社区医务人员艾滋病相关歧视行为及影响因素研究

目的:了解社区医务人员对艾滋病相关态度及歧视行为情况,分析歧视行为的影响因素,为进一步开展医务人员艾滋病健康教育,落实患者社区化管理措施提供科学依据.方法:采取现场集中问卷调查的方式,对8家社区卫生服务中心医务人员的艾滋病相关态度、行为进行调查.结果:74.59％的人认为自己可能因工作原因感染艾滋病,27.60％的医务人员不同意给HIV/AIDS患者同等医疗服务,57.38％和63.39％的医务人员拒绝为遇紧急外伤和门诊就诊的HIV/AIDS患者提供医疗服务,31.15％的医务人员不同意与患者握手,不同意与患者一起吃饭为54.64％.57.92％的人不愿意对辖区HIV/AIDS患者实施随防管理.临床、护理、预防保健、药检、管理岗位的医务人员歧视分值分别为4.86、5.12、3.98、4.97、5.49,不同工作岗位的医务人员的歧视水平差异有统计学意义(P＜0.05).结论:采取有针对性的健康教育方式,加强对不同岗位社区医务人员的艾滋病基本知识、相关法律及职业暴露预防教育,以消除恐惧和歧视;强调政府的职能是提供关怀、消除歧视的关键.     

Heterosexual and mother-to-child transmission of AIDS in the hemophilia community.

Growing awareness of the potential modes of transmission of the human immunodeficiency virus (HIV) has encouraged interest in the epidemiology of infection among sexual partners and children of HIV-infected persons. The authors reviewed data on two groups, the first being those with HIV infection acquired heterosexually from a person whose hemophilia, or other chronic bleeding disorder, was treated with blood products. The second group was children with HIV infection acquired from a mother (vertical transmission) who either had been treated for a chronic bleeding disorder or had been the heterosexual partner of a person being treated. Surveillance data were examined for cases of acquired immunodeficiency syndrome (AIDS) in the United States reported to the Centers for Disease Control and Prevention, diagnosed before January 1, 1992, and for whom the only identified risk factor was being either the heterosexual partner or the child of a parent with a chronic bleeding disorder. Of the cases examined, 107 were in persons who were heterosexual partners of persons with chronic bleeding disorders. Of the 107, 98 (92 percent) were women and 87 (81 percent) were white; all were 17 years of age or older. In addition to the 107, there were 14 children, 10 (71 percent) of whom were diagnosed with AIDS in the first year of life. The rate of increase in such cases has not been as great in recent years as that observed early in the primary epidemic of AIDS among persons with hemophilia and other chronic bleeding disorders.(ABSTRACT TRUNCATED AT 250 WORDS)     

泰安市社区居民艾滋病预防知识现况调查

目的 了解社区居民对艾滋病知识的知晓情况,进一步采取健康教育和促进措施。方法 采用整群抽样方法,对泰安市泰山区4089名社区居民进行艾滋病知识的问卷调查。结果 社区居民对艾滋病相关知识的正确率较高,对性传播、血液传播、垂直传播的正确认知率分别为87％,90．2％。90．2％,对一些非传播途径认识不清。半数居民对艾滋病病毒感染者有恐惧心理。多数居民还没有将预防艾滋病付诸于实际行动。结论 要进一步提高社区居民对艾滋病的认知水平,尤其是对非传播途径的宣传教育。     

Organizing community research partnerships in the struggle against AIDS.

Despite pharmaceutical advances, AIDS remains a health problem difficult to treat, leaving preventive interventions as the primary means of promoting risk avoidance. Increasing the capacity of university-based researchers to develop culturally, developmentally, and contextually appropriate AIDS prevention strategies requires the collaboration of community service and advocacy partners. To date, neither university researchers nor community providers have a great deal of partnership experience. Thus, a common language and set of experiences are yet to be developed. This article reviews the history of university-community and researcher-community collaboration for AIDS research and intervention, placing the innovative work of the University of California, San Francisco (UCSF) Center for AIDS Prevention Studies and its community and foundation partnerships among those efforts at the forefront of the community-university dialogue. It concludes with suggestions derived from the collaborative work of UCSF researchers and community service partners to strengthen efforts to develop theory, research methods, and results that are immediately useful and productive of long-term prevention research efforts.     

探索以社区为基础的艾滋病防治关爱模式

[目的]探索以社区为基础的艾滋病防治关爱模式,减少社区居民、家庭对吸毒者和HIV感染者的歧视。[方法]建立目标人群(静脉吸毒者)档案、入户随访和例会制度;组织社区居民、目标人群及其家属开展丰富多彩的宣教、联谊活动;对吸毒者和HIV感染者实施情感交流、生活照顾、转介就业等。[结果]通过项目干预,吸毒人群建档率达70%以上,111个吸毒者和HIV感染者获得了生活救助;转介目标人群就业人数达75人;社区居民对艾滋病知识的知晓率达80%以上;新婚登记人员中接受艾滋病自愿咨询率和婚检时进行HIV检测率分别达67%和36%。[结论]利用社区资源,在社区内大力宣传艾滋病防治知识,对目标人群实施关怀和救助,营造社会对HIV/AIDS的支持性环境,是防治艾滋病的有效措施之一。     

河南省涉艾社区组织的生存现状及其防艾成效评估

目的调查参与河南省艾防工作社区组织的生存现状及其参与艾防工作所取得的成效,了解涉艾社区组织的资源优势与发展所遇阻碍,为进一步依托涉艾社区组织开展艾滋病防治工作提供依据。方法采用整体抽样抽取河南省全球基金艾滋病项目社区组织项目80个中标的涉艾社区组织,进行问卷调查。结果 10.00%的组织已经注册,1 940名工作人员中仅有9.02%为全职人员,其中72.62%为志愿者。最主要资金来源为国际机构/基金会,占91.25%;暗娼HIV感染率由2010年的0.07%下降到0.04%;男男性行为者感染率由2010年的4.85%提高到6.78%。结论社区组织在防艾工作中发挥了巨大作用。建议相关部门应降低注册准入标准,组织应拓宽资金来源渠道,完善资金管理制度。社区组织应加强自身能力建设,强化社团自治,提高人员的专业化水平,和队伍的稳定性。     

艾滋病高危人群的社区护理干预

目的 研究如何在高危人群中开展有效的艾滋病干预活动.方法 对丰台区大红门街道的18家娱乐场所的高危人群开展艾滋病的干预活动,在干预前后对她们对艾滋病的知识水平、防治意识及防治行为进行问卷调查.结果 通过干预,调查对象艾滋病知识知晓率提高,安全套使用率上升.结论 有效的社区护理干预能提高目标人群的艾滋病知识水平、防治意识和行为正确率,对在艾滋病高危人群中推行百分百安全套活动和建立安全性行为起到积极的推动作用.有效提高高危人群的自我保护意识和降低艾滋病的传播.     

社区艾滋病综合防治效果评价

目的；探索社区艾滋病综合防治模式。方法：利用社区网络，建立组织，开展志愿者入户宣传、广场文艺晚会、科普讲座、高危行为干预等形式多样的活动，动员社区各方力量，整合社区资源，实施社区艾滋病综合防治。结果：在社区营造了浓厚的宣传氛围，有效地提高了社区居民艾滋病防治知识的知晓率（知晓率从项目开始前的74．08％提高到91．92％）；提高了群众主动参与艾滋病防治活动的积极性，并使社区群众对艾滋病病毒感染者的态度有了一定程度的改变。结论：社区综合防治是我国当前艾滋病防治的有效模式。     

Household and community responses to HIV and AIDS in developing countries

Household and community responses to HIV and AIDS are shaped by the contexts in which women, men and children live and socialize. In this study carried out in the Dominican Republic, Mexico, India, Tanzania and Thailand, factors relating to economic resources and gender influenced the forms of care and support made available to people living with HIV and AIDS. Adults and children in poorer households and communities suffered most. Beliefs about sexual transmission were influenced by what was, and was not, thought to be appropriate conduct for men and women. Prevailing gender relations affected what care was provided, by whom, to people living with HIV and AIDS. Future programmes of HIV-related prevention and care should place more stress on the vulnerability of poorer households and women. More attention needs to be paid to investing in, and supporting, those in the informal sector (mostly women) who provide care. Furthermore, the responsibilities of men to appraise their own HIV-related risk and to protect and support their partners should be addressed.     

广州市社区居民艾滋病知识态度调查研究

目的了解城市社区居民艾滋病的知识与态度情况,为进一步实施社区艾滋病综合防治提供依据。方法对3 156名16岁以上社区居民的艾滋病知信行进行问卷调查。结果居民对共用注射器吸毒认知率最高83.14%;对艾滋病三大传播途径:性传播、血液传播和母婴传播的认知正确率分别为79.15%、82.16%和72.53%,但对非传播途径的认知正确率较低,蚊虫叮咬和共用坐厕分别为27.88%和52.41%。近半数认为自已艾滋病知识不足,78.83%的受调查者是从电视获得HIV病知识;接受宣传服务以社区张贴海报者最多31.75%。艾滋病自愿检测知晓率及检测率分别为26.65%和3.99%;对艾滋病的恐惧是最主要的态度问题。结论必须深化普及社区居民的艾滋病知识宣传,大众媒体和社区宣教相结合,引导广大居民正确对待艾滋病,减少恐慌和歧视。     

河南省涉艾社区组织的生存现状调查

目的 调查河南省参与艾滋病预防与控制工作的社区组织现状,了解涉艾社区组织参与艾滋病防治工作的资源优势以及发展过程中的困难与阻力,为进一步依托涉艾社区组织开展艾滋病防治工作提供依据.方法 对87个中标的社区组织进行问卷调查和现场访谈.结果 组织工作人员文化程度相对不高,65.1％的工作人员学历在高中(中专)或大专学历;45.5％的工作人员曾经参加过各级相关培训,参加培训率偏低.73.2％的人提到在进行艾滋病宣传教育过程中资金不足.结论 社区组织工作人员自身能力有待提高;艾滋病防治工作需要系统的组织管理和多部门配合;经费不足问题为阻碍社区组织发展的关键性问题.     

Facing the HIV / AIDS challenge: a study on household and community responses

In countries where the health care system cannot cope with the growing number of AIDS cases, the family and the community are significant sources of care and treatment. A qualitative study conducted in Mumbai, India, in 1994 sought to identify household- and community-based strategies for effective AIDS care. Enrolled were 26 individuals with HIV or AIDS, 4 couples (both partners infected), and 25 members of households with an HIV-infected person; in addition, 18 focus group discussions were held with low-income youth. None of the households contacted had abandoned a member with HIV. Household dynamics played a crucial role in the nature and quality of care received, however. The most supportive care was received by men, even when their female partner was also sick. In-laws often showed little compassion toward widowed, infected daughters-in-law. Individuals without open sores or lesions were better accepted by family members and perceived as less likely to transit the virus. Concerns about social stigmatization and isolation prevented many family members from turning to their community for support. Recommended, on the basis of these findings, are measures such as support programs to reduce the burden on female caregivers, subsidized and appropriate medical care, support groups for people with AIDS, HIV/AIDS community awareness programs, and increased involvement on the part of nongovernmental organizations in integrated programming.     

HIV/AIDS and community conflict in Nigeria: implications and challenges

This paper discusses how HIV/AIDS prevention, treatment and mitigation activities and funding for such work can lead to community conflict. The central role of communities in combating HIV/AIDS is widely agreed, with the contributions of social capital networks and civil society seen as pivotal; a rights-based approach to HIV/AIDS activities is considered essential. Yet experiences from a UK Department for International Development funded project in Nigeria suggest that greater critical attention must be given to the impacts and effects of HIV/AIDS on communities, and the ways in which conflict can develop, emerge and be sustained, resulting in severe breakdown of social cohesion and reduction or cessation of HIV/AIDS activities. It is argued here that conflict can be fuelled by the different priorities and perceptions of community members and groups vis-à-vis those of development organisations, and by the impact of funds on often desperately poor communities. Case studies analyse the development of the conflict, failed attempts at resolution, and two post-conflict project interventions whose design and implementation were informed by its experiences and outcome. The paper concludes by considering the potential input of participatory approaches, community psychology and change management in the development and implementation of HIV/AIDS interventions specifically so as to reduce potential for conflict. Its intention is to contribute to the debate on how best to implement genuinely community-based and managed HIV/AIDS interventions.     

Epidemic in the war zone: AIDS and community survival in New York City

The characteristics and consequences of the AIDS/HIV epidemic in New York City are examined, with special attention to its impact on inner-city communities. The high numbers of AIDS cases are the source of increasing stress on public and community treatment and family and neighborhood networks of support. As the epidemic deepens (8 to 10 thousand new cases per year are expected by 1992) these resources, already weakened by years of underfunding, are becoming overwhelmed and are in danger of collapse. The high rates of HIV infection in these communities (5 to 20 percent of adults aged 25 to 45) and their linkage to widespread drug use prefigure the development of endemic levels in several population subgroups, with substantial risk of heterosexual spread. Simultaneously, there is a steady diffusion of infection to adjacent urban areas and, via migration patterns, to localities quite distant from New York City (e.g., Puerto Rico). Some hope can be found in the advent of more effective methods of early intervention for presymptomatic HIV infection. These offer an opportunity for combining clinical care with public health strategies that may restrict the spread of HIV while providing humane care for large numbers of people with AIDS and support for their families.     

AIDS in the family and community: The impact on child health in Malawi

Pediatric HIV infections jeopardize children’s health and survival. Much less is known about how the experiences of being orphaned, living with chronically ill parents, or living in a severely affected community impact child health. Our study responds by examining which HIV/AIDS-related experiences place children at greatest risk for poor health. Data from the 2004–2005 Malawi Integrated Household Survey were analyzed using logistic multilevel modeling to examine whether HIV/AIDS-related experiences within the family and community predicted reported health status among children age 6–17 years. We found higher burdens of acute and chronic morbidity for children whose parents have an AIDS-related illness. No other AIDS-related exposure, including orphanhood and recent household deaths, demonstrated a clear relationship with health status. Children living with sick parents may be at increased risk due to the spread of infectious disease and receiving limited adult care. Community home-based care programs are best situated to identify children in these difficult circumstances and to mitigate their disadvantage.     

Improving community support for HIV and AIDS prevention through national partnerships.

If the transmission of human immunodeficiency virus (HIV) is to be prevented, the environment in which people live should predispose them to engage in and sustain safe behaviors. Too often in public health, the range of organizations that make up that environment are overlooked, and prevention strategies are limited to familiar medical and public health institutions. Improvement in public health does not occur in isolation, apart from the other institutions of society--and so it is with the HIV-AIDS epidemic. Education; business and labor; religion; government; voluntary, civic, and social organizations; and the media can all serve as facilitators or as barriers to creating the environment--at the national, regional, State, or local level--that will prevent and control the spread of HIV infection and AIDS and support the needs of those already infected. Collectively, they become a comprehensive HIV prevention network with access to and influence on the total public. One of the most significant benefits of this network is the multiplier effect on the limited resources of public health. Therefore, as part of its HIV and AIDS prevention strategy, the Centers for Disease Control (CDC) has developed national partnerships to involve the leadership of business, labor and industry, religious institutions and organizations, and voluntary organizations in HIV and AIDS prevention and service. Some of these partnerships are federally funded, others are not. The national partnership program described in this paper has produced increased resources for HIV education and services and has demonstrated the synergistic benefits resulting from public and private cooperation in addressing the HIV epidemic.