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基于证据的自愿医疗男性割礼计划的传播和实施:矛与盾计划
Stephen M Weiss1, Kasonde Bowa2, Robert Zulu3,4
1Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
PLOS global public health
|January 31, 2024
概括
"矛与盾2" (S&S2) 计划成功地利用基于社区的方法在赞比亚增加了自愿医疗男性割礼 (VMMC) 的普及率. 这一艾滋病毒预防战略在四个省份表现出有效的覆盖和实施.
科学领域:
- 公共卫生 公共卫生
- 预防艾滋病毒 预防艾滋病毒
- 医疗保健服务研究 医疗服务研究
背景情况:
- 自愿医疗男性割礼 (VMMC) 在撒哈拉以南非洲显著降低艾滋病毒风险,但在赞比亚的吸收仍然很低.
- 赞比亚政府的目标是通过社区干预来提高VMMC率.
- 矛与盾 (S&S) 计划是为了提高VMMC的需求和供应而开发的.
研究的目的:
- 评估赞比亚大规模的"矛与盾2" (S&S2) 计划的省级部署.
- 通过RE-AIM框架评估该计划的覆盖范围,有效性,采用,实施和维护.
- 了解社区层面干预措施对VMMC吸收的影响.
主要方法:
- 从2015年11月到2020年12月,S&S2计划在赞比亚四个省份的96家诊所实施.
- 当地卫生保健工作者接受了VMMC程序的培训,艾滋病毒辅导员领导了S&S小组会议.
- 使用RE-AIM模型来衡量主要结果:覆盖范围,有效性,采用,实施和维护.
主要成果:
- 在S&S2计划中,通过小组会议,达到了45,630人.
- 在临床层面进行了大约58,301次额外的VMMC.
- 项目实施时间超过2866个临床月,忠实度在42%-95%之间.
结论:
- 在S&S2项目中,RE-AIM模式得到了有效的应用,使其在赞比亚成功实施和传播.
- 像S&S2这样的创新VMMC计划对于提高VMMC作为艾滋病毒预防战略的采用至关重要.
- 该项目的可持续性受到研究资金停止的限制.
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