under this strategy, the correct AIDS knowledge increased from 68.3% to 89.6%, the proportion of people who had not received the AIDS knowledge education decreased from 66.9% to 2.8%, and the proportion of who had received condoms increased from 5.8% to 45.6%. CONCLUSION The three types of community-based AIDS prevention and control strategy are all effective and practicable. It is necessary to make innovations in the fields of funding, staff training, supervision and assessment.