新疆基层综合医院医务人员提供艾滋病检测咨询试点工作分析

The pilot of provider-initiated HIV testing and counseling(PITC)in grassroots general hospitals of Xinjiang

目的探索新疆基层综合医院医务人员开展主动提供HIV检测咨询(PITC)的适宜模式。方法 2013年在新疆5个县的8家县级综合医院、40家乡镇/场医院开展PITC试点,收集数据进行分析。结果县级医院各门诊医务人员HIV推荐检测率、就诊者接受HIV检测率均高于乡镇级医院;乡镇级医院住院部医务人员HIV推荐检测率、就诊者接受HIV检测率高于县级医院。无论是HIV高流行区还是中低流行区,皮肤性病科、泌尿科、肛肠科、传染科、感染科等重点科室,HIV检测阳性率(2.04%)均高于其他科室(P<0.01)。结论基层医院开展PITC工作需要政策的支持,开展医务人员的培训,加强各环节的衔接。在HIV高流行区,综合医院的所有科室开展PITC都是有效的,而在中低流行区,可以选择在一些重点科室开展PITC工作。

Objective To assess the suitability of PITC in grassroots general hospitals in Xinjiang. Methods Eight county-level general hospitals and 40 township-level hospitals were selected as pilot units in Xinjiang to imple- ment PITC. Data from 2013 were collected and analyzed. Results Rates of HIV testing recommended by providers and rate of HIV testing accepted by country-level hospital outpatients were higher than those of township level hos- pital outpatients. Rate of HIV testing recommended by providers and rate of HIV testing accepted by inpatients in township-level hospitals were higher than those of in country-level hospitals （P〈0.05）. Regardless of the local HIV prevalence, HIV positive rates in key outpatient departments （including dermatology/STD, urology, anorec- tal, infectious disease and infection departments） were higher than those in other departments （P〈0.01）. Conclu- sions To implement PITC, it needs policy support, medical staff training and linkage of different departments and agencies. In high HIV prevalence areas, PITC can be implemented in all hospital departments. In low prevalence ar- eas, however, it is recommended to carry out PITC in key departments of the hospital.