安徽省全球基金艾滋病项目高危人群干预模式调查分析

Assessment of the effect of intervention models supported by the Global Fund AIDS Project among high risk populations in Anhui

目的通过调查暗娼(FSWs)、男男性接触者(MSM)、静脉吸毒者(IDUs)的行为干预模式,评价干预模式的有效性,为下一步制订有效干预模式提供依据。方法采取典型抽样方法抽取调查单位,对2012年安徽省FSWs、MSM、IDUs干预模式进行面对面定性、定量问卷调查。采用方差分析、秩和检验分析评价干预模式有效性,P<0.05为差异有统计学意义。结果在所有干预模式中,人均干预19人,月均计划完成率109.40%。七种干预模式效率分析:疾病预防控制中心(CDC)、社区服务中心和社区(草根)组织效率最高,其次为CDC及同伴教育员、同伴教育员,以及戒毒/监管场所人员和其他(P<0.05)。干预目标贡献率以CDC、社区服务中心和社区(草根)组织为主,分别占30.97%、30.55%和21.11%。86.96%调查对象认为社区卫生服务中心干预FSWs模式、社区(草根)组织干预MSM模式、美沙酮门诊/戒毒所干预IDUs模式可以推广;85.19%调查对象认为目标人群的隐匿性和不配合是干预的主要障碍。结论社区卫生服务中心、社区(草根)组织和美沙酮门诊/戒毒所分别对FSWs、MSM、IDUs的干预模式可行,进一步加大多部门合作和目标人群间的交流是有效策略,全球基金项目的管理模式和资金的持续、足额支持是后续工作的有力保障。

Objective To assess the effect of intervention models among high risk populations as female sex workers（FSWs）,men who have sex with men（MSM）and intravenous drug users（IDUs）. Methods A structured questionnaire survey was conducted for the evaluation of intervention models among FSWs,MSM and IDUs selected by typical sampling method in Anhui in 2012.The effectiveness was evaluated by the analysis of variance and rank-sum test. Results Nineteen high risk individuals were intervened by each person with a monthly rate of fulfillment of 109.40%in all 7models.The effectiveness analysis showed staff in the models of CDC,community service center and community organizations had the highest efficiencies,followed by those of CDC and peer education,methadone clinic or drug treatment and the others（P〈0.05）.The contribution rates of intervention targets for CDC,community service center and community organizations were30.97%,30.55%and 21.11%,respectively.86.96%of individuals surveyed preferred the intervention models of community service center for FSWs,community organizations for MSM and methadone clinic or drug treatment for IDUs.85.19% claimed that the concealment and uncooperation were the major obstacles.Conclusions The intervention models of community service center for FSWs,community organizations for MSM and methadone clinic or drug treatment for IDUs are proved to be effective and feasible.Integrated strategy of multi-section cooperation and communication among targeted populations are critical and need to be further improved.