德宏州中缅跨境婚姻人群HIV感染及卫生服务利用现况和影响因素的定性研究——基于供需双方视角

目的  探讨德宏傣族景颇族自治州(德宏州)中缅跨境婚姻人群HIV感染及卫生服务利用的现况和影响因素。 方法  以Andersen卫生服务利用行为模型为理论框架，对德宏州卫生服务机构工作人员(供方)进行焦点小组访谈，对中缅跨境婚姻人群(需方)开展一对一访谈，对访谈文本进行主题分析。 结果  共招募40人，其中供方7人，需方33人；需方受访者中女性13人，平均年龄(38.61±5.74)岁，男性20人，平均年龄(39.30±5.90)岁。德宏州跨境婚姻人群对中国的医疗保险政策满意，获得的社会支持较好、健康信念水平较高，对其卫生服务利用产生了影响。同时，影响该人群HIV感染的因素有AIDS知识欠佳、追踪溯源、检测工作不足等。 结论  德宏州对跨境婚姻人群的管理工作取得了一定成效，在当地获得卫生服务的公平性较高，但仍应加强多部门合作，多维度解决身份识别、婚检、溯源等管理工作上的困难，加强对该人群的卫生服务保障。

Qualitative study on influencing factors of HIV infection and health service utilization among China-Myanmar cross-border couples in Dehong Prefecture: Based on provider-demander perspectives

Objective To investigate the status and influencing factors of HIV infection and health service utilization among the China-Myanmar cross-border couples in Dehong Prefecture. Methods Upon the theoretic frame of Andersen′s behavioral model, focus group interviews were conducted on professionals of local health service institutions (health service providers) in Dehong Prefecture, and one-to-one in depth interviews were conducted on the China-Myanmar cross-border couples (health service demanders). Thematic analysis was conducted on the interview texts. Results Forty participants were interviewed, including 7 health service providers and 33 health service demanders. Among the demanders, 13 were female with an average age of (38.61±5.74) years old, and 20 were male with an average age of (39.30±5.90) years old. Cross-border couples in Dehong were satisfied with Chinese medical insurance policy, received better social support, and had a higher level of health belief, which also influenced their utilization of health services. Meanwhile, the factors influencing HIV infection among the China-Myanmar cross-border couples include poor knowledge of AIDS, lack of tracing and testing management, etc. Conclusions Dehong Prefecture has well achieved goals in the management of China-Myanmar cross-border couples. The fairness of cross-border couples in obtaining local health services is relatively high. Multi-departmental cooperation should be strengthened to solve the difficulties in the management of identity identification, premarital examination and source tracing in a multi-dimensional way, and strengthen the guarantee of health service for cross-border couples.