云南省目标人群寻求和接受艾滋病自愿咨询检测服务的困难和障碍调查

目的了解阻碍云南省高危人群寻求和接受艾滋病自愿咨询检测（VCT）服务的影响因素，为改进现行的咨询检测服务体系和服务质量，提高VCT服务在高危人群中覆盖率提供科学依据。方法采用个人深入访谈和问卷调查相结合的方法，对云南省艾滋病流行水平和VCT服务水平不同的4个县（市）区的注射吸毒者、暗娼、男男性行为者和男性流动人口进行了调查，对VCT服务提供方进行个人深入访谈。对访谈资料进行归纳、整理和分析，用EPI和SPSS软件进行问卷资料的录入和分析。结果目标人群寻求和接受VCT服务的困难和障碍如下：（1）艾滋病本身的不可治愈性以及沉重的医疗负担；（2）社会恐惧和歧视；（3）VCT服务质量不高，服务方式单一；（4）对艾滋病及其相关服务的宣传不到位；（5）治疗、关怀和支持措施的落实不到位；（6）VCT服务资源投入不足，服务的主动性不够。结论（1）建立以咨询为基础的检测服务体系，完善转介服务网络，提高服务的可及性；（2）正面宣传艾滋病，加强对咨询检测和治疗、关怀服务的宣传；（3）加强对咨询检测工作的投入，建立和完善咨询检测工作的考核和激励机制，维护队伍的稳定，提高咨询检测服务质量。

Survey of constraints and obstacles for seeking for and receiving VCT services among high risk population in Yunnan province

Objective To understand the obstacles and constraints for seeking for VCT services among the most at risk populations （MARPs） so as to provide evidence for the improvement of VCT service,its quality and coverage. Methods IDUs,FSWs,MSM and floating male individuals from the four counties/cities were surveyed by indepth interviews and questionnaires. Leaders and counselors from VCT service sites and local health departments were interviewed. The data collected from the interviews and surveys were synthesized and EPI and SPSS were used for data input and analysis. Reusult The constraints and obstacles for seeking for VCT services among MARPs were presented as follows ; 1 Incurability of AIDS itself and incurred high cost of treatment;2. Social stigma and discrimination;3. Poor quality of VCT service and monotonous approach of service provision;4. Inadequate and inappro priate publicity of HIV/AIDS and related services; 5. Poor accessibility of HIV/AIDS care and treatment services among PLHA; 6. Shortage of resources invested into VCT services and lack of initiative from VCT providers. Conelusion 1. To set up counseling based HIV testing service and improve VCT referral services for increasing accessibility;2. To promote positive health education on HIV counseling and testing as well as care and treatment service;3. To increase the input for HIVcounseling and testing and to establish an assessment and incentive system to improve the quality of VCT service and to stabilize the counselor team.