针对3类艾滋病高危人群的健康传播方式研究

目的探索艾滋病高危人群健康传播的有效途径，提高健康传播的效果。方法问卷调查和个人访谈相结合，采用方便抽样的方法调查了203名暗娼和154名吸毒人群，采用整群抽样的方法调查了178名既往有偿献血人群。结果暗娼希望从医生处获得更多的艾滋病防治知识，吸毒人群希望从艾滋病防治人员处获得更多的艾滋病知识，既往有偿献血者希望通过文艺节目获得艾滋病知识。结论要想提高艾滋病健康教育传播效果，必须针对不同人群采取不同传播方式。     

Country watch: Zimbabwe

In 1991, the Matabeleland AIDS Council (MAC) in Bulawayo, Zimbabwe, established a peer education program for industry workers. To date, workers from 45 companies, particularly manufacturing companies, have participated in the program. Program goals include prevention of the spread of HIV and promotion of a supportive response to co-workers known or suspected to have HIV infection or AIDS. MAC first contacts senior management to get company support. It then helps personnel and training management staff develop each company's program. MAC negotiates free time for the 5-day initial training course of peer educators and for the quarterly follow-up meetings. Workers complete questionnaires so MAC can determine training content and materials required. Management and workers choose workers to be trained as informal resource persons. The criteria for the non-paid peer educators are that they be permanent employees, good communicators, literate in English, highly motivated, and persons trusted and respected by their co-workers. The peer educator/worker ratio is 1-2/100. The task of peer educators is dispelling misconceptions and myths and creating on-going discussions about HIV/AIDS both in and outside the workplace. MAC also trains nurses in 16 companies in AIDS counseling and methods of training peer educators. MAC conducted an evaluation of the peer educator program in 1994 in 15 companies. 13 companies either did not have an AIDS policy or did not address AIDS in its general health policy. 91% of workers had received written materials. 74% attended drama or video sessions, 66% received condoms. 30% asked a peer educator personal questions. Between 1992 and 1993, distribution of condoms increased from 25,776 to 49,392. Workers have adopted a positive attitude towards persons with AIDS. Many peer educators have taken up AIDS related-community work. Business leaders acknowledge the benefits of the peer educator program.     

艾滋病同伴教育效果分析

目的提高娱乐场所女性性工作者(以下简称CSW)对艾滋病防治知识的知晓率及安全套的使用率,改变其高危行为,遏制艾滋病在高危人群中的流行。方法在娱乐场所中选取有一定号召力的CSW作为同伴教育者,建立同伴教育核心小组,由她们对其他CSW进行同伴教育,在实施10个月后进行评估。结果 CSW对艾滋病知识的知晓率从干预前的47.3%变为干预后的72.8%,高危行为最近3次用套率由43.5%上升为63.2%。结论在CSW中进行同伴教育综合干预,效果明显,具有推广性。     

HIV / AIDS and STD health promotion in Tanzanian fishing villages

The Tanzania-Netherlands Project to Support AIDS Control (TANESA) conducted rapid appraisals in 14 villages with fishing camps along Lake Victoria to determine needs and resources available for HIV/STD (sexually transmitted disease) prevention. Discussions with village members sparked interest, so TANESA launched a health promotion program. It first set up a pilot project in a village of about 600 persons with an established fishing camp. TANESA trained 6 young women and 8 fishermen during a 4-day workshop as peer educators. The topics included anatomy and biology, STDs, HIV prevention, adult education, counseling, and communication skills. Training techniques used were short lectures, group discussions, role-playing, and exercises from a workbook. The newly trained peer educators helped set up a general education campaign: video shows, exhibition boards, pamphlets, condom distribution, and discussion sessions with peers. Village leaders did not support the idea of official classes, an AIDS information room, or a village health committee. Nevertheless, the peer educators continued their mission. Once a month, the program coordinator visits them and advocates the program to village leaders. TANESA next replicated the program in a larger village (about 6000 population). This time, it first mobilized village leaders to develop the program themselves. The core groups were fishermen, female bar and guesthouse workers, and young unemployed women offering sex for money. Each group chose its own peer educators. Village leaders were responsible for the educational campaign organized by the peer educators. The campaign received a positive response and effected positive attitudes towards condom use. Village leaders organized an AIDS action committee. TANESA now provides technical support, fosters a team spirit among peer educators, and supports monitoring activities. Peer educators express an increase in their self-esteem and self-confidence.     

Effects of peer education on the peer educators in a school-based HIV prevention program: where should peer education research go from here?

Although many HIV/AIDS prevention programs for adolescents have used peer educators to deliver risk reduction information, few researchers have evaluated the effects of participation in educational activities on the peer educators themselves. The present study compares several outcomes experienced by peer educators involved in a school-based HIV prevention program with those of their classmates to determine areas in which involvement in the curriculum had an effect on peer educators. Analyses revealed few differences between peer educators that could be attributed to the implementation of the intervention. The findings are discussed in terms of their implications for prevention programs targeting adolescent populations, and suggestions are made concerning the importance of future research on the selection, training, and integration of peer educators into school-based programs.     

艾滋病防治国际合作项目资源配置分析

目的 了解中国艾滋病防治国际合作项目投入状况以及影响因素,为国际合作项目资源分配提供决策依据.方法 收集中央和各省2000-2006年国际合作项目资源与分配相关数据,选择各省GDP、艾滋病病毒感染者和艾滋病患者(HIV/AIDS)数作为影响国际合作项目投入的因素,通过多因素回归分析计算他们与国际合作项目投入经费数量的相关性,在此基础上计算了各省需求Z值并与国际合作项目投入状况进行了比较.通过卡方检验计算艾滋病防治国际合作项目与中央经费在不同防治领域投入的一致性.结果 2000-2006年国际合作项目投入地方的资金分别为489.30、2466.91、5056.65、5294.96、11 214.31、36 339.63和24 704.53万元;投入中央的资金分别为300.65、1972.56、2903.52、3753.00、7749.99、10 578.62和7703.54万元.各省国际合作项目的投入情况与HIV/AIDS数(R=0.56,P＜0.01)及艾滋病患者数(R=0.69,P＜0.01)的相关系数差异有统计学意义,但是与GDP之间差异无统计学意义(R=0.066,P=0.725).各省的国际合作项目投入与需求并不完全对应,广东、山东、江苏的Z值排名分别为3、5、6,而国际合作项目的经费投入排名仅为18、13、28.在监测(检测)、宣传教育干预、治疗关怀和其他领域的经费投入比例2005年中央经费分别为22.4%、19.7%、36.8%和21.1%,国际合作项目分别为11.5%、20.8%、10.4%和57.4%,2者比较差异有统计学意义(x2=35.09,P＜0.001);2006年中央经费分别为18.6%、23.8%、32.6%和25.0%,国际合作项目分别为14.0%、34.3%、17.1%和34.6%,2者比较差异有统计学意义(x2=9.26.P=0.026).说明国际合作项目与中央项目投入的侧重点不同.结论 国际合作项目应该纳入国家和项目地区的整体防治工作,结合各地的疫情流行严重程度和各地的经济发展水平确定投入的数量和领域,同时要强调国际合作项目的技术优势.     

Process evaluation of a three-year community-based peer education intervention for HIV prevention among Yemeni young people

This community process evaluation highlights key enabling factors that facilitated the implementation of a community peer education program for youth HIV prevention in four poor and vulnerable areas of Aden, Yemen. It also explains the implementation process and provides a deeper understanding of the impact evaluation outcomes, which revealed improved HIV knowledge and risk perception and decreased stigma and risky behavior. This process evaluation was based on qualitative methodologies, where five focus group discussions and 15 in-depth interviews were conducted among 52 participants: community peer educators, community focal points, targeted young people, and local councils. The results revealed that contributing factors to implementing the peer education program had been community participation, mobilization of targeted communities, and capacity building of all those included in the intervention. Existing community-based organizations like the Social Service Centre played a key role in building trust with the targeted communities and linking HIV peer education intervention to other existing community services. This process evaluation could provide lessons learned for replicating similar youth peer education programs in conservative communities.     

Are Health Educators Being Prepared to Provide HIV/AIDS Education?: A Survey of Selected Health Education Professional Preparation Programs

Health education professional preparation programs were surveyed to determine the extent of HIV/AIDS education health educators are receiving. The survey also addressed content areas, skills being developed or enhanced, areas of deficiency in preparation programs, and areas in which national professional associations may assist in the preparation of AIDS educators. One hundred eight-three surveys were mailed; 114 (68%) were completed and returned. Twenty-one institutions reported planning a separate course on HIV/AIDS. Most were designing general service courses to reach a broad cross-section of students. Twenty-five institutions (23.8%) reported previously offering or currently offering a specific course on AIDS. One hundred two (89.5%) respondents reported HIV/AIDS warranted the attention and funding it had received. Thirty-seven (35.2%) respondents reported AIDS education was of sufficient importance to influence hiring of faculty members in their departments. Survey findings demonstrate that current AIDS education courses targeted to the general student population may not be adequate in meeting the professional preparation needs of health educators charged to provide AIDS education.     

HIV / AIDS,STDs and the workplace

Even though the workplace is ideal for promoting HIV/STD (sexually transmitted disease) prevention to benefit workers and employers, many workplaces are not convinced that they should be involved in HIV/AIDS and STD education, prevention, and support. They do not realize that time and money spent on health programs save them money. Perhaps they do not feel obligated to protect the health of their employees. The AIDS epidemic adversely affects society and the economy at both the macro and micro level. AIDS tends to strike the productive age group, thereby seriously affecting the workplace. In many Sub-Saharan African countries, at least 20% of the urban workforce may be infected with HIV. Persons living with HIV include top management, skilled professionals, general hands, and farm laborers. HIV/AIDS costs for formal employment are assumed through reduced productivity; increased costs of occupational benefits and social security measures; loss of skilled labor, professionals, and managerial expertise as well as the experience among workers; increased costs of training and recruitment; and low morale from stigmatization, discrimination, and subsequent industrial relation problems. Needed are comprehensive HIV/AIDS and STD workplace programs that ensure the rights of persons with HIV and compassionate treatment of these persons. Trade union or other labor representatives, management, and appropriate government departments should work together and build on existing health legislation and policy to bring about effective negotiation and policy development concerning AIDS and employment. Training of peer educators, support services (counseling, STD referral and/or treatment), community action, management commitment, monitoring and evaluation, and supportive workplace conditions make for effective comprehensive workplace programs. Successful programs operate in fishing villages in Tanzania, tea plantations in India, the University of Papua New Guinea, and Ugandan army camps.     

Tips for starting a peer education program for inmates

Peer education programs have met with some success in changing HIV risk behaviors in the prison setting. Peer educators effectively communicate with other inmates about how the virus is spread and what can be done to reduce the risk of infection. Properly trained, peer educators may be more credible and relevant with inmates. Prisons can initiate a peer education program with the help of outside AIDS service agencies, through grant opportunities, and by establishing links with prison advocacy groups. The language and cultural differences in prison populations should be considered. Prison officials should recruit a mix of HIV-positive individuals, HIV-negative individuals, and those with a history of injection drug use to be trained for the peer educator positions.