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目的在中国-世界卫生组织-瑞典艾滋病综合防治项目支持下,探索、提高针对吸毒人群的卫生服务干预质量,建立一个艾滋病防治关怀的综合服务关联体系。方法邀请吸毒人群、感染HIV的吸毒者及其家属参加研讨会,召开有疾控机构、医院、社区、性病门诊和目标人群参加的协调会,探索建立一个针对吸毒人群的“一站式”艾滋病综合防治体系,采用SAS8.01软件分析数据。结果通过疾控机构、美沙酮门诊、医院系统之间形成的强效转介机制,通过密切转介、协调防治关系、形成服务环路,建立了针对吸毒人群的“一站式”转介服务模式,发动目标人群及其家属的参与,又使服务链的功能实现成为可能。三年的综合防治探索,该转介服务模式发挥了作用。湖南国家级哨点监测信息显示,吸毒人群的艾滋病病毒阳性率明显下降,由2006年的15.58%下降到2007年的3.60%;高危行为发生率明显下降,共用针具率由2004年的74.88%,下降到2007年57.84%,商业性性行为由2004年的32.07%,下降到2007年的20.15%。结论一站式转介服务模式是有效的。成功的持续的动态转介,是扩大吸毒人群覆盖率的关键,而对防治人员的激励机制和吸毒志愿者的不断招募需要国家加大投入,以维持该人群的有效干预的持续性。
Objective To explore and improve the quality of health service interventions for drug addicts based on the China-WHO-Sweden Integrated HIV / AIDS Prevention and Control Project and establish an integrated service-related system for AIDS prevention and care. Methods Involvement of drug addicts, drug addicts infected with HIV and their families to participate in the symposium and convened a coordination meeting attended by CDCs, hospitals, community clinics, STD clinics and target groups to explore a “one-stop ”AIDS prevention and control system, the use of SAS8.01 software analysis of data. Results Through the referral mechanism of methadone, methadone clinics and hospital system, through close referral, coordination and prevention and control, a service loop was formed and a “one-stop” referral for drug addicts was established Service model, mobilize the target population and their families, and make the service chain realize the function. Three years of comprehensive prevention and treatment of exploration, the referral service model has played a role. Hunan national sentinel surveillance information shows that the HIV-positive rate of drug users decreased significantly from 15.58% in 2006 to 3.60% in 2007; the incidence of high-risk behavior decreased significantly, sharing needle rate from 2004 to 74.88% , Down to 57.84% in 2007, and commercial sexual activity dropped from 32.07% in 2004 to 20.15% in 2007. Conclusion One-stop referral service model is valid. A successful and continuous dynamic referral is the key to expanding the coverage of drug abusers. However, the incentive mechanism for prevention and control of drug addicts and continuous recruitment of drug volunteers will require increased state investment to maintain the sustainability of effective interventions for this population.