对HIV暴露前和暴露后预防服务提供者的质性研究  

A descriptive qualitative study for service providers of pre-exposure prophylaxis and post-exposure

作　　者：章清[1,2] 孙美艳 卢洪洲[1] ZHANG Qing;SUN Meiyan;LU Hongzhou(Shanghai Public Health Clinical Center,Shanghai 201508,China;Fudan University,School of Nursing,Fudan University,Shanghai 200032)

机构地区：[1]复旦大学附属公共卫生临床中心,上海201508 [2]复旦大学护理学院,上海200032

出　　处：《中国艾滋病性病》2021年第10期1091-1095,共5页Chinese Journal of Aids & STD

基　　金：上海市2020年度“科技创新行动计划”医学创新研究专项(20MC1920100)。

摘　　要：目的了解我国目前暴露前和暴露后预防服务开展的现状和存在问题。方法选取2020年12月至2021年2月在上海市、浙江省杭州市、江苏省常州市、江苏省无锡市4所艾滋病定点诊疗医院的医护人员进行半结构化访谈,运用归纳式内容分析法分析资料。结果共纳入22名医护人员,根据访谈资料提炼出4个部分,第一部分为目前暴露前后预防服务开展现况,包括目前服务开展现况、暴露前后预防提供的服务和实施暴露前预防的争议3个一级主题;第二部分为开展暴露前后预防服务遇到的困难,包括用药、人群沟通交流、人群监测和管理3个一级主题;第三部分为目前暴露前后预防服务存在的不足之处,包括缺乏随访管理、药物可及性低、知识普及不足、环境和人力资源欠缺、缺乏客观的依从性评估工具以及缺乏心理疏导6个一级主题;第四部分为完善暴露前后预防服务的建议,包括服务流程规范化、加强管理和监测、扩大知识宣传与教育、提供心理咨询服务以及设立专业化门诊5个一级主题。结论目前暴露前后预防服务仍存在许多不足与难点,建议加强暴露前后预防知识宣传与教育,构建艾滋病定点诊疗医院和疾病预防控制中心间的医联体,并提高个案管理师在其中的重要作用,促进暴露前后预防服务更加全面、专业和规范化。Objective To understand the current situation and existing problems of pre-exposure and post-exposure prevention services in China.Methods from December 2020 to February 2021,the medical staff of 4 hospitals in Shanghai,Zhejiang,Hangzhou,Jiangsu Changzhou,and Wuxi City,Jiangsu province were interviewed by semi-structured interviews,and the data were analyzed by inductive content analysis.Results a total of 22 medical and nursing staff were included.Four parts were extracted according to the interview data.The first part was the current situation of preexposure and post-exposure prevention services,including three first-class themes:the current situation of services,the services provided by pre-exposure and post-exposure prevention,and the disputes over the implementation of preexposure prevention.The second part was the difficulties encountered in carrying out preventive services before and after exposure,including three primary themes:medication,population communication,population monitoring,and management;The third part was the deficiencies of preventive services before and after exposure,including the lack of follow-up management,low drug accessibility,insufficient knowledge popularization,lack of environment and human resources,lack of objective compliance assessment tools and lack of psychological counseling.The fourth part was the suggestions to improve the prevention services before and after exposure,including five first-class themes:standardizing the service process,strengthening management and monitoring,expanding knowledge publicity and education,providing psychological counseling services,and establishing professional outpatient clinics.Conclusion there were still many shortcomings and difficulties in preventive services before and after exposure.It was suggested that publicity and education should be strengthened before and after exposure,to establish a medical conjoined body between hospitals and CDC of AIDS,and enhance the important role of case managers in promoting more comprehensive,professional

关 键 词：艾滋病病毒 暴露前预防 暴露后预防 服务现状 质性研究 

分 类 号：R373.9[医药卫生—病原生物学]