南宁市基层艾滋病防控工作模式效果评价

Evaluation on the effect of AIDS prevention and control mode at the grassroots in Nanning city

目的了解南宁市基层艾滋病防控工作模式的效果。方法在武鸣区率先通过建立行政+技术两个网格体系,明确工作职责,充分整合优化卫生计生服务资源,共同开展基层艾滋病防控的试点工作,并通过对比试点工作实施前后艾滋病防控工作指标的变化情况,评估防控效果。结果试点地区新报告艾滋病病例数年均下降率为3.85%,有效遏制艾滋病疫情快速增长的势头。暗娼人群的干预覆盖率、HIV检测率和坚持使用安全套的比例分别由试点实施前的74.85%、71.86%和90.82%提高到试点实施后的94.52%、94.52%和96.08%,均呈现逐年上升的趋势(P值均<0.01),差异均有统计学意义(P值均<0.01);存活艾滋病病例的随访CD4检测率及其配偶HIV检测率均始终保持在较高水平(≥85.00%);抗病毒治疗比例由试点实施前的78.93%提高到试点实施后的98.68%,也呈现逐年升高趋势(P <0.001),差异有统计学意义(P <0.001)。农村居民、城镇居民、校外青少年、校内青少年、流动人口、暗娼人群、HIV/AIDS病例等人群的艾滋病知识知晓率始终保持在85.00%以上。HIV检测人数逐年增加,阳性检出率呈平稳态势。结论南宁市基层艾滋病综合防控试点工作模式可以提高艾滋病防控工作管理指标,有效遏制了艾滋病疫情快速增长的势头,值得进一步推广。

Objective To understand the effect of AIDS prevention and control mode at the grassroots in Nanning city.Methods Two grid systems taking the lead, administration and technology were established in Wuming district, clarifying work responsibilities, fully integrating and optimizing health and family planning service resources, and jointly carrying out the pilot work on of AIDS prevention at grassroots. By comparing the changes of AIDS prevention and control indicators before and after pilot implementation, the prevention and control effect was evaluated.Results The number of newly reported AIDS cases in the pilot areas decreased by 3.85% annually, which the rapid growth of the AIDS epidemic was effectively controlled. The intervention coverage rate, HIV detection rate, and condom use rate of female sex workers increased from 74.85%, 71.86%, and 90.82% before pilot implementation to 94.52%, 94.52%, and 96.08% after pilot implementation, showing increasing trends year by year(P<0.01), and the differences were statistically significant(P<0.01).The follow-up CD4 testing rate of surviving AIDS cases and their spouses HIV testing rates remained at high levels(≥85%). The proportion of antiviral treatment increased from 78.93% before pilot implementation to 98.68% after pilot implementation, showing an increasing trend year by year(P<0.001), and the difference was also statistically significant(P<0.001). The awareness rate of AIDS knowledge among rural residents, urban residents, teenagers outside school, teenagers inside school, floating population, female sex workers, AIDS patients, and other groups had always been maintained at≥85%. The number of people tested for HIV was increased year by year, and the positive detection rate showed a stable trend.Conclusion The pilot work mode of comprehensive prevention and control of AIDS at grassroots in Nanning can improve the management index of AIDS prevention and control, which effectively controls the rapid growth of AIDS epidemic, and is worthy of further promotion.