A Study On AIDS Spending Assessment And Utilization For Men Who Have Sex With Men In Shanghai, Chongqing, Hangzhou

BackgroundMen Who Have Sex with Men(MSM) has become one of the most high risk group in HIV/AIDS control and prevention in China. In order to ensure the effective implementation of the work, the Chinese government actively explored effective prevention and control strategy and constantly increase the funds investment of the group. We encouraged and supported community-based organizations to participate in HIV/AIDS control and prevention for MSM. At present, although resources of HIV/AIDS prevention and control is increasingly and the input is an upward trend, there is lack of science approach using for AIDS funding to comb and calculate and analyze the cost-efficiency in this field. This is not only the premise of HIV/AIDS resources allocation,but also the key content to measure and evaluate. Using a scientific method to calculate the HIV/AIDS spending and provide related expenditure evaluation of MSM has a great significance, which can also provide reliable basis for future policy making.ObjectivesTo calculate and analyze the HIV/AIDS spending of MSM in Shanghai, Chongqing, Hangzhou in 2010-2013, we use national AIDS spending assessment (NASA) to calculate spending from multiple dimensions.Combined with the specific work output, we also analyze the relationship between spending and output, and explore the service efficiency of funds. We analyze the specific spending for different spending organizations in different activities, and focus on the change of the unit cost of HIV positive cases.MethodsAccording to classification system of NASA method and local spending classification, the AIDS expenditure classification system suitable for MSM in Shanghai, Chongqing, Hangzhou’ was built. The questionnaire survey, qualitative methods such as interviews trace the financial data were used to measure the spending in 3 cities in 2010-2013. We use the theory of economics to measure the unit cost of mobilization and HIV case finding among MSM in 3 cities in 2010-2013. Data is given to descriptive statistical analysis, table and chart production use MS excel software.ResultsThe NASA estimations showed that financing resource include financial fund, international cooperation programs, domestic scientific research funds in 3 cities in 2010-2013. During the 4 years, Shanghai city spent a total of 21.529 million RMB,and4.09 million RMB,4.884 million RMB,4.09 million RMB,6.041 million RMB respectively. Chongqing city spent a total of 21.478 million RMB, during the 4 years it cost 3.647 million RMB,4.32 million RMB,6.288 million RMB and 7.223 million RMB respectively. Hangzhou city spent a total of 10.382 million RMB, during the 4 years it cost 1.824 million RMB,2.294 million RMB,3.464 million RMB and 2.799 million RMB respectively. Number and the proportion of financial funds increased. Findings showed that there were 3 main funds management systems in 3 cities in 2010-2013,which were the health bureau systems, CDC systems and Local Preventive Medicine Association. There were 3 main spending organization systems, including CDC systems, health systems and NGO.The actual proportion of expenditures is notably different institutions in different cities in different years. The main activities among MSM AIDS prevention and control include prevention, project management, human resources, scientific research and policy advocacy. Different sources of funds use mechanism and key input field is not exactly the same. The use of different sources of funding agencies key input fields is not exactly the same. financial fund mainly used for all of the above areas; International cooperation programs focus on the field of prevention, treatment and follow-up care areas, project management and human resources; domestic scientific research funds was mainly used for applied research. The unit costs of MSM mobilization was 1085.0,388.3, 664.8,and 390.2 respectively and the unit costs of MSM HIV case finding was 4773.4,3082.4,4896.6,and 3075.7 respectively in Shanghai. The unit costs of MSM mobilization was 162.3,139.6,210.8 and 132.8 respectively and the unit costs of MSM HIV case finding was 1851.4,1496.3,1995.0 and 1232.5 respectively in Chongqing. The unit costs of MSM mobilization was 448.2,342.4,342.9, 183.Orespectively and the unit costs of MSM HIV case finding was 3479.5,2403.6, 3526.4,1792.3 respectively in Hangzhou. In Chongqing, contribution rate for MSM HIV case finding increased year by year for CBOs, which was from 37.5% in 2010 to 50.5% in 2013. And the unit costs of MSM HIV case finding had a downward trend. Which was 3645.6,1674.2,2436.4 and 1880.0 respectivelyConclusionWe use NASA’s method to calculate and evaluate the expenditure of HIV/AIDS prevention and control MSM——a single group. According to different dimensions and classification of the method, we can master the use and flow of the expenditure which can fully exploited advantages of NASA. Financial fund was the main fund source, and different fund sources focus on different activities field. Financial fund focus on antiviral therapy support and related laboratory testing work in the field of HIV treatment and care. International cooperation programs focus on HIV intervention and mobilization in the field of prevention, follow-up care service in in the field of HIV treatment and care, domestic scientific research funds was mainly used for applied research. The spending of the field of HIV treatment and care, which prompt.Financial fund assure increased significantly. The unit costs of MSM mobilization and HIV case finding has the downward trend,which is mean that funds use efficiency enhances increasingly, and The unit costs of HIV case finding show decreasing trend in CBOs, we should strengthen the cooperation with CBOs closely.