MSM人群艾滋病高危干预从全球基金到政府购买服务的探索

The initiative process of AIDS high-risk interventions from global funding to governments purchasing services among men who have sex with men

目的总结社会组织参与MSM人群的高危干预的情况,探讨如何通过政府购买服务动员社会组织参与艾滋病防控的方法。方法根据全球基金工作经验,结合当地疫情及具体情况,建立政府购买服务的量化指标,明确服务的质量、标准、规格、费用、违约责任等,与社会组织就MSM人群的高危干预签订政府购买合同,以动员检测人次数和HIV阳性检出率考核评价社会组织参与MSM人群艾滋病高危干预的效果。结果社会组织得到发展壮大,动员检测人数逐年上升,2012年较2011年增长422.95%,社会组织动员MSM人群HIV阳性检出率高于其他病例来源;2012年社会组织动员检测发现感染者来源构成比54.76%,2013年61.36%,成为市中区发现艾滋病感染者的最主要来源。结论建立健全政府购买服务的量化指标,实行绩效管理,是推动社会组织参与艾滋病防控的有效途径。

Objective To summarize the effect of the high-risk intervention among men who have sex with men （MSM）, and explore a initiative process to mobilize Non-government Organizations （NGO） participation in AIDS prevention and control through the government purchasing service. Methods According to the experience of global funding and local epidemic of AIDS, a quantitative indicators frame was designed, including the mobilized MSM number of per month and HIV-positive detection rate, to clarify the service quality, standard, specification, cost, liability for breach of contract. Then a purchase contract was signed with NGO. Results The number of detected individuals by NGO increased year by year. Compared with 2011, the growth rate was 422.95% in 2012, HIV-positive detection ＇rate was significantly higher than others（P 〈 0. 05 ）. HIV-positive cases were found through detection of social mobilization accounting for 54.76 % in 2012 and 61.36% in 2013, which had become the main source of HIV infection in Shizhong district. Conclusions It is crucial to promote the active participation of social bodies in prevention and control of AIDS through improving the quantitative standards of governmental purchasing services and performance management.