采用 "计划科学 "方法,大幅降低津巴布韦女性性工作者在性交易中传播和感染艾滋病毒的风险。

IF 4.6 1区 医学 Q2 IMMUNOLOGY Journal of the International AIDS Society Pub Date : 2024-07-10 DOI:10.1002/jia2.26262
Frances M. Cowan, Sithembile Musemburi, Primrose Matambanadzo, Phillip Chida, Richard Steen, Rumbidzo Makandwa, Sungai T. Chabata, Albert Takura, Amber Sheets, Raymond Yekeye, Owen Mugurungi, Bernadette Hensen, Joanna Busza, James R. Hargreaves
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引用次数: 0

摘要

简介我们利用 "计划科学 "平台,为非洲性工作者计划的实施提供证据支持。在津巴布韦,女性性工作者估计占 15-49 岁女性人口的 1.6%(1.3%-1.8%)。我们强调了如何利用计划科学来帮助区分计划实施的时间、地点和对象,并讨论了两个案例研究,分别说明了如何更好地实施计划(案例研究 1(2019 年 6 月 1 日至 2021 年 6 月 30 日)优化风险差异化微观计划干预措施的实施)和以不同方式实施计划(案例研究 2(2016 年 10 月 1 日至 2022 年 9 月 30 日)调整针对年轻卖春女性的 DREAMS 计划的实施方向):津巴布韦的全国性性工作者计划于 2009 年与性工作者合作建立,旨在为性工作者提供全面服务,并为计划的设计、实施和推广提供证据。自该计划启动以来,已从所有寻求服务的性工作者那里收集了全面的数据。随着服务范围的扩大,数据收集和分析的范围也在扩大。在登记时,性工作者会被分配一个字母数字的唯一标识符,该标识符可将计划站点内部和站点之间的咨询联系起来。我们对关键人群(KP)计划数据进行描述性分析,以指导计划的实施和重新设计,并根据需要纳入计划定性调查:结果:本报告介绍了两个案例研究,描述了不同的计划优化方法。在第一个案例中,利用优化工作加强了计划的实施,确保了重点人群计划在第二次非典之后重新走上正轨。在第二项计划中,通过对研究和计划数据的深入审查,对 DREAMS 计划进行了重新定位,以确保感染艾滋病毒风险最高的年轻妇女能够加入该计划并获得 DREAMS 社会支持干预措施,从而加强她们对艾滋病毒预防措施的吸收:要优化和持续开展艾滋病护理和治疗计划,就必须有效地实施计划,并使其具有足够的规模和强度,从而对人群产生影响。我们的计划科学方法为津巴布韦扩大 KP 计划的规模提供了指导,为战略、实施和持续管理提供了证据支持,更重要的是帮助我们区分了何时需要实施、更好地实施或以不同的方式实施。
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Using a Programme Science approach to substantially reduce the risk of HIV transmission and acquisition in sex transactions among female sex workers in Zimbabwe

Introduction

We used a Programme Science platform, to generate evidence to support the implementation of programmes for sex workers in Africa. Female sex workers are estimated to make up 1.6% (1.3%–1.8%) of the population of women aged 15−49 years in Zimbabwe. We highlight how programme science can be used to help distinguish between when, where and with whom programmes need to be implemented and discuss two case studies that exemplify implementing better (Case study 1 (1 June 2019−30 June 2021) Optimizing implementation of a risk differentiated microplanning intervention) and implementing differently (Case study 2 (1 October 2016−30 September 2022) Reorientating implementation of DREAMS for young women selling sex).

Methods

Zimbabwe's nationally scaled programme for sex workers was established in 2009 in partnership with sex workers to provide comprehensive services for sex workers and generate evidence for programme design, implementation and scale up. Since inception, comprehensive data have been collected from all sex workers seeking services. As the scope of service provision has expanded so has the scope of data collection and analysis. At enrolment, sex workers are assigned an alphanumeric unique identifier which links consultations within and across programme sites. We conduct descriptive analyses of the Key Population (KP) programme data to guide programme implementation and redesign, embedding programmatic qualitative enquiry as required.

Results

Two case studies describing different approaches to programme optimization are presented. In the first, an optimization exercise was used to strengthen programme implementation ensuring that the KP programme got back on track after SARS-COV-2. In the second, an in-depth review of research and programme data led to a re-orientation of the DREAMS programme to ensure that young women at the highest risk of HIV acquisition were enrolled and had access to DREAMS social support interventions in turn strengthening their uptake of HIV prevention.

Conclusions

Optimizing and sustaining HIV care and treatment programmes requires effective delivery with sufficient scale and intensity for population impact. Our programme science approach guided the scale up of the KP programme in Zimbabwe, providing evidence to support strategy, implementation and ongoing management, and importantly helping us distinguish between when we needed to just implement, implement better or implement differently.

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来源期刊
Journal of the International AIDS Society
Journal of the International AIDS Society IMMUNOLOGY-INFECTIOUS DISEASES
CiteScore
8.60
自引率
10.00%
发文量
186
审稿时长
>12 weeks
期刊介绍: The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.
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