四川省基层机构艾滋病防治人力资源现状调查

目的了解四川省基层卫生机构以及政府相关部门艾滋病防治人力资源能力现状,为基层机构艾滋病防治人力资源能力建设提出意见和建议。方法采用问卷调查和小组访谈方法,对四川省27个县（区）的127个乡镇（社区）卫生服务机构、315名乡镇（社区）卫生服务机构卫生人员、137名乡镇政府以及相关部门人员进行调查。结果调查机构中仅13．4％的机构具有专职艾滋病防治人员;艾滋病防治人员的学历主要为中专和大专,分别占45．4％、41．9％;职称以初级职称为主,占调查总人数的62．1％。被调查人员的艾滋病知识技能总体培训率为51．4％;97．1％的调查对象希望参加艾滋病相关知识培训,对艾滋病防治技能方面的内容培训最为迫切;74．2％的人期望“学术讲座”的培训方式;基层机构艾滋病防治相应政策制度没有很好的落实,缺乏人力资源建设组织保障。结论四川省基层卫生机构艾滋病防治相关人力数量较少,艾滋病防治人员学历、职称均较低。加强四川省基层机构艾滋病防治相关人力数量的配置;优化基层机构艾滋病防治人员结构,提高人员素质;加强基层机构艾滋病防治相关人员培训;加强对基层艾滋病防治的重视并落实规划制度。     

Assessing interorganizational networks as a dimension of community capacity: illustrations from a community intervention to prevent lead poisoning.

Network analysis is often cited as a method for assessing collaboration among organizations as an indicator of community capacity. The purpose of this study was to (1) document patterns of collaboration in organizational networks related to lead poisoning prevention in a Native American community and (2) examine measurement issues in using organizational network analysis to assess community capacity. Interviews were conducted with representatives from 22 tribes, government agencies, schools, and community-based organizations in northeastern Oklahoma. Intensity, density, and reliability were assessed for several stages of collaboration. Intensity and density were greater for similar types of organizations than for the network as a whole and decreased as stage of collaboration increased. Network data were more reliable when responses were dichotomized than when intensities were compared. Mean reliability scores across two respondents from the same organization ranged from 60% to 90%. Results from network studies may help communities learn how to strengthen organizational networks to enhance community capacity.     

Sampling for evaluation. Issues and strategies for community-based HIV prevention programs

Sampling methods are an important issue in the evaluation of community-based HIV prevention initiatives because it is through responsible sampling procedures that a valid model of the population is produced and reliable estimates of behavior change determined. This article provides an overview on sampling with particular focus on the needs of community-based organizations (CBOs). As these organizations continue to improve their capacity for sampling and program evaluation activities, comparisons across CBOs can become more rigorous, resulting in valuable information collectively regarding the effectiveness of particular HIV prevention initiatives. The author reviews several probability and non-probability sampling designs; discusses bias, cost, and feasibility factors in design selection; and presents six guidelines designed to encourage community organizations to consider these important sampling issues as they plan their program evaluations.     

湖北省相关社区组织参与艾滋病防治项目活动模式调查分析

目的：调查分析湖北省社区组织（community-based organizations,CBO）参与艾滋病防治项目活动模式,为制定更为规范的 CBO 参与艾滋病预防干预、关怀支持模式与策略提供参考。方法自行设计调查表格,汇总分析46个 CBO 相关内容。结果对暗娼人群干预以同伴教育为主;男男性行为（MSM）人群干预在社区开展自愿咨询监测、扩大艾滋病病毒检测;吸毒人群干预以家庭走访、动员吸毒者家属教育;对艾滋病病毒感染者/艾滋病患者的关怀与支持以提供医疗和心理关怀,构建社区支持网络,开展生产自救为主要模式。结论 CBO 目前已针对不同类型的艾滋病相关高危人群形成了有针对性的干预模式,并开展了大量有效的干预活动,取得了明显成效,为卫生管理部门和专业机构分担了工作任务,达到了取长补短的作用。     

Conspicuous by their absence? Men who have sex with men (msm) in developing countries: Implications for HIV prevention

Men who have sex with men remain conspicuously absent from the HIV policy and programme agendas of the majority of developing countries despite efforts by activists and community groups to draw attention to their existence and needs. This paper charts the existence of male to male sex across much of central and south America, Africa and Asia and describes governmental and international responses to date. In contrast with the denial and homophobia which have characterized most official responses are the actions of some non-governmental and community organizations which have struggled hard with often limited resources to undertake HIV and AIDS-related health promotion, and to draw attention to the as yet unmet needs of homosexually active men in developing countries across the world. Effective approaches to HIV prevention are discussed.     

Bridging the gap between the science and service of HIV prevention: transferring effective research-based HIV prevention interventions to community AIDS service providers

OBJECTIVES: AIDS service organizations (ASOs) rarely have access to the information needed to implement research-based HIV prevention interventions for their clients. We compared the effectiveness of 3 dissemination strategies for transferring HIV prevention models from the research arena to community providers of HIV prevention services. METHODS: Interviews were conducted with the directors of 74 ASOs to assess current HIV prevention services. ASOs were randomized to programs that provided (1) technical assistance manuals describing how to implement research-based HIV prevention interventions, (2) manuals plus a staff training workshop on how to conduct the implementation, or (3) manuals, the training workshop, and follow-up telephone consultation calls. Follow-up interviews determined whether the intervention model had been adopted. RESULTS: The dissemination package that provided ASOs with implementation manuals, staff training workshops, and follow-up consultation resulted in more frequent adoption and use of the research-based HIV prevention intervention for gay men, women, and other client populations. CONCLUSIONS: Strategies are needed to quickly transfer research-based HIV prevention methods to community providers of HIV prevention services. Active collaboration between researchers and service agencies results in more successful program adoption than distribution of implementation packages alone.     

HIV prevention programs of nongovernmental organizations in Latin America and the Caribbean: the Global AIDS Intervention Network project.

OBJECTIVE: The objective of this paper is to describe HIV prevention programs conducted by nongovernmental organizations (NGO) that are meeting this challenge. METHODS: One NGO undertaking HIV prevention programs was evaluated in each of the 23 countries participating in the Global AIDS Intervention Network (GAIN) Project throughout Latin America and the Caribbean. A two-stage selection process was used: (1) a search in databases and other information sources; (2) identification of NGOs that were best established and most actively engaged in HIV prevention activity. Executive directors were questioned about staffing, budget issues, populations served and barriers faced by these entities. RESULTS: The 23 NGOs conducted 58 direct-service programs and had been conducting HIV prevention activities for a mean of 8 years (SD=4.45; range 1-18 years). Average annual program budget was US $205,393 (range: US $10,000 to US $1,440,000). The NGOs reported a mean of 4.5 full-time employees (range 0-15, SD=4.7). Many relied on volunteers (median=10, mean=51, range 0-700, SD=150) to conduct HIV prevention activities. The NGOs provided prevention services for the general community (82.6%), children and adolescents (34.8%) and men who have sex with men (30.4%). Activities conducted by NGOs included train-the-trainer activities (43.5%) and face-to-face prevention activities (34.8%). Obstacles cited included lack of funding (60.9%) and HIV-related stigma and discrimination (56.5%). CONCLUSION: The strategies used by NGOs to overcome barriers to prevention are a testament to their ingenuity and commitment, and serve as examples for NGOs in other world regions.     

Paradoxes and asymmetries of transnational networks: a comparative case study of Mexico's community-based AIDS organizations

This article examines whether transnational networks reconfigure state-civil society relationships in ways that lead to civil society empowerment and increased organizational capacity to address the HIV/AIDS epidemic in Mexico. Using a comparative case study, I identify the types of transnational networks and exchanges that both help and hinder community-based HIV/AIDS organizations (CBOs) that provide AIDS prevention and treatment services in Tijuana and Mexico City. Data derive from over 50 formal interviews, organizational documents and archival records, and observation. I argue that the form and function of transnational networks is shaped by the geo-political context of local organizational fields and that, in turn, transnational networks provide innovative opportunities for civil society-state partnerships that favor some local organizations over others. Ultimately, I take apart the prevailing assumption that transnational networks are inherently good, and show how they can (re)produce inter-organizational stratification at the local level. The conclusions of this research are helpful to international health practitioners and social scientists seeking to understand how civil society's participation in transnational networks can both challenge and reproduce existing community-state power regimes and health inequities.     

Technical assistance for the evaluation of community-based HIV prevention programs.

Funding agencies are using technical assistance (TA) to strengthen the evaluation capacity of community-based organizations (CBOs) engaged in HIV prevention efforts. The authors used qualitative methods to identify the types of evaluation TA needed by CBOs, to understand CBOs' past experiences with evaluation TA, and to elicit ideas for optimal delivery of evaluation TA. Assistance in developing evaluation tools and data analysis were the most commonly cited needs. Preferred TA providers were characterized as having practical expertise, accessibility, cultural competence, communication skills, and collaboration skills. Critical elements of an ideal TA system were adequate funding, program-specific TA, and extensive interaction between TA providers and CBO staff. Study data were used to generate a set of recommendations for health educators and others who may provide CBOs with TA for evaluating prevention programs.     

Collaborative community research consortium: a model for HIV prevention.

In 1991, the Center for AIDS Prevention Studies (CAPS) at the University of California, San Francisco, set out to develop a model of community collaborative research that would bring the skills of science to the service of HIV prevention and the knowledge of service providers into the domain of research. Essential elements of the model were training for community-based organizations (CBOs) in research protocol writing, partnership between CBOs and CAPS researchers, program research funding, support to implement studies and analyze results, and a program manager to oversee the effort and foster the relationships between CBOs and researchers. In this article, the authors describe the CAPS model of consortium-based community collaborative research. They also introduce a set of papers, written by researchers and service providers, that describes collaborative research projects conducted by research institutions and CBOs and illustrates how collaboration can change both HIV prevention research and service.     

我国社会组织的男男性行为人群艾滋病预防级联服务效果研究

目的分析我国社会组织参与艾滋病防治基金(CAFNGO)支持的MSM干预项目艾滋病预防级联服务效果和主要差距, 为提高社会组织艾滋病防治服务质量和项目管理优化提供建议。方法通过CAFNGO项目管理信息系统及访谈等收集指标数据和信息, 对不同类型社会组织、不同地区的MSM干预项目艾滋病预防级联服务中HIV初筛和确证检测、HIV感染者发现和转介治疗等各项工作指标完成情况进行统计学分析, 绘制服务链图。结果 2016-2020年CAFNGO支持的1 508个MSM干预项目, 共动员1 183 234名MSM接受HIV检测, 占社会组织申请HIV检测服务容量的68.8%(1 183 234/1 719 139), 发现初筛HIV阳性55 783人, HIV确证检测比例86.6%(48 327/55 783), 新报告HIV感染者比例3.8%(45 347/1 183 234)。2017-2020年新报告HIV感染者治疗转介比例89.8%(32 719/36 444)。未在民政部门登记的社会组织项目和在民政部门登记的社会组织项目分别占项目总数的75.8%(1 143/1 508)和24.2%(36...     

Promovision: designing a capacity-building program to strengthen and expand the role of promotores in HIV prevention

This article describes the development of Promovisión, a program based on the utilization of promotores in community-based organizations (CBOs) to improve the provision of HIV prevention services to recent immigrants and Latinos who are less acculturated. Promovisión aims to demonstrate the contribution of promotores as a cost-effective strategy in HIV prevention efforts, and how promotores facilitate the formation of community, regional, and national CBO networks working collaboratively to prevent the spread of HIV in Latino communities. In addition, this article examines the interpersonal, organizational, community, and sociocultural dimensions that facilitate or hinder community mobilization, and coalition formation and growth, and how these findings shaped the final design of the program. Finally, the Promovisión program seeks to demonstrate that a promotor-based program is a culturally appropriate model for HIV prevention and care, which can be successfully implemented in community and clinical settings among ethnic populations with limited English proficiency.     

Facilitators and challenges to organizational capacity building in heart health promotion

The authors describe the facilitators and challenges to a multi-sectoral initiative aiming at building organizational capacity for heart health promotion in Nova Scotia, Canada. The research process was guided by participatory action research. The study included 21 organizations from diverse sectors. Participant selection for the data collection was purposive. The authors collected data through organizational reflection logs and one-to-one semistructured interviews and used grounded theory techniques for the data analyses. Factors influencing organizational capacity for heart health promotion varied, depending on the project stage. Nonetheless, leadership, organizational readiness, congruence, research activities, technical supports, and partnerships were essential to capacity-building efforts. Approaches to organizational capacity building should be multi-leveled, because organizations are influenced by multiple social systems that are not all equally supportive of capacity.     

Positive prevention: contemporary issues facing HIV positive people negotiating sex in the UK

Over 40,000 people are now living with diagnosed HIV in the UK. The term 'positive prevention' has been coined to describe HIV prevention that focuses on people living with an HIV diagnosis. There is uncertainty, however, about how people with HIV manage risk and how their ability to prevent the transmission of HIV is linked to their mental health and social circumstances. We analysed 44 individual and three group interviews with the people most affected by HIV in the UK: black African heterosexual men and women and gay men (mostly white). We found that participants had similar as well as contextually different needs when it came to negotiating safe sex, assimilating prevention knowledge. The themes that emerged included taking 'additional responsibility' for partners, negotiating with partners who are willing to have unprotected (anal or vaginal) sex, links with mental health, constructing the moral 'other' and power differences. We conclude with a discussion of the priorities for positive prevention for men and women living with diagnosed HIV in the UK.     

Community-based Organizations’ Capacity to Plan, Implement, and Evaluate Success

Community-based organizations (CBOs) have the potential to promote and sustain health, prevent disease, and address health disparities, but many lack the capacity to do so. An assessment of the 20 CBOs receiving supplemental grant funding from the Pfizer Foundation Southern HIV/AIDS Prevention Initiative indicated a high level of knowledge for developing goals and objectives (mean score=3.08 on a scale of 0 (none) to 4 (extensive)) and high self-assessed abilities to conduct six of 20 specific intervention activities, including the development of community relationships and coalitions. Lower knowledge and skill levels were observed for intervention evaluation. While CBOs of this Initiative have established prerequisite abilities, they have self-acknowledged needs for technical assistance to maximize HIV/AIDS prevention capacity.     

Primary Prevention of Sexually Transmitted HIV Infections: Transferring Behavioral Research Technology to Community Programs

Behavioral research to prevent the spread of human immunodeficiency virus (HIV) infection has made significant progress over the past decade. Most importantly, studies have repeatedly shown that theory-based prevention interventions that build self-efficacy through self-management and communication skills training successfully reduce HIV risk behaviors. Simultaneously, communities have mobilized to develop programs that assist persons in reducing their risk for HIV infection. The degree to which behavioral sciences have contributed to community-based HIV prevention programming is examined in this paper through a systematic assessment of technology transfer in the area of sexual risk behavior reduction. We analyzed the content of twelve community-based HIV risk-reduction programs targeting gay and bisexual men developed by seven of the nation's largest AIDS service organizations. Telephone interviews were conducted with community program developers to determine the source of their programs and whether they had been influenced by behavioral sciences. Evidence was mixed with respect to the degree to which behavioral sciences have contributed to the development of community-based programs. Program elements often reflected research-based models but with questionable fidelity. Evidence for diffusion of research-based information occurred most often when community organizations received direct consultation from behavioral scientists. We suggest that technology transfer in HIV prevention requires behavioral scientists working in communities to serve as translators of theoretical constructs for practical applications. Preventing the spread of HIV could therefore be improved through partnerships between behavioral researchers and communities.     

The protective effects of community involvement for HIV risk behavior: a conceptual framework

This paper presents a conceptual framework of the protective effects of community involvement in HIV/AIDS-related groups and organizations for HIV sexual risk behavior among gay and bisexual men. The framework delineates hypotheses for future research, and provides a guide for prevention programs based on the active and direct involvement of participants, particularly communities of color. The framework (1) argues that community involvement moderates the association between three socio-structural risk factors (i.e. poverty, homophobia and racism) and sexual risk behavior; (2) posits that community involvement in HIV/AIDS reduces sexual risk behavior via its effects on four mediating factors (i.e. peer norms, self-efficacy, positive self-identity and alienation); (3) proposes five socio-cultural barriers to and facilitators of community involvement in HIV/AIDS (i.e. motives for participation, poverty, acculturation, stigma and perceived opportunities); and (4) addresses burnout as one potential negative consequence of community involvement in HIV/AIDS-related organizations and groups. The conceptual framework advances the understanding of HIV sexual risk behavior by integrating both its socio-structural risk and protective factors. It contributes to health education by specifying how interventions based on collective action (e.g. community involvement) for social change may be effective in generating healthy behaviors at individual and community levels.     

Building community capacity around chronic disease services through a collaborative interorganizational network.

This article presents the findings of a study examining the evolution of a network of health and human service organizations operating in a rural community on the Southwest border. The aim of the network was to build the capacity of the community to provide chronic disease education, prevention, and treatment services by developing collaborative relationships among a broad range of organizations. The impetus for the effort was based on receipt of a Turning Point grant. The findings, based on two waves of data collected 1 year apart, demonstrate how network structure and attitudes toward collaboration evolve as a community attempts to build capacity to address its health needs.     

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.     

Assessing the effectiveness of HIV prevention peer education workshops for gay men in community settings

Objective : To use existing evaluation data of community‐based HIV prevention peer education workshops (PEWs) for gay men to explore the challenges in evaluating such programs in community settings. Methods : Data came from 33 PEWs conducted with gay and bisexual men. A basic pre/post‐test design was used to measure sexual health capacity. The Sexual Health Capacity Scale (SHCS) was anonymously completed before participation and twice afterward, with the men measuring perceptions of themselves before participation and perceptions of themselves after participation. The anonymous nature of the SHCS created problems for matching data so, for the most part, independent samples tests were used for analysis. Results : Overall, 399 gay and bisexual men participated in PEWs. Participants perceived themselves as having more sexual health capacity after participation than before (p<0.001). Those who had previously been HIV tested before the PEW had higher perceived capacity (p<0.001). Conclusions and Implications : Participation in the PEWs appeared to increase the perceived sexual health capacity of gay and bisexual male participants. Several limitations in the data arose from issues in the original data collection. A mixture of anonymous and identifiable data‐sources meant that data could not always be matched to individuals. Stronger partnerships between HIV researchers and professionals within community organisations could significantly improve evaluation of the effectiveness of HIV peer education.