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目的探讨煤矿农民工预防艾滋病不同干预措施的效果及成本效果。方法于2009年7—12月选取开滦矿业集团某煤矿农民工459人,在基线调查基础上分成3组,分别采用发放宣传品、专业讲座、同伴教育3种干预措施;收集干预前后艾滋病相关危险性行为及安全套使用率,使用艾滋病病毒(HIV)传播模型计算每种干预措施所能避免的HIV感染例数,同时计算成本效果比。结果以近5个月内有偿性服务的安全套使用率为指标评价实施干预后危险性行为的变化,发放宣传品组由50.7%(35/69)上升到了55.2%(32/58),差异无统计学意义;而专业讲座组由51.0%(50/98)上升到了78.0%(32/41),同伴教育组由44.6%(25/56)上升到了66.7%(30/45),差异均有统计学意义(χ2=23.342、15.920,P<0.05);从总的知晓率来看,干预后专业讲座组61.3%(92/150),高于发放宣传品组的45.8%(66/144)和同伴教育组的50.3%(83/165),而后两者无明显差异;3种干预措施每避免1例HIV感染需要的平均成本分别为48 214.29、41 195.65和55 138.89元,专业讲座的成本效果比最高。结论以3种干预措施的效果和成本效果比为评价指标,专业讲座最好、同伴教育次之、发放宣传品最差。
Objective To explore the effectiveness and cost effectiveness of different interventions for AIDS prevention among migrant workers in coal mines. Methods From July to December 2009, 459 migrant workers from a coal mine in Kailuan Mining Group were selected and divided into three groups based on the baseline survey. Three kinds of interventions, including publicity materials, professional lectures and peer education, were collected respectively. Before and after the intervention, HIV / AIDS related Risk behaviors and condom use rates, use the HIV transmission model to calculate the number of HIV infections that each intervention can avoid, and calculate the cost-effectiveness ratio. Results The changes in risk behaviors after intervention were evaluated using the condom use rate of paid services in the recent 5 months. The distribution of publicity materials increased from 50.7% (35/69) to 55.2% (32/58) with no statistical difference The proportion of professional lecture group increased from 51.0% (50/98) to 78.0% (32/41), while that of peer education group increased from 44.6% (25/56) to 66.7% (30/45) (Χ2 = 23.342,15.920, P <0.05). From the total awareness rate, 61.3% (92/150) of the professional lecture groups after intervention were higher than 45.8% (66/144) of the publicity materials and 50.3% (83/165) of the peer education group, and there was no significant difference between the two. The average cost per HIV infection for the three interventions was 48.2429, 41.195.65 and 55.138.89 yuan, respectively. The cost-effectiveness of the professional lecture Than the highest. Conclusion The results of three kinds of interventions and the cost-effectiveness ratio are the evaluation indexes. The professional lectures are the best, the peer education is the second, and the publicity materials are the worst.