深圳市多部门开展流动人口艾滋病防治工作现状与策略

目的了解深圳市多部门开展流动人口艾滋病防治工作现状,为制定相关策略提供科学依据。方法采用定性研究的方法,对于流动人口管理和艾滋病防治有关的政府部门、社会团体和街道及社区的相关人员,进行小组讨论和深入访谈,并对讨论和访谈的内容进行整理、汇总和分析。结果本次调查共完成问卷34份,其中市级和区级各17份。各相关部门均表示曾参与过有关艾滋病防治的宣传教育活动,大部分是结合日常工作开展的。全市尚没有专门针对流动人口艾滋病防治工作的规划和部署,普遍缺乏专项经费和专业人员,也没有专门的统筹协调机制。结论多部门开展流动人口艾滋病防治工作还面临很多困难,政府应发挥领导作用,打破户籍的禁锢,建立以居住地为基础的针对流动人口中艾滋病病毒（HIV）感染者和艾滋病（AIDS）病人的服务机制。     

流动人口管理者对艾滋病和VCT知识和态度的定性研究

目的 为了解流动人口相关管理人员对艾滋病和自愿咨询检测(VCT)的知识和态度,为开展VCT工作提供依据. 方法 在上海某区采用多阶段抽样,选取流动人口相关管理人员28人,采用个人深入访谈法,了解他们对艾滋病和VCT的相关知识和态度. 结果 该人群对艾滋病防治的知晓率低,但是愿意支持艾滋病宣传干预工作;对艾滋病存有恐惧心理,同时对艾滋病病毒(HIV)感染者有着较为严重的歧视情节;对VCT的知晓率较低,多数人认为周围的流动人口不会感染HIV,没有必要做HIV检测,也存在对检测者的歧视心理. 结论 应进一步加强针对该类人群的艾滋病宣传教育,消除该人群对HIV感染者和检测者的歧视,为流动人口创造好的艾滋病防治环境.     

上海市闵行区外来流动人口与艾滋病VCT相关的知信行的定性研究

目的 了解社区中外来流动人口对艾滋病自愿咨询检测(VCT)的认知、态度和参与VCT服务的影响因素.方法 采取方便抽样的方法,对上海市闵行区3个社区的74名流动人员、27名社区关键知情人和20名社区服务人员,进行个人深入访谈和小组访谈.结果 外来流动人口以青壮年居多,文化程度低,艾滋病防治意识薄弱;只有1/3的外来流动人员知道免费的VCT,知道VCT服务地点和做过HIV检测的流动人员更少;约一半的外来流动人员和社区关键知情人对他人参与VCT的行为存有偏见.流动人员参与VCT服务的影响因素主要包括VCT知识、有危险行为并知觉到危险性、环境支持和可及的VCT服务.结论 迫切需要在外来流动人口社区中开展更广泛的VCT健康教育,并采取灵活可及的VCT服务和完善检测后关怀服务.     

中小城市妇科门诊管理人员VCT服务态度的调查分析

目的 了解妇科门诊的管理人员对在妇科门诊开展由医务人员主动提供艾滋病咨询检测(VCT)服务的必要性和可行性,探索有效的艾滋病防治策略.方法 采用定性访谈方法,选择主管妇科门诊的管理人员进行个人深入访谈.结果 访谈对象对艾滋病病毒(HIV)检测的重要性表示一致认同,在妇科门诊开展VCT工作应重点针对有生殖道感染或高危行为史的病人,但面临经费不足、病人接受性不高等困难;妇科医务人员需要加强培训,重点是艾滋病基本常识、自我保护方法、国家相关政策和当地服务机构信息.结论 做好大众人群的宣传教育工作和多部门协调的倡导工作,解决检测所需的费用等困难,结合妇科特点开展灵活多变的宣传工作是取得成效的关键.     

影响地方领导开展艾滋病防治工作的相关因素及领导力建设模式研究

目的了解影响地方多部门领导开展艾滋病防治工作的相关因素,探索适合中国国情的防治艾滋病领导力建设的可行性模式。方法采用定性研究的方法,对2省15县市地方领导共47人,分为卫生和非卫生部门两组进行个人深入访谈及专题小组讨论。结果影响地方领导开展艾滋病防治工作的相关因素包括外部和内部两方面。外部影响因素分为部门共同及特殊影响因素两类,如主要领导的重视程度、政策的可操作性和实效性等;内部影响因素两组的共性是,因缺乏明确的针对个人和部门的考核评估机制而导致的自我激励机制的缺乏等,2个省情况基本一致。防治艾滋病领导力建设的培训,应针对不同性质的领导在培训内容、方法和时间上区别对待,突出艾滋病与执政的关系。防治艾滋病领导力建设的模式,除通过目前培训的短期行为外,还需配合实施和评估等长期综合措施。结论地方领导开展艾滋病防治工作在不同程度上受到内外多种因素的影响和制约。防治艾滋病领导力建设的培训可采用"目的分层"的策略。领导力建设的模式应建立培训-实施-评估的长效机制。     

吉林省延边朝鲜族地区艾滋病防治策略研究

目的 对延边朝鲜族地区艾滋病防治现状以及相关社会经济、文化等因素进行分析,提出适合朝鲜族地区艾滋病防治的策略性建议.方法 采用访谈和填写问卷的方式,开展各类人群调查和需求评估,结合少数民族地区的文化、经济特点等进行分析,提出防治策略建议和政策性文件.结果 延边州目前防治工作的主要问题是:从事性病艾滋病防治工作的专业人员数量和经费投入还不能满足实际工作的需要;各类人群中艾滋病预防知识水平有待进一步提高;娱乐场所艾滋病预防教育和安全套推广工作的覆盖面不够;感染者管理工作有待改进;归国劳务人员的检测工作有待规范.结论 延边州艾滋病综合防治工作需要进一步加强,针对州艾滋病防治工作的需求和特点,提出相应的措施建议和有关管理工作文件,对推动延边地区艾滋病防治工作具有重要意义.     

艾滋病相关话题人群访谈调查分析

目的通过对8类人群有关艾滋病(AIDS)话题的访谈调查,了解北京市东城区这8类人群对艾滋病的知晓程度。方法选择8类人群采取个别访谈、团体访谈的方式,按提纲进行访谈调查。结果艾滋病高危人群、传播途径等相关知识的知晓率达100%,不歧视率为78.8%。对艾滋病防治关怀和干预的可利用资源和可接受方法提出了多种思路,但对艾滋病疫情现状缺乏科学认识。流动人口缺乏必要的艾滋病预防知识。结论加强艾滋病防治的科学性教育,注重在流动人口中普及艾滋病防治知识。     

丰台区不同职业流动人口艾滋病认知情况及影响因素调查

目的了解北京市丰台区不同职业流动人口的艾滋病相关知识知晓率及其影响因素,针对性地开展流动人口艾滋病预防工作。方法采取横断面研究设计,分段整群抽样方法选取四类不同职业类别的流动人口,即建筑工人、企业工人、三星级宾馆服务人员及劳务市场寻工人员,进行问卷调查。结果共调查1 625人,艾滋病相关知识知晓率为76.9%。不同职业人群艾滋病相关知识知晓率的影响因素有所不同。结论不同职业类别流动人口对艾滋病相关知识知晓率的影响因素有所差别。因此,需要针对不同职业的流动人口开展有针对性的艾滋病相关宣传教育和行为干预。     

云南省社会组织参与艾滋病防治工作状况分析

目的对云南省社会组织参与艾滋病防治工作的现状及存在问题进行分析,为社会组织参与艾滋病防治工作相关政策的制定提供参考。方法选择参与云南省全球基金艾滋病整合项目的170个社会组织,通过邮件组收集全省执行全球基金艾滋病项目的社会组织的名单和有关信息,深入访谈收集相关定性资料,采用SPSS 13.0对收集的资料进行汇总和分析。结果云南省参与艾滋病防治的社会组织分为6类,其中艾滋病病毒感染者/病人关怀小组占73.5%(125/170),学会、协会小组占8.2%(14/170),男男性行为者小组占7.6%(13/170),暗娼小组占4.1%(7/170),注射吸毒人群小组占4.1%(7/170),其他社会组织占2.4%(4/170)。社会组织发展较不平衡,以HIV感染者/病人关怀的社会组织为主,92.9%的社会组织未注册;社会组织专职人员中位数3人,兼职人员中位数2人,志愿者中位数2人。结论调查结果初步反映了云南省社会组织参与艾滋病防治的基本情况,社会组织需加强自身能力建设,业务主管部门应发挥社会组织的自身优势,将其纳入艾滋病防治的常态化管理,形成全社会共同参与艾滋病防治的局面。     

社区组织参与HIV感染者/AIDS病人综合管理模式的探索

目的探索社区组织(NGOs)如何与疾病预防控制机构(CDC)、医疗机构更加紧密地合作,建立具有实效的、符合当地文化和经济背景的艾滋病病毒(HIV)感染者/病人综合管理模式。方法分析项目实施策略、过程和产出,对相关合作机构和受益人群进行焦点小组访谈和个案访谈。结果项目的实施,建立了昆明市"三位一体"HIV感染者/病人综合管理模式,充分体现政府主导,多部门合作的工作原则,也为NGO充分参与艾滋病防治工作提供了必要的支持性环境和资金保障。正确引导HIV感染者进行治疗,并配合医院开展依从性教育、提供心理支持。促进了HIV感染者/病人随访关怀工作及转介机制,感染者和病人的CD4检测及抗病毒治疗转介成功率达100%,对发现新报告感染者告知率达到100%。结论随着艾滋病防治工作的拓展,NGO小组在各地区参与感染者/病人的随访关怀及提供转介服务的重要性不断显现,但CDC、抗病毒治疗医疗机构、NGOs的职责、人员能力以及协调机制的建立和完善仍然是有效工作模式建立的重要影响因素。     

Need and acceptability of story books intended to help with the process of informing children about their HIV status in Malawi: a mixed methods study

The rate of disclosure of HIV status to children living with HIV in sub-Saharan Africa remains low despite the World Health Organisation’s recommendation that children should be told about their HIV status by the age of 12 years. Authors of previous studies have identified lack of disclosure materials as the main barrier to disclosure of HIV status. This study aimed to assess the need and acceptability of a series of age-appropriate children story books intended to help with informing children about their HIV status. Questionnaires, interviews, and focus group discussions were used to collect data from caregivers, healthcare workers, and school teachers, adolescents living with HIV, and community leaders across the three administrative regions of Malawi. Information about the need and acceptability of the story books and the sociodemographic characteristics of the participants was collected using reliable instruments. Quantitative data were tabulated while thematic analysis was used to analyse qualitative data. Almost 600 participants responded to the survey questionnaire, and 19 interviews and 12 focus groups were conducted with 106 participants. Ninety-eight per cent of participants supported the idea of developing the proposed series of story books and reported that they would use the books once they are developed. Most of the participants expressed that the books will help to improve their knowledge and understanding of HIV disclosure, increase their confidence on how to disclose and help to provide consistent information about HIV disclosure to children.The results of this study show a high acceptability rate of the story books. The process of HIV disclosure to children is a very complex issue that will require the development of guidelines and materials that are rigorously evaluated prior to dissemination.     

Responses to VCT for HIV among young people in Kampala,Uganda

Attitudes to voluntary counselling and testing (VCT) for HIV among young men and women in a slum area of Kampala, Uganda, were studied through 22 individual semi-structured interviews and 5 focus group discussions. Attitudes to VCT ranged from having no problem with the procedure to being very reluctant. Despite fear of stigma, the participants perceived 'positive living' after HIV testing as realistic. VCT was regarded as an important step to avoid HIV infection, but informants expressed the need for the service to be more accessible in terms of cost, time and quality of pre- and post-test counselling. We argue that counselling without HIV testing should be available for those who are reluctant to test. Poverty and gender power imbalances appeared to limit youths' possibility of making rational decisions about sexual behaviour and accessing VCT. The importance of considering the context in which such issues are being negotiated and decided is highlighted.     

Psycho-social and behavioural impact of COVID 19 on young adults: Qualitative research comprising focused group discussion and in-depth interviews

A qualitative study comprising eight focus group discussions and two in-depth interviews were conducted to explore the social and behavioural changes in young adults during COVID pandemic. Common themes identified were changes in interpersonal and intrapersonal relationships, changes in health-related behaviour, lifestyle modifications and impact on academic and professional life.     

The church and paediatric HIV care in rural South Africa: a qualitative study

Religion has substantial – positive and negative – influence on South Africa's HIV context. This qualitative study explored possibilities for positive church engagement in paediatric HIV care in a rural district in Limpopo Province, South Africa. Opinions, attitudes and experiences of various stakeholders including religious leaders, healthcare workers and people infected/affected with/by HIV were investigated through participant observation, semi-structured interviews and focus group discussions. During the research the original focus on paediatric HIV care shifted to HIV care in general in reaction to participant responses. Participants identified three main barriers to positive church engagement in HIV care: (a) stigma and disclosure; (b) sexual associations with HIV and (c) religious beliefs and practices. All participant groups appreciated the opportunity and relevance of strengthening church involvement in HIV care. Opportunities for positive church engagement in HIV care that participants identified included: (a) comprehensive and holistic HIV care when churches and clinics collaborate; (b) the wide social reach of churches and (c) the safety and acceptance in churches. Findings indicate that despite barriers great potential exists for increased positive church engagement in HIV care in rural South Africa. Recommendations include increased medical knowledge and dialogue on HIV/AIDS within church settings, and increased collaboration between churches and the medical sector.     

Perceptions of educators of Deaf and hard-of-hearing adolescents of HIV-risk factors for these youths

Like the general population in South Africa, adolescents with deafness or who are hard-of-hearing may be vulnerable to HIV infection. They are exposed to all known risk factors for HIV infection. Educators who work in schools for Deaf (meaning culturally deaf) and hard-of-hearing adolescents can provide valuable information about HIV-risk factors for these youths. We conducted 21 in-depth interviews and two focus group discussions with educators of Deaf and hard-of-hearing adolescents in six schools in two provinces of South Africa. We explored the participants’ perceptions of the HIV-risk factors to which their learners are exposed. The educators were aware of the adolescents’ vulnerability to HIV infection. All the participants believed that Deaf and hard-of-hearing adolescents are at risk of contracting HIV due to vulnerability to sexual abuse and higher-risk sexual behaviour. The participants were aware of substance abuse patterns, such as excessive alcohol use or recreational drug use, among their learners. Adolescence is a vulnerable period, and adolescents who are Deaf or hard-of-hearing are likewise exposed to the risk of HIV infection.     

Enhancers and barriers to uptake of male circumcision services in Northern Uganda: a qualitative study

ABSTRACT

Uganda adopted voluntary medical male circumcision (VMMC) in 2010, but uptake remains disproportionately low in the Northern region despite implementing several demand creation strategies. This study explored the socio-cultural and structural enhancers and barriers to uptake of VMMC services in Gulu, a district in Northern Uganda where uptake is lowest. In September 2016, we conducted 19 focus group discussions, 9 in-depth interviews, and 11 key informant interviews with 149 total participants. Data were collected and analyzed thematically using both inductive and deductive approaches, then framed in four levels of the social ecological model. Enhancers included adequate knowledge about VMMC services, being young and single, partner involvement, peer influence, perceived increased libido after circumcision, and availability of free and high-quality VMMC services. Barriers included sexual abstinence during wound healing, penile appearance after circumcision, religion, culture, and misconceptions. Optimizing enhancers and addressing barriers could increase VMMC service uptake in northern Uganda.     

Alcohol Use and High-Risk Sexual Behavior Among Adolescents and Young Adults in Harare, Zimbabwe

We conducted a quantitative and qualitative study of alcohol use and high-risk sexual behavior among adolescents and young adults of age 15–21 years in Harare, Zimbabwe. Methods included a cross-sectional survey of youth sampled at nightclubs and bottle stores informed by participant observation, key informant interviews, and focus group discussions. Findings corroborated a cycle of HIV transmission that involves older men, younger women, and ultimately the steady partners of both. Nightclubs and other drinking establishments catering to youth can provide opportunities for preventing HIV transmission through stuctural interventions or targeted outreach education.     

Opportunities for strengthening provider-initiated testing and counselling for HIV in Namibia

This short report identifies enablers and barriers to the uptake of provider-initiated testing and counselling for HIV (PITC) in Namibia and identifies key opportunities for strengthening this vital aspect of the national HIV response. We explored this through facility mapping, register reviews and qualitative methods including focus group discussions and in-depth interviews. Four health facilities (clinics and hospitals) in two regions were included in the study. We identified that PITC in Namibia was largely delivered by lay counsellors operating in designated rapid testing rooms located in health facilities and found a large number of missed opportunities for HIV testing through this model. Nurses did not see it as an integral part of their role, were not aware of HIV testing and counselling policy, felt inadequately trained and supported, and experienced staffing shortages. Institutional issues also acted as barriers to nurses performing or initiating discussions about PITC. Wider dissemination and implementation of policy, increasing privacy of consultation spaces and community sensitisation are simple measures that represent opportunities for strengthening this response and ensuring that symptomatic individuals who are unaware of their HIV status do not fall through the net.