CAJ | 학술논문

目的分析社区卫生服务中心参与艾滋病防治服务的可行性.方法 2011年11月至2012年12月,收集中盖艾滋病项目在北京等8个城市的42个基层社区卫生服务中心进行HIV阳性发现和病例管理试点的数据,同时采用自行编制的问卷对接受社区HIV检测服务的意愿进行调查,综合分析实施社区HIV检测服务的可行性.结果 2011年11月至2012年12月期间,社区卫生服务中心与社区组织合作,共为男男性行为人群开展HIV检测6 729人次,新发现阳性者235例.42家参与项目的社区卫生服务中心中有40家已经开展HIV快速检测服务.检测对象来源广泛,重点科室高危行为就诊者的HIV筛查阳性检出率为0.66％ (38/5 769),明显高于通过常规外展干预的高危人群检出率(0.41％,15/3623)及体检人群检出率(0.31％,20/6 532).HIV初筛阳性检出率为0.4％(96/23 609),明显高于常规医疗机构检出率(0.1％,11 870/9 644 944).HIV确证检测阳性比例为73.7％(56/76),略低于常规项目(80.1％,8 038/10 039).社区管理的感染者接受随访和CD4+T淋巴细胞检测比例分别为100.0％(1 046/1 046)和99.1％(1 037/1 046).从费用上看,项目平均检测1名人员的费用为6.1元,发现1例HIV阳性者的成本平均为2 727.3元.在调查的361名服务提供者中,愿意从事或支持本社区艾滋病防治工作的比例分别为68.1％(246名)、91.4％(330名);在调查的755名服务对象(重点科室就诊人员、男男性行为人群和社区高危人群)中,愿意接受社区免费HIV检测的比例分别为77.3％(348名)、73.9％(173名)和78.1％(57名).结论社区卫生服务中心HIV阳性发现率较高,成本较低,病例随访和管理质量较好,多数服务提供者和服务对象支持和认可社区HIV服务,初步认为社区HIV服务具有可行性.
목적 분석사구위생복무중심삼여애자병방치복무적가행성.방법 2011년11월지2012년12월,수집중개애자병항목재북경등8개성시적42개기층사구위생복무중심진행HIV양성발현화병례관리시점적수거,동시채용자행편제적문권대접수사구HIV검측복무적의원진행조사,종합분석실시사구HIV검측복무적가행성.결과 2011년11월지2012년12월기간,사구위생복무중심여사구조직합작,공위남남성행위인군개전HIV검측6 729인차,신발현양성자235례.42가삼여항목적사구위생복무중심중유40가이경개전HIV쾌속검측복무.검측대상래원엄범,중점과실고위행위취진자적HIV사사양성검출솔위0.66％ (38/5 769),명현고우통과상규외전간예적고위인군검출솔(0.41％,15/3623)급체검인군검출솔(0.31％,20/6 532).HIV초사양성검출솔위0.4％(96/23 609),명현고우상규의료궤구검출솔(0.1％,11 870/9 644 944).HIV학증검측양성비례위73.7％(56/76),략저우상규항목(80.1％,8 038/10 039).사구관리적감염자접수수방화CD4+T림파세포검측비례분별위100.0％(1 046/1 046)화99.1％(1 037/1 046).종비용상간,항목평균검측1명인원적비용위6.1원,발현1례HIV양성자적성본평균위2 727.3원.재조사적361명복무제공자중,원의종사혹지지본사구애자병방치공작적비례분별위68.1％(246명)、91.4％(330명);재조사적755명복무대상(중점과실취진인원、남남성행위인군화사구고위인군)중,원의접수사구면비HIV검측적비례분별위77.3％(348명)、73.9％(173명)화78.1％(57명).결론 사구위생복무중심HIV양성발현솔교고,성본교저,병례수방화관리질량교호,다수복무제공자화복무대상지지화인가사구HIV복무,초보인위사구HIV복무구유가행성.
Objective To explore and analyze the feasibility of Community Health Service Center (CHSC)-based HIV prevention and intervention in China.Methods Data on case finding and case management indexes were collected from 42 CHSCs in 8 cities from November,2011 to December,2012,and complemented by questionnaires to investigate the willingness to accept community-based HIV services among health care providers and the service targets.Results During November,2011 and December,2012,6 729 person-times HIV tests were carried out among MSM in the cooperation between CHSCs and CBOs,and 235 HIV positives were found.A total of 40 CHSCs among 42 have conducted HIV rapid tests.The sample sources were broad and the HIV screening positive detection rate from high-risk populations in key divisions of CHSCs 0.66％ (38/5 769) was higher than that in outreach high-risk populations 0.41％ (15/3 623) and people receiving physical check 0.31％ (20/6 532).HIV positive detection rate in CHSCs was higher 0.4％ (96/23 609) than that in conventional medical institutions 0.1％ (11 870/9 644 944) and newly found positives among the confirmed positives was a little lower 73.7％ (56/76) than conventional programs 80.1％ (8 038/10 039).The case follow-up and CD4+ T cell testing rates in CHSCs were 100.0％(1 046/1 046) and 99.1％ (1 037/1 046),respectively.The testing cost was 6.1 RMB per person on average,and the cost of 1 case found positive was 2 727.3 RMB on average.Among 361 service providers,68.1％ (246)and 91.4％ (330) service providers were willing to be involved in AIDS response and support HIV service in local CHSCs.Among 755 service targets including people who seek health care in key divisions of CHSCs,MSM,and high-risk populations in local communities,77.3％ (348),73.9％ (173) and 78.1％ (57) were willing to accept free HIV tests in local CHSCs.Conclusion The effect of case finding and case management in CHSCs was good and the cost of conducting HIV tests and finding new cases were relatively low,meanwhile,most of the service provides in CHSCs and service targets support HIV service in local CHSCs.The future CHSC-based HIV prevention and intervention was feasible.