| BackgroundThe characteristics of the epidemic in China is:The epidemic continues to expand, but the rate is slowing; sexual transmission is now the major mode of HIV transmission; geographic distribution is heterogeneous; and the epidemic continues to be driven by high-risk behaviour within particular sub-populations. Researches and practices have shown that community health service sector is playing an active role in HIV/AIDS prevention and control, and it providers a well-functioned platform for HIV/AIDS prevention in the community. In China, the Community Health Service Centre (CHS) is a provider of primary health services in the community, carrying out health education, disease prevention, health care, rehabilitation, family planning services, diagnosis and treatment of general common and frequently-occurring diseases. In some areas of China, CHSs has begun to implement the HIV/AIDS prevention based on the local characteristics. However, the CHSs are still at an exploratory stage to conduct HIV/AIDS prevention which varies in different CHSs and regions. Few related researches has conducted in this field, therefore, A survey is conducted to well understand the mode of HIV/AIDS-related intervention for female sex workers in community health service centres.ObjectiveTo understand the current situation of the HIV/AIDS behavioral intervention for female sex workers in community health service centres in Shanghai, and elucidate the strengths, weaknesses, opportunities, and threats (SWOT) of behavioral intervention.MethodsQualitative and quantitative survey were carried out among female sex workers, service providers and service perspectives in 9 districts of Shanghai by using SWOT analysis method as the analysis framwork. Quantitative data was managed by EpiData3.1, and analyzed by SPSS 13.0. Qualitative data was managed and analyzed by Nvivo8.0 with the main body frame law.Results1. A total number of 360 sex workers,78 community health centers staff were investigated, a questionnaire was used to collect needed information. Heads or department heads of the local health administrative departments, sub-district office, CDC and community health service sectors from 9 directions were interviewed.2. A community health system and a three-level network (city, district and town) on HIV/AIDS-relatied services have been establish in Shanghai. With the technical guidance of CDC and multi-sectoral cooperation, CHSs has set up high risk intervention teams to implement the HIV/AIDS-related intervention for female sex workers.3. There were 6 persons in average in each CHSs involved in HIV/AIDS prevention and control. Among them,43.59% were below 35 years old,61.54% were College degree or above, and 57.69% were with the major of public health. The rate of staff's HIV awareness reached 93.59%, and 96.15% have got HIV/AIDS-related training; 50% had positive attitude towards people living with HIV/AIDS. The job adaptability rate was 60.26%, and the people who were willing to engage in HIV/AIDS-related work for a long time accounted for 51.28%.4. The HIV/AIDS-related interventions for female sex workers provided by CHSs covered: FSWs information collection, outreach service (including health education, condom promotion, peer education, STD referral), peer training, intervention during medical treatment. In 2008 by one CHS outreach health education was carried out 60 times in average, with peer education 21 times,4134 condom and 411 health education materials distributed.5. There were 76.11% FSWs received HIV/AIDS behavioral intervention services provided by CHSs.29.17% FSWs has been to the CSHs to seek heailth care over the last year, in which 64.76% received health education while seeing the doctor.6.81.16% of the FSWs surveyed were satisfied with the service, and the rate of HIV/AIDS awareness was 82.22%. 7. The factors that affected the AIDS behavioral intervention was as followed:the HIV/AIDS awareness of leaders, budget, human resources, multi-sectoral cooperation, social attitudes, working mechanism, etc.8. Compared with CDC, the strengths, weaknesses, opportunities, and threats (SWOT) of CHSs in behavioral intervention for female sex workers was as followed:the aspects of strengths in CHS included service network, service accessibility, integration of clinical services, and integration of community resources; the aspects of weaknesses included leadership awareness, budget, professional qualification, and personnel stability; the aspects of opportunities included government support of community health services, acceptance from service users; the aspects of threats included multi-sectoral cooperation, hidden behavior and high mobility of FSWs, public awareness and discrimination.ConclusionsA community health system and a three-level network (city, district and town) on HIV/AIDS-relatied services have been establish in Shanghai. With the technical guidance of CDC and multi-sectoral cooperation, CHSs has set up high risk intervention teams to implement the HIV/AIDS-related intervention for female sex workers.The factors that affected the AIDS behavioral intervention was as followed:the HIV/AIDS awareness of leaders, budget, human resources, multi-sectoral cooperation, social attitudes, working mechanism, etc. Compared with CDC, the strengths, weaknesses, opportunities, and threats (SWOT) of CHSs in behavioral intervention for female sex workers was as followed:the aspects of strengths in CHS included service network, service accessibility, integration of clinical services, and integration of community resources; the aspects of weaknesses included leadership awareness, budget, professional qualification, and personnel stability; the aspects of opportunities included government support of community health services, acceptance from service users; the aspects of threats included multi-sectoral cooperation, hidden behavior and high mobility of FSWs, public awareness and discrimination.The coverage and intensity of intervention service of CHS in Shanghai is guaranteed with internal resources and external development opportunities because of the accessibility and feasibility of the service.In order to improve the HIV/AIDS-related intervention for female sex workers in CHS, the strengths and opportunities should be exploited and made full use of to overcome the weaknesses and threats.
|
PDF Full Text Request