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[目的]了解上海市艾滋病病毒感染者和艾滋病患者(people living with HIV/AIDS,PHA)获得医疗服务的可及性及其影响因素,为进一步的干预研究提供针对性的建议。[方法]采用个人深入访谈和小组访谈的方式,调查50名PHA以及46名包括政策决策者、服务提供者等在内的相关人员,定性调查资料采用N-Vivo 8.0进行编码和分析。[结果]上海市PHA医疗服务可及性不足,主要表现在距离可及性远,各区距上海市公共卫生临床中心平均距离达69.0 km,平均车程62 min;目前仅一家定点服务机构,服务能力有限、免费抗病毒药物少、流动人口抗病毒治疗服务可及性差;PHA支付艾滋病相关诊疗服务能力不够。[结论]上海市PHA获得医疗服务的可及性很不乐观,而且获得医疗服务的负担重,亟需扩大和合理利用医疗资源,提高艾滋病相关医疗服务的可及性,增强临床关怀。
[Objective] To understand the availability of access to medical services and its influencing factors in people living with HIV / AIDS (PHA) in Shanghai and provide targeted suggestions for further intervention research. [Methods] Using personal in-depth interviews and group interviews, we investigated 50 PHAs and 46 related personnel, including policy makers and service providers. Qualitative survey data were encoded and analyzed by N-Vivo 8.0. [Results] The lack of accessibility of PHA medical service in Shanghai mainly lies in distance accessibility. The average distance from Shanghai Public Health Clinical Center to each district is 69.0 km and the average journey time is 62 minutes. At present, only one designated service agency, service capability Limited free anti-viral drugs, poor access to anti-viral treatment services for floating population; PHA is not enough to pay for AIDS-related medical services. [Conclusion] The availability of medical services in Shanghai PHA is not optimistic, and the burden of obtaining medical services is heavy. It is urgent to expand and rationalize the utilization of medical resources, improve the accessibility of AIDS related medical services and enhance the clinical care.