The Study On Needs And Utilization Of Health Services Of HIV/AIDS In High-incidence Area

ObjectiveHenan is one of the most serious provinces of HIV/AIDS epidemic situation in China, and most infected people have become AIDS patients. Through investigating the HIV/AIDS patients, we can learn about this population’s health service need, health services utilization condition and the influencing factors. Furthermore, it can provide certain scientific basis for carrying out AIDS prevention and control as well as the management work, making new stage health policy and configurating health resources rationally. In addition, Henan has made great achievements in AIDS prevention and control; the results can be a reference data and provide baseline data for the prevention and control of AIDS in other parts of the country.MethodsOn the basis of literature investigation and expert consultation, we collected data through the questionnaire survey. Firstly, we randomly selected three AIDS counties in Henan province, nine townships,27 administrative villages and then conducted a questionnaire survey on these sites. Secondly, we collected and reorganized the original data, we established a database with Epidata3.1 and finished data entry. Finally we used SPSS 17.0 and Excel to analyze the data.Results1 The two-week prevalence rate of HIV was 62.25%, and the main influential factor of prevalence was family economic situation. The chronic diseases prevalence rate was 18.99% for HIV infector, and 31.96% for AIDS patient. The main chronic diseases were digestive system disease, cardio-cerebral vascular disease, hypertension, diabetes and tuberculosis, etc.2 (1) The two-week outpatient(consultation) rate of HIV was 57.59% with the average 2.46 times per person, and AIDS was 82.46% with the average 3.57 times per person, and the difference was statistically significant between them(χ=9.755, P =0.002). The majority of HIV (80.95%) and AIDS (77.55%) chose village clinics for treatment. The patients of HIV and AIDS who needed treatment but non-seeking medical services were respectively 7.14% and 17.54%, and 68.75% of them were for the reason of economic difficulty. In addition, family economic status, marital status, treatment and social support of HIV/AIDS patients make a certain extent influence too, the impact on AIDS patients was more obvious.(2) The hospitalization rate of HIV was 19.62% with the average 24.79 days per person, while AIDS was 25.22% with the average 48.13 days per person.61.29% of HIV and 56.90% of AIDS patients chose county level medical institutions or above for hospitalization, while 38.71% of HIV and 43.10% of AIDS chose rural hospitals. The difference of AIDS patients choosing medical institution was statistically significant (χ=6.621, P=0.01). In addition, the patients of HIV and AIDS who required hospitalization but not were 44.64% and 60.96%, and 79.11% of them were for the reason of economic difficulty.3. The average of smallest distances from respondents to the county health agencies was 7.95 kilometers, and 4.57 kilometers to the township health hospitals, 618.05 meters to the village clinics.156 HIV infections(98.73%) and 671 AIDS patients(97.25%) received the new rural cooperative medical treatment, and 47.47% HIV and 33.62% AIDS patients were totally deducted while 44.94% HIV and 48.26% AIDS patients got partial relief. In addition, for the health services satisfaction, most of the HIV infectors were "basic satisfaction" (48.71%) and "very satisfied" (46.57%), and with an average points of 79.39. As for AIDS patients, most of them were "basic satisfaction" (60.79%), and the "very satisfied" (33.65%) was in the second place, scoring an average points of 77.52.The health service satisfaction of HIV and AIDS have statistically significant differences (χ2=7.468, P=0.024).Conclusions1 The health services needs of HIV/AIDS were solved effectively by "Four Frees and One Care" policy and it also promotes the health services utilization of them. 2 The health services needs and utilization of HIV/AIDS patients were greater than normal people (including the requirements of AIDS patients are greater than HIV), which led to the increase of the burden of medical institutions.3 The factors contribute to health service needs and utilization of HIV/AIDS patients were many-sides and the family economic is one of the most influential factors.4 The aid of government, to a great extent, reduces the patients’ financial burden.5 More care should be done for prevention and control of AIDS, and the AIDS knowledge publicizing need to be strengthened.