2016—2021年甘肃省社会组织参与艾滋病防治基金项目分析

Evaluation of projects supported by China AIDS Fund for Nongovernmental Organizations in Gansu in 2016—2021

目的 分析2016—2021年甘肃省社会组织参与艾滋病防治基金(China AIDS Fund for Nongovernmental Organizations,CAFNGO)项目的总体情况,为更好地开展社会组织艾滋病防治工作提供参考。方法 提取CAFNGO管理系统数据,分析2016—2021年CAFNGO项目相关指标随时间变化趋势。结果 2016—2021年甘肃省CAFNGO项目159个,市(州)覆盖率为85.71%,经费为586.78万元,干预197 973人次,新发阳性365例,完成两次随访关怀5 121人。2016—2021年甘肃省男男同性性行为人群(men who have sex with men, MSM)项目首次接受人类免疫缺陷病毒(human immunodeficiency virus,HIV)检测比、初筛阳性率、新发阳性率分别下降0.034、 1.17%、 1.22%(χ^(2)_(趋势)=44.274、 18.684、22.637, P<0.01);接受确证检测比例先增加后减少(χ^(2)_(趋势)=5.911, P=0.015);转介治疗比例上升20.21%(χ^(2)_(趋势)=6.397,P=0.011);女性性工作者项目接受HIV抗体检测比上升0.014 (χ^(2)_(趋势)=7.678,P=0.006),吸毒人群项目逐年递减(χ^(2)_(趋势)=4.154,P=0.042);HIV感染者/艾滋病患者随访管理和关怀救助的病毒载量检测比例下降10.73%(χ^(2)_(趋势)=91.132,P<0.01),抗病毒治疗比例、治疗成功比例、配偶检测比例的差异无统计学意义。结论 2016—2021年甘肃省CAFNGO干预效果明显,干预人群中新发阳性率下降,转介治疗比例上升,抗病毒治疗比例长期维持在较高水平。但接受确证检测、病毒载量检测的工作还存在不足,建议社会组织应在传统干预工作模式外积极尝试新型干预手段,增进与专业机构的合作,实现防治工作有效衔接。

Objective To analyze the overall situation of projects supported by China AIDS Fund for Nongovernmental Organizations(CAFNGO) in Gansu province from 2016 to 2021, so as to provide reference for better implementation of AIDS prevention and control by community-based organizations(CBOs). Methods Data from the project management information system of CAFNGO were extracted, and the time trends of indicators of projects between 2016 and 2021 were analyzed. Results From 2016 to 2021, CBOs in Gansu implemented 159 CAFNGO projects, covering 85. 71% of the cities and prefectures in this province, received a total funding of 5. 867 8 million RMB, having provided interventions for 197 973 person-times, detected 365 new positive cases, and provided twofollow-up care for 5 121 people. Among the men how have sex with men(MSM) in Gansu in 2016—2021, the ratio of receiving the first human immunodeficiency virus(HIV) test, the detection rate of initial screening, and the incidence of new positive cases decreased by 0. 034, 1. 17%, and 1. 22%, respectively(χ^(2)_(trend)=44. 274, 18. 684,22. 637, all P<0. 01);the proportion of receiving confirmatory testing first increased and then decreased(χ^(2)_(trend)=5. 911, P=0. 015);the proportion of referral for treatment increased by 20. 21%(χ^(2)_(trend)=6. 397, P=0. 011). The ratio receiving HIV antibody test in the female sex workers(FSW) programs increased by 0. 014(χ^(2)_(trend)=7. 678, P=0. 006), but decreased year by year in the drug users(DU) programs(χ^(2)_(trend)=4. 154, P=0. 042). The proportion of people receiving viral load test in the follow-up management, care and assistance programs for people living with HIV(PLWH) dropped by 10. 73%(χ^(2)_(trend)=91. 132, P<0. 01), and there were no significant differences in the proportions receiving anti-retroviral therapy, achieving treatment success, and having their spouse tested. Conclusions From 2016 to 2021, the CAFNGO-funded intervention projects in Gansu had obvious effect, illustrated by the decreased rate of new positive cases in the intervention population, the increased proportion of referral for treatment, and the constant high proportion of people receiving anti-retroviral treatment over a long time. However, there are deficiencies in the interventions promoting confirmation tests and viral load tests. CBOs should actively try novel intervention methods supplemental to the traditional intervention mode. In addition, they should enhance cooperation with professional institutions to achieve effective connection between prevention and control.