Research Of Resources Allocation And Intervention Effect On AIDS Prevention And Control In Intravenous-drug Users

Objective: This paper shows the current situation of several groups of people’s knowledge，attitude and behavior on AIDS prevention. Those groups of people include Injection DrugUser(IDU) and medical staff in compulsory detoxification settings, communities and methadonemaintenance treatment clinic. It also studies the resources available for preventing AIDS. Itprovides the methods of prevention of AIDS and improving the treatment of IDU. It alsoprovides suggestions that are suitable for China’s specific situation on resource allocation forprevention and treatment of AIDS.Methods:To investigate and analyze the knowledge, attitude and behavior of AIDS preventionand cure by extracting165target population of IDU in compulsory rehabilitation center,94incommunity and52in methadone maintenance treatment clinic. To investigate and analyze theknowledge about the characteristic of social demography and methadone, and the attitude ofAIDS prevention and cure of the staffs in compulsory rehabilitation center by extracting80staffsin it. To investigate and analyze the allocation of resource of human and physical of communityand methadone maintenance treatment clinic by extracting20communities and15methadonemaintenance treatment clinics.To evaluate the intervening effect of AIDS prevention and cure ofIDU through the participatory health education to41IDU in compulsory rehabilitationcenters,peer education to15IDU in community and peer education to32backbone of IDU inmethadone clinics and outreach services of knowledge and skills training.Results:The awareness rates of IDU population about sharing the syringes could transmit HIV incompulsory rehabilitation centers,communities and methadone maintenance treatment clinics are91.5%,88.3%,100%respectively,which are quite high. The awareness rates of IDU populationabout the location for voluntary counseling and testing(VCT) and the policy and content of FourFree and One Care for prevention of AIDS are low:7.9%、23.4%、30.8%respectively for theformer and7.9%、16.0%、26.9%respectively for the latter. The positive attitude of consideringthemselves possessing the risk of HIV infection of IDU population in compulsory rehabilitationcenters,communities and methadone maintenance treatment clinics are46.1%、38.3%、80.8%respectively. The positive attitude of willing to do VCT are84.2%、68.1%、78.8%respectively.43.0%IDU in compulsory rehabilitation centers have sex with non-fixed sex partners, and19.1%of them never use condom;19.1%IDU in communities have sex with non-fixed sexpartners, and9.6%of them never use condom; the rate of the dangerous behaviors of IDU inmethadone maintenance treatment clinics about their sneaking behavior of drug use during thetreatment, having sex with non-fixed sex partner, and their never using of condom arerespectively44.2%、19.1%、16.0%. The main factors that influence IDU’ knowledge, attitude andbehavior towards prevention and cure of AIDS are marital status, living condition, the relationship with family members and the quality of the service of methadone maintenancetreatment (p<0.05). The awareness rates of the staff in compulsory rehabilitation centers aboutthe danger of transmitting HIV by sharing syringes, the possibility of infecting HIV withoutprotection procedure, the fact that giving birth to children and breast feeding could transmit HIVto children, and knowledge that normal contact in daily life does not transmit HIV are100.0%、98.8%、96.3%、95.0%、93.8%and92.5%respectively.Their awareness rates about the locationfor voluntary counseling and testing(VCT) and the Policy and Content of Four Free and OneCare for prevention of AIDS are only65.0%and50.0%. There are15methadone maintenancetreatment clinics belonging to the rehabilitation agencies, general hospitals, mental health specialinstitutions and disease prevention and control centers respectively. They possess145workingstaff including physicians, pharmacists, nurses and security personnel, in which there are100medical staff (35physicians,13pharmacists,52nurses),and also82.0%medical staff haveparticipated in the special training about the MMT knowledge and AIDS prevention and cure.There are432staff engaged in drug prohibition and AIDS prevention and cure in those20communities, among them, the full-time, part-time volunteers respectively accounts for4.9%,14.3%,80.8%. The drug prohibition and AIDS prevention and cure in those communities islacking of human resources and funds. In addition, experimental groups and control groups havestatistical variance in the understanding of the factors like giving birth to children and breastfeeding could lead to HIV infection, the location of ‘voluntary counselling and testing’, thecontents of Four Free and One Care Policy and the ways of HIV transmission (p<0.05).Conclusion: IDU in compulsory rehabilitation centers,communities and methadone maintenancetreatment clinics are faced with the situation of low rates of awareness of AIDS prevention andits cure, low positive attitude as well as high-risk behaviors; marital status, living condition, therelationship with family members and the quality of the service of methadone maintenancetreatment help to improve the knowledge about their AIDS prevention and cure, attitude andbehavior of IDU; the conducting of participatory health education among IDU can obtain goodintervening effects; priority should be given to the resources for injection-drug users’ AIDSprevention and cure such as the enhancement of the working staff’s capabilities in the area ofAIDS prevention and cure in compulsory rehabilitation centers, the solutions of addressing theshortages of human resources and material means in AIDS prevention and cure in thecommunities as well as the strengthening of psychological intervention efforts among methadonemaintenance treatment clinics.