The Survey On The Present Service Situation Of HIV/AIDS Prevention And Control In Grass-roots

Background:At present,Chinese HIV/AIDS epidemic situation is still grim,the disease is not only in high risk groups,but it has spread to the public.The infected populations are more diverse and complicated,and the task of prevention and control is more difficult.It is very important to adopt the strategies and measures for the current situation of HIV/AIDS epidemic in China.The grass-roots medical institutions play an irreplaceable role in HIV/AIDS prevention and control.Our government have pay more attention to grass-roots HIV/AIDS prevention and control,and Introduced related policies to support the work of grass-roots,part of the local grass-roots medical institutions have undertook several service of HIV/AIDS,including antiretroviral therapy for HIV/AIDS,follow-up and management for patients,prevention for high risk population,rapid detection and publicity education.But the work HIV/AIDS prevention and control work in grass-roots medical institutions has not yet formed a perfect system and unified service standard,the HIV/AIDS prevention and treatment mechanism,service contents,standards and requirements are different,it is difficult to make unified supervision appraisal and the control effect evaluation.So the current vital problem to be solved is to establish the mechanism that accord with the situation of our country grass-roots AIDS prevention and treatment and formulate unified grass-roots HIV/AIDS prevention and treatment service specification.Objective:Through the investigations of the present service situation of HIV/AIDS prevention and control in the project areas,to understand obey the situation of grass-roots HIV/AIDS prevention and treatment service,the problems in HIV/AIDS prevention and treatment services,working mechanism,safeguard measures services,and the combination between HIV/AIDS work and other disease,to provide the basis for the draft of HIV/AIDS prevention and control services criterion at the grassroots institutions and the establishment of Chinese HIV/AIDS prevention and control system.Method:Based on the literature review,We gather the data on the grass-roots HIV/AIDS prevention and control in three regions of Hefei,Wuhan and Chengdu,and carry out key important interview,focus group discussion,face-to-face survey for the population who have got service.We used epidata3.2 to input data and construct databases,then SPSS18.0 software was used to analyze.The interview results were analyzed by qualitative analysis and text analysis.Results1.Present service situation of grass-roots HIV/AIDS prevention and control services(1)Antiretroviral therapy The institutions which provide antiretroviral therapy are different in different areas,it provided by the centers for disease in low epidemic areas;and towns and townships/treatment of community health service center provide this service in high epidemic areas,they have established the county and town/community secondary HIV/AIDS treatment system of medical institutions,and designated persons in charge of the work.(2)Follow-up and management for infected/patients Follow-up and management of infected/patients in high prevalence areas is managed by township hospitals / community health service centers in accordance with the relevant regulations.The work including antiretroviral therapy of drug toxicity and opportunistic infections,medication compliance,assessment of treatment and treatment,social support and referral services and other measures.In the low prevalence areas the patients is relatively small,follow-up management is controlled by the disease control.(3)Prevention for high risk population and floating population In addition to Feixi County,high-risk population intervention has been implemented to grass-roots medical institutions and social organizations.Township health centers / community health service centers are mainly responsible for the intervention of sex workers and floating population,the service content of health education,the issue of condoms and promotional materials.While the intervention of drug addicts was carried out by methadone clinics and drug addiction treatment under the coordinated management of CDC.The interventions of gays are mainly conducted by social organizations,and CDC staff regularly visit social organizations to meet the gathering place of gays.(4)Publicity education The publicity education includes public education,youth student education,floating population education.Education of public health and floating population are organized by township hospitals / health centers,community health service centers / stations,unit infirmaries and individual clinics.Grass-roots government organizations such as streets,town governments and residents will also assist medical institutions to carry out the education.The ways of educations are mainly Issuing promotional material,setting up publicity column in the community,broadcasting promotional films and knowledge lectures in the medical institutions.The young students health education is by the CDC,schools and school clinics jointly carried out,HIV/AIDS-related courses are explaining by professional public health physicians in the normal teaching.(5)Detection monitoring Most of the counseling and testing work is carried out by the medical staff of grass-roots medical institutions.If the patients have high risk factors for HIV/AIDS,the informed and non-refusal will be carried out according to the relevant procedures.The CDC is responsible for regular collection of epidemic information.2.The knowledge,attitude and behavior of HIV/AIDS prevention and treatment among different groups of people The awareness rates of community residents and young students were 78.8% and 87.2,respectively;Community residents still have discrimination against HIV/AIDS,and young students have poor knowledge of stds.The awareness of HIV / HIV/AIDS knowledge among the four high-risk groups is different,female sex workers were72.6%,drug addicts were 87.2%,the gays were 82.4%,migrant population were 71.6%,44.8% of them have heard of counseling and testing,56.7% of them have received,and 85.6% of people are willing to use condoms to prevent HIV/AIDS.In respect of condom use in every sexual behavior in the past month female sex workers were 32%,the gays were 35.3%,migrant population were 8.0%.3.Mechanism of organization and management in grass-roots HIV/AIDS prevention and control:In respect of administration management,the Committee of HIV/AIDS Prevention and control was the general guidance,health and family planning commission was actual management,CDC was responsible institution and coordinate all levels of medical institutions.In terms of funding sources,the government funding was increasing,the local government arranged matching funds,the health and Family Planning Commission allocated to medical institutions and CDC in batches.The grass-roots was lack of human resources and their academic and professional titles were poor.4.Combination between HIV/AIDS Prevention and control and basic public health service The survey found that some areas put HIV/AIDS antiretroviral therapy and follow-up and management,prevention of high-risk population,health education into the basic public health service package,and take a unified assessment.Conclusions(1)Grass-roots medical institutions have become the main body in grass-roots HIV/AIDS prevention and control services system,the services of prevention and treatment services including publicity education,treatment and care,behavioral interventions,counseling and testing have been integrated into the diversification of primary health care services.(2)At present,there have formed the mechanism of the various levels of medical institutions working together: the HIV/AIDS Prevention and Control Committee is the general guide,the Health and Family Planning Commission is the actual management,CDC is the specific responsibility.But the source of funding,capacity building and the supervision and evaluation mechanism are still lack of relevant policies in the primary AIDS prevention and treatment services.Therefore,the improvement of grass-roots HIV/AIDS prevention and control system has become a key issue for grassroots HIV/AIDS prevention and control.(3)Antiretroviral therapy and follow-up management for HIV/AIDS,prevention for high risk population,publicity education health education have been put into the basic public health service package,and take a unified assessment method.In some areas,HIV/AIDS prevention work has not been included in basic public health services,but grassroots workers are often engaged in the work at the same time.The effective combination of HIV/AIDS prevention and basic public health service is the foundation and guarantee of the sustainable development of HIV/AIDS prevention and control at the grass-roots.