天津深蓝工作组参与MSM扩大HIV检测和治疗一体化服务的效果分析

目的分析＂天津深蓝工作组＂参与扩大艾滋病病毒（HIV）检测和治疗一体化服务的成果,明确社区组织参加艾滋病防治的作用,为政府制定相关政策提供依据。方法对2009-2011年＂天津深蓝工作组＂干预覆盖的男男性行为人群（MSM）参加HIV检测和接受治疗的情况建立数据库,并进行分析。结果 2009-2011年,深蓝工作组共参与检测MSM 9 482人,HIV初筛阳性率为3.17%（301/9 482）;初筛阳性者中接受确证检测的比例为80.73%（243/301）,确证阳性率为86.01%（209/243）。2011年发现的确证阳性者全部进行CD4T淋巴细胞计数检测,CD4T淋巴细胞计数平均为405.35个/μL,其中CD4T淋巴细胞计数〉200个/μL的占77.69%（94/121）,≤50个/μL的比例为5.79%（7/121）。2009-2011年发现的HIV感染者和病人中,CD4T淋巴细胞计数≤350个/μL的114例病人中,接受抗病毒治疗的99人（占86.84%）。结论天津深蓝工作组参与扩大HIV检测和治疗一体化服务工作,具有动员参加HIV检测人数多、初筛阳性者接受确证检测率高、阳性发现率高、确证阳性者CD4T淋巴细胞计数高、符合治疗标准的接受治疗率高等特点。     

中国男同社区小组开展HIV快速检测服务的效果

目的对男男性行为人群（MSM）社区小组开展艾滋病病毒（HIV）快速检测服务的防治工作效果进行调查,为政府购买社区社会组织服务提供依据。方法设计调查问卷,通过电子邮件组向全国各地MSM社区小组发布调查通知,MSM社区小组从电子邮件组下载问卷后填写;对调查定量数据进行描述性分析,对服务流程和经验分享等定性资料进行归纳等定性分析。结果12个社区小组在6—18个月内完成10513人的HIV快速检测,初筛阳性808人,初筛阳性检出率7．7％。初筛阳性者接受确证的比例为88．9％（718／808）,确证阳性者CD4^＋T淋巴细胞检测比例为95．1％（626／658）,符合抗病毒治疗标准者接受治疗的比例为90．3％（130／144）。“同伴”式服务、无歧视、深入的检测前后咨询、隐私信息保密以及后续跟踪服务,是社区小组快检服务取得成效的关键。社区小组快检单位成本各地差异很大,中位数为145元／人次检测。结论男同社区小组开展的HIV快检服务具有显著的效果和突出的优越性,需要加大对社区小组快检服务的支持。     

HIV partner notification: a 2002 Victorian audit

This audit was carried out in August 2003 and examined HIV notification data in Victoria. We aimed to determine the proportion of partners reported as being traced from newly diagnosed HIV individuals, the type of contact tracing used and identify the number of HIV cases newly diagnosed from contact tracing. We compared men who have sex with men (MSM) with all other newly diagnosed HIV individuals in Victoria (non-MSM). Of the 215 newly diagnosed HIV-positive individuals, 49% (n = 105) could potentially carry out contact tracing. There was a difference between MSM and non-MSM in the proportion of contactable partners (44% vs 63% respectively, P = 0.017). MSM less commonly used provider referral than non-MSM (12% vs 53% respectively, P < 0.001) but more commonly used patient referral (41% MSM vs 9% non-MSM, P = 0.001). Of the 13 individuals found to be HIV-positive through contact tracing, nine (69%) were non-MSM.     

Stigma and discrimination experiences of HIV-positive men who have sex with men in Cape Town, South Africa

Since the primary mode of HIV transmission in sub-Saharan Africa is heterosexual, research focusing on the sexual behaviour of men who have sex with men (MSM) is scant. Currently it is unknown how many people living with HIV in South Africa are MSM and there is even less known about the stigmatisation and discrimination of HIV-positive MSM. The current study examined the stigma and discrimination experiences of MSM living with HIV/AIDS in South Africa. Anonymous venue-based surveys were collected from 92 HIV-positive MSM and 330 HIV-positive men who only reported sex with women (MSW). Internalised stigma was high among all HIV-positive men who took part in the survey, with 56% of men reporting that they concealed their HIV status from others. HIV-positive MSM reported experiencing greater social isolation and discrimination resulting from being HIV-positive, including loss of housing or employment due to their HIV status, however these differences were not significant. Mental health interventions, as well as structural changes for protection against discrimination, are needed for HIV-positive South African MSM.     

Cost-utility of HIV Testing Programs Among Men Who Have Sex with Men in the United States

Few groups in the United States (US) are as heavily affected by HIV as men who have sex with men (MSM), yet many MSM remain unaware of their infection. HIV diagnosis is important for decreasing onward transmission and promoting effective treatment for HIV, but the cost-effectiveness of testing programs is not well-established. This study reports on the costs and cost-utility of the MSM Testing Initiative (MTI) to newly diagnose HIV among MSM and link them to medical care. Cost and testing data in 15 US cities from January 2013 to March 2014 were prospectively collected and combined to determine the cost-utility of MTI in each city in terms of the cost per Quality Adjusted Life Years (QALY) saved from payer and societal perspectives. The total venue-based HIV testing costs ranged from $18,759 to $564,284 for nine to fifteen months of MTI implementation. The cost-saving threshold for HIV testing of MSM was $20,645 per new HIV diagnosis. Overall, 27,475 men were tested through venue-based MTI, of whom 807 (3 %) were newly diagnosed with HIV. These new diagnoses were associated with approximately 47 averted HIV infections. The cost per QALY saved by implementation of MTI in each city was negative, indicating that MTI venue-based testing was cost-saving in all cities. The cost-utility of social network and couples testing strategies was, however, dependent on whether the programs newly diagnosed MSM. The cost per new HIV diagnosis varied considerably across cities and was influenced by both the local cost of MSM testing implementation and by the seropositivity rate of those reached by the HIV testing program. While the cost-saving threshold for HIV testing is highly achievable, testing programs must successfully reach undiagnosed HIV-positive individuals in order to be cost-effective. This underscores the need for HIV testing programs which target and engage populations such as MSM who are most likely to have undiagnosed HIV to maximize programmatic benefit and cost-utility.     

Exchange Sex and HIV Infection Among Men Who Have Sex with Men: 20 US Cities, 2011

This study assessed the prevalence of exchanging sex for money or drugs among men who have sex with men (MSM) in the 2011 US National HIV Behavioral Surveillance system. Prevalence of HIV, being HIV-positive but unaware (HIV-positive–unaware), risk behaviors and use of services were compared between MSM who did and did not receive money or drugs from one or more casual male partners in exchange for oral or anal sex in the past 12 months. Among 8411 MSM, 7.0 % exchanged sex. MSM who exchanged sex were more likely to be non-Hispanic black, live in poverty, have injected drugs, have multiple condomless anal sex partners, be HIV-positive and be HIV-positive–unaware. In multivariable analysis, exchange sex was associated with being HIV-positive–unaware (aPR 1.34, 95 % CI 1.05–1.69) after adjusting for race/ethnicity, age, education, poverty, and injecting drugs. MSM who exchange sex represent an important group to reach with HIV prevention, testing, and care services as they were more likely to report behavioral risk factors that put them at risk of HIV.     

Risk Factors for Acute and Early HIV Infection Among Men Who Have Sex With Men (MSM) in San Diego, 2008 to 2014: A Cohort Study

The objectives of this study were to identify risk factors associated with acute and early HIV infection (AEH) among men who have sex with men (MSM) undergoing community HIV testing and to compare demographics in those diagnosed with AEH with those diagnosed at chronic stage of HIV infection.In this retrospective cohort study, we analyzed risk factors associated with AEH among 8925 unique MSM (including 200 with AEH [2.2%] and 219 [2.5%] with newly diagnosed chronic HIV infection) undergoing community-based, confidential AEH screening in San Diego, California.The combination of condomless receptive anal intercourse (CRAI) plus ≥5 male partners, CRAI with an HIV-positive male, CRAI with a person who injects drugs, and prior syphilis diagnosis were significant predictors of AEH in the multivariable Cox regression model. Individuals reporting ≥1 of these 4 risk factors had a hazard ratio of 4.6 for AEH. MSM diagnosed with AEH differed in race (P = 0.005; more reported white race [P = 0.001], less black race [P = 0.030], trend toward less Native American race [P = 0.061]), when compared to those diagnosed with chronic HIV infection, while there was no difference observed regarding age.We established a multivariate model for the predicting risk of AEH infection in a cohort of MSM undergoing community HIV screening, which could be potentially used to discern those in need of further HIV nucleic acid amplification testing for community screening programs that do not test routinely for AEH. In addition, we found that race differed between those diagnosed with AEH and those diagnosed at chronic stage of HIV infection underlining the need for interventions that reduce stigma and promote the uptake of HIV testing for black MSM.     

中盖项目实施对天津地区艾滋病发现与管理的效果评估

目的评估比尔及梅琳达.盖茨基金会资助的艾滋病防治合作项目(简称"中盖项目")的实施,对天津地区艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人(简称HIV/AIDS病人)的发现与管理的效果。方法以天津市2008-2010年的中盖项目数据为基础,通过项目检测男男性行为人群(MSM)HIV/AIDS阳性、梅毒阳性的发现结果、项目实施地区HIV/AIDS病人随访率、CD4检测情况以及CD4细胞均值情况的比较,对项目实施对天津地区HIV/AIDS病人的发现与管理的效果进行评估。结果截至2010年底,中盖项目在MSM人群中累计发现233例HIV/AIDS病人,项目发现的HIV感染者,最高占当年全市发现的HIV感染者人数的30.7%。2009年中盖项目MSM人群中,新发现HIV阳性者的CD4检测率为75%,首次CD4检测均值为491.1个/μL,仅次于性病门诊就诊者;2010年中盖项目MSM人群中,新发现HIV阳性者的CD4检测率为96.84%,首次CD4检测均值为461.5个/μL,仅次于公安、司法、在押人员。结论中盖项目的实施,充分发挥了非政府组织的作用,促进了HIV/AIDS病人的早期发现与管理,对当地疾病控制工作产生了有益的影响。     

南京市2008-2010年不同感染途径和不同报告来源的HIV/AIDS病例的随访率分析

目的分析南京市新发现的艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人(简称HIV/AIDS病人)的不同感染途径和报告来源,对随访管理以及CD4检测的影响。方法收集2008-2010南京市所有报告单位上报的病例及随访资料,对不同感染途径和报告来源的HIV/AIDS病人的随访管理率及CD4检测率进行分析。结果 2008-2010年南京市共报告HIV/AIDS病人955例,随访率呈现上升趋势,CD4检测率总体下降。母婴途径感染者随访率最高(100%),注射吸毒途径感染者随访率最低(71.4%);男男性途径感染者CD4检测率最高(71.3%),注射吸毒途径感染者最低(37.3%)。不同报告来源病例的随访率总体上升,专题调查发现的病例随访率降低;不同报告来源病例的CD4检测率总体下降,但是医院报告病例的CD4检测率上升。结论不同感染途径和病例报告来源对南京市HIV/AIDS病例的随访和CD4检测有不同程度的影响,注射吸毒感染和专题调查发现的病例应成为随访工作的重点,从强化初筛阳性者信息资料的收集入手,提高随访率。     

Testing rates for sexually transmitted infections among HIV-infected men who have sex with men attending two different HIV services

This study compares the testing rates of bacterial sexually transmitted infections (STIs) among HIV-positive men who have sex with men (MSM) attending two HIV clinics in Melbourne. Data on STI testing over a 12-month period were obtained for all HIV-positive MSM who attended the clinics between January and March 2006. Screening rates for bacterial STIs were significantly higher at a sexual health clinic (n = 254) compared with an infectious diseases clinic (n = 351), whether this was measured according to: at least one STI test being performed for chlamydia, gonorrhoea or syphilis (69% vs. 38%, P < 0.01); serological testing for syphilis alone (67% vs. 34%, P < 0.01); or 'complete' STI screening for pharyngeal gonorrhoea, urethral chlamydia, anal gonorrhoea, anal chlamydia and syphilis (41% vs. 6%, P < 0.01). Substantial differences in STI testing rates among HIV-positive MSM may exist between HIV clinical services depending on the measures in place that promote STI screening.     

HIV prevalence among men who have sex with men in New Zealand 1985-2009: 25 years of public health monitoring

Annual population-based estimates of the number of men who have sex with men (MSM) with diagnosed HIV infection (HIV prevalence pool), and the proportion of all MSM this represents (HIV prevalence), have been insufficiently described over the long term. We investigated the dynamic effects of ongoing HIV diagnoses, lower mortality due to treatment and growth in the MSM population over time on these two epidemic indicators using national HIV/AIDS surveillance data in New Zealand, 1985-2009. The diagnosed HIV prevalence pool rose 79% between 1989 and 1999, and 137% between 1999 and 2009. Estimates of diagnosed HIV prevalence as a proportion of MSM were 0.2% of MSM in 1985, and were between 1.5% and 5.0% of MSM by 2009. New Zealand continues to have a relatively low-prevalence HIV epidemic among MSM; however, the number of MSM living with diagnosed infection is growing rapidly 25 years after HIV testing was introduced.     

金华市MSM人群HIV阳性者某些特征分析

目的了解金华市男男性行为人群（MSM）HIV阳性者的疫情及变化趋势,为针对该人群开展的艾滋病防治工作提供依据。方法回顾分析金华市2002-2012年MSM中HIV阳性者的疫情特征,并对自愿咨询与检测（VCT）门诊MSM求询者的资料和2012年MSM哨点的监测资料,采用IBMSPSS11．0软件进行分析。结果2002—2012年共报告MSMHIV感染者261例,占总HIV阳性者数的20．3％（261／1283）;其中20～39岁占81．2％（212／261）;2005-2012年年平均增长率为71．1％。与总的疫情相比,MSM疫情呈现年轻化、以未婚为主、文化程度相对较高、当地户籍所占比较高等特点。同性性伴数中位数为4人。结论相关部门应进一步加大MsM的HIV筛查和阳性者的发现力度,加强对MSM中HIV阳性者的随访管理与阳性干预,减少二代传播,降低新发感染。     

Epidemiologic data on young men of color who have sex with men

Young men of color who have sex with men (YMSM of color) have been disproportionately affected by the HIV/AIDS epidemic in the United States. Between 2001 and 2006, HIV/AIDS diagnoses increased 93.1% among African-American MSM aged 13-24 and 45.8% among Latino MSM aged 13-24. Many multisite studies have yielded valuable information on the behaviors associated with HIV infection in adolescents, MSM, African-Americans, and Latinos. Studies among adolescents found a high prevalence of risky sexual behaviors, including having multiple partners and unprotected intercourse and frequent substance use. Multisite studies of MSM also found frequent reports of alcohol and drug abuse, and one study found that nearly one-half (48%) of HIV-positive MSM were unaware of their infection. Similarly, two multisite studies of YMSM found high rates of unprotected sex, substance use, and HIV-infection among YMSM of color. Recognizing these challenges, the HIV/AIDS Bureau (HAB) of the Health Resources and Services Administration (HRSA) funded the first multisite study to improve engagement, linkage to HIV care, and retention in care for HIV-positive YMSM of color. The objective of this article is to review the epidemiologic data on HIV-positive YMSM of color from surveillance and multisite studies in order to identify the needs of this population and the gaps in the literature.     

Racial/ethnic disparities in delayed HIV diagnosis among men who have sex with men,Florida, 2000–2014

Only about 85% of men who have sex with men (MSM) with human immunodeficiency virus (HIV) have been tested for and diagnosed with HIV. Racial/ethnic disparities in HIV risk and HIV care outcomes exist within MSM. We examined racial/ethnic disparities in delayed HIV diagnosis among MSM. Males aged ≥13 reported to the Florida Enhanced HIV/AIDS Reporting System 2000–2014 with a reported HIV transmission mode of MSM were analyzed. We defined delayed HIV diagnosis as an AIDS diagnosis within three months of the HIV diagnosis. Multilevel logistic regressions were used to estimate adjusted odds ratios (aOR). Of 39,301 MSM, 27% were diagnosed late. After controlling for individual factors, neighborhood socioeconomic status, and rural–urban residence, non-Latino Black MSM had higher odds of delayed diagnosis compared with non-Latino White MSM (aOR 1.15, 95% confidence interval [CI] 1.08–1.23). Foreign birth compared with US birth was a risk factor for Black MSM (aOR 1.27, 95% CI 1.12–1.44), but a protective factor for White MSM (aOR 0.77, 95% CI 0.68–0.87). Rural residence was a risk for Black MSM (aOR 1.79, 95% CI 1.36–2.35) and Latino MSM (aOR 1.87, 95% CI 1.24–2.84), but not for White MSM (aOR 1.26, 95% CI 0.99–1.60). HIV testing barriers particularly affect non-Latino Black MSM. Social and/or structural barriers to testing in rural communities may be significantly contributing to delayed HIV diagnosis among minority MSM.     

Impact of gender on the risk of AIDS-defining illnesses and mortality in Danish HIV-1-infected patients: A nationwide cohort study

Abstract Background: Gender differences in the risk of AIDS-defining illness (ADI) and mortality have been reported in the HIV-1-infected (HIV-positive) population, with conflicting findings. We aimed to assess the impact of gender on the risk of ADI and death in HIV-positive patients infected sexually. Methods: This was a population-based, nationwide cohort study of incident Danish HIV-positive individuals infected by sexual contact. Outcomes were progression to AIDS and death. We used Cox proportional hazards models and Poisson regression analyses to calculate the risk of progression to AIDS and mortality rate ratios (MRR) between risk groups and compared these with the general Danish population. Results: We identified 587 heterosexually infected women, 583 men who have sex with women (MSW), and 1089 men who have sex with men (MSM). The total follow-up time was 13,708 person-y. At the time of HIV diagnosis MSM had a lower prevalence of AIDS compared to MSW. Women and MSW presented more often with tuberculosis and less often with AIDS-defining cancers compared to MSM. In the adjusted analyses we observed no differences in progression to AIDS. In the adjusted analyses of risk of death, there were no differences between the 3 risk groups, although we saw a trend towards a higher risk of death in older MSW. MSM had a lower risk of death compared to the background population than women and MSW. Conclusions: In the Danish HIV population, gender has no major impact on progression to AIDS or mortality. Differences in these factors between women, MSW, and MSM are mainly due to confounding from race and CD4 + cell count at diagnosis.     

天津市2008-2011年MSM人群HIV流行趋势分析

目的了解天津市2008-2011年男男性行为人群(MSM)艾滋病病毒(HIV)的流行趋势,为在该人群中开展相关控制措施提供依据。方法分析2008-2011年天津市监测中新发现的MSM中的HIV/艾滋病(AIDS)病例情况、MSM人群血清学监测的数据以及横断面调查数据。结果新发现HIV/AIDS病例中,MSM病例所占比例最高,2008-2011年病例报告显示的构成比及报告数量增长最快的传播途径是男男性传播。MSM病例中流动人口占53.3%,未婚占61.0%,高中及以上文化程度占69.6%,15～29岁占47.2%。无偿献血及自愿咨询和检测发现的阳性病例中,MSM所占的比例最高。血清学监测结果显示,天津市MSM人群HIV感染率维持在稳定水平。横断面调查结果显示,MSM近6个月发生同性性行为时每次都使用安全套构成的中位数为35.85%,近6个月中最近1次发生同性性行为时安全套使用率中位数为59.55%,近6个月与异性发生性行为比例的中位数为18.05%,梅毒检出的中位数为18.25%,HIV检出的中位数为6.25%。结论 MSM人群为天津市HIV/AIDS感染的主要人群,艾滋病流行趋势严重,危险行为普遍存在,急需采取有效措施控制HIV通过其传播及扩散。     

Using Social Networks to Reach Black MSM for HIV Testing and Linkage to Care

Black men who have sex with men (MSM) are disproportionately affected by HIV infection. Black MSM in San Francisco may have higher rates of unrecognized HIV infections. Increased HIV testing among Black MSM may reduce the numbers of unrecognized infections, inform more men of their status and thus reduce the potential for ongoing transmissions. Social network HIV testing programs have focused on asking HIV-positive and/or high-risk negative men to recruit their social or sexual contacts. We used a network approach to deliver HIV testing to Black MSM in San Francisco and collected risk assessment data. Participants were asked to recruit any of their social contacts who were also Black MSM. Recruitment by risk level and HIV status was heterogeneous. HIV infection among this population is associated with older age, having a high school education or higher and currently being homeless. Fully 23% of HIV positive Black MSM are unaware of their infection. Only a third of unrecognized infections were recruited by a known HIV-positive participant. Linkage to care was a challenge and underscores the need for comprehensive systems and support to link Black MSM to care and treatment.     

Implementation and assessment of a model to increase HIV testing among men who have sex with men and transgender women in Thailand, 2011–2016

HIV testing among men who have sex with men (MSM) and transgender (TG) women remains low in Thailand. The HIV prevention program (PREV) to increase HIV testing and link those who tested HIV-positive to care provided trainings to peer educators to conduct target mapping, identify high risk MSM and TG women through outreach education and offer them rapid HIV testing. Trained hospital staff provided HIV testing and counseling with same-day results at hospitals and mobile clinics and referred HIV-positive participants for care and treatment. We used a standardized HIV pre-test counseling form to collect participant characteristics and analyzed HIV test results using Poisson regression and Wilcoxon rank sum trend tests to determine trends over time. We calculated HIV incidence using data from participants who initially tested HIV-negative and tested at least one more time during the program. Confidence intervals for HIV incidence rates were calculated using the Exact Poisson method.

From September 2011 through August 2016, 5,629 participants had an HIV test; their median age was 24 years, 1,923 (34%) tested at mobile clinics, 5,609 (99.6%) received their test result, and 1,193 (21%) tested HIV positive. The number of people testing increased from 458 in 2012 to 1,832 in 2016 (p?p?p?HIV testing among MSM and TG women increased during the PREV program. HIV incidence remains alarmingly high especially among young participants. There is an urgent need to expand HIV prevention services to MSM and TG women in Thailand.     

The changing demographics of women living with HIV/AIDS in southern Alberta from 1982 to 2006

INTRODUCTION:

Women account for a growing proportion of HIV infections in Canada. This has implications with respect to prevention, diagnosis and treatment.

OBJECTIVE:

To describe the female population presenting for HIV care in southern Alberta and to examine the impact of opt-out pregnancy screening.

METHODS:

A retrospective review of demographic and clinical characteristics of all patients presenting to the Southern Alberta HIV Clinic (SAC) care program from 1982 to 2006, was performed.

RESULTS:

The proportion of newly diagnosed patients who were female increased from 7.5% before 1998 to 21.5% after 1998. Women were more likely to be from vulnerable populations, such as intravenous drug users (31.3% versus 13.7%, P<0.001), aboriginals/Métis (21.5% versus 8.7%, P<0.001), blacks (28.9% versus 4.9%, P<0.001) and immigrants (36.6% versus 14.7%, P<0.001). Heterosexual intercourse was the main risk factor for HIV acquisition (43.7%). Women were less likely than men to have requested HIV testing (20.9% versus 37.8%, P<0.001). Opt-out pregnancy screening accounted for 12.7% of HIV-positive tests in women, following its introduction in 1998. Of the women diagnosed by pregnancy screening, 62.1% were from HIV-endemic countries. There was an association between reason for testing and CD4 count at presentation; women who requested their HIV test had higher median CD4 counts than those diagnosed because of illness (478 cells/mL, interquartile range [IQR]=370 cells/mL versus 174 cells/mL, IQR=328 cells/mL, P<0.001) or pregnancy screening (478 cells/mL, IQR=370 cells/mL versus 271 cells/mL, IQR=256 cells/mL, P=0.001).

CONCLUSIONS:

Women were less likely than men to have requested HIV testing and were more likely to be diagnosed by population-based screening methods. Women, especially vulnerable groups, account for a growing number and proportion of newly diagnosed HIV infections in Alberta. The implications of expanded screening in this population merit further consideration.     

男性性病诊疗服务体系的完善及规范化服务

目的通过完善男男性行为人群（MSM）的性病诊疗服务体系,促进男性性病诊疗服务的规范化。方法完善MSM的性病转介体系和性病服务内容,形成性病、艾滋病检测阳性者的服务机构、组织之间的顺畅转介关系,开展医务人员主动提供艾滋病病毒（HIV）检测咨询（PITC）促进。对服务日志进行统计并分析。结果自2011年4月至10月15日期间,MSM社区组织向性病门诊转介疑似性病患者156例;HIV感染者组织转介的性病患者诊治17例;性病门诊求诊者中453人接受了PITC服务,完成转介初筛HIV阳性25例。性病转介诊疗服务满意度和HIV阳性转介咨询服务满意度均很高。结论社区组织和医疗机构的合作是促进规范化性病服务的重要策略,医疗机构与成熟的社区组织开展进一步实质性合作可以促进服务质量提高。