Comprehensive evaluation of AIDS spending in Dehong prefecture of Yunnan province in 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To comprehensive evaluate the rationality of Acquired Immune Deficiency Syndrome (AIDS) expenditure through the analysis of AIDS expenditure circumstances based on the application of National AIDS Spending Assessment in Dehong prefecture in 2010.</p><p><b>METHODS</b>Demographic and economic indicators of Mang City, Yingjiang, Longchuan, Ruili City, Lianghe and Wanting zone in Dehong prefecture of Yunnan province were collected from the reports issued by Dehong Statistical Bureau of 2010, and HIV/AIDS epidemic indicators were collected from the annual report of national AIDS prevention and control data.NASA method was used to analyze the actual spending and demand index was used to calculate the demand of AIDS funding in these counties (cities). The correlations between HIV/AIDS expenditures and demographic, economic and HIV/AIDS epidemic index were analyzed, respectively, as well as the correlation between the expenditures of AIDS prevention and control and proportion of major transmission approaches.</p><p><b>RESULTS</b>In 2010, the actual expenditures on HIV/AIDS in the 5 counties (cities) of Dehong prefecture was ¥28 752 772, the population was 1 211 400, and Gross Domestic Product (GDP) was ¥11 693. The intervention expenditures in injection drug users, sexually transmitted people, and prevention of mother to child transmission in Ruili county were ¥130 345, ¥71 484 and ¥164 100, the proportions of HIV transmission in these groups were 23.9% (49/205), 73.7% (151/205), and 0.5% (1/205), respectively; and in Lianghe county was ¥141 665, ¥257 142, and ¥99 961, and the proportions of HIV transmission were 17.1% (6/35), 80.0% (28/35) and 0.0% (0/35), respectively. The intervention expenditures in Ruili and Lianghe counties were positive related to the proportion of corresponding people with HIV infection (both r values were 0.99, all P values < 0.05). In the other 4 counties (cities) and the development zone, no correlations. The expenditures of government departments, international projects, domestic research programs and personal and family pays (r value were 0.94, 0.83, 0.99 and 0.88, respectively, all P values < 0.05) were positive related to the number.Except the personal and family pays, other sources of expenditures were all positive related to the number of reported HIV/AIDS cases (r values were 0.94, 0.89 and 0.81, respectively, all P values < 0.05).</p><p><b>CONCLUSION</b>Population and HIV/AIDS epidemic index were considered as factors in AIDS spending. The expenditures corresponded with the demand of different areas basically.</p>

Health economic evaluation for the extension clinics of methadone maintenance treatment / 中华预防医学杂志

<p><b>OBJECTIVE</b>To discuss the cost, cost-effectiveness, and cost-utility of the extension methadone maintenance treatment (MMT) clinics and provide the evidences of the strategy of scaling up the extension MMT clinics.</p><p><b>METHODS</b>A study was conducted in Dehong prefecture, Yunnan province, including Mang, Ruili city, Longchuan, Yingjiang, Lianghe county. 117 newly enrolling heroin addict patients in 17 extension MMT clinics were recruited as subjects from December 2010 to February 2011. An interview was conducted by the trained interviewers for the quality of life score of patients, and the cost of drug use was calculated. Table of outpatient costs of methadone maintenance treatment clinic of Dehong prefecture in Yunnan was used for collecting and calculating the fixed cost, operating cost of the clinics, and the unit cost and incremental cost of the patients from 2008 to 2010. Cost-effectiveness and cost-utility of the extension clinics were analyzed by using the Markov model.</p><p><b>RESULTS</b>The total spending of extension clinics for 2008, 2009, and 2010 on average was ¥57 294, ¥80 752 and ¥74 739 respectively, or about ¥4379 annually per patient. The cost of averting one HIV infection was ¥316 509; the cost of averting one acquired immune deficiency syndrome (AIDS) patients was ¥508 676; and the cost of averting one death was ¥152 330. The cost of obtaining one life year (LY) was ¥3696 and the cost of obtaining one quality adjusted life year (QALY) was ¥9014. Comparing with drug users, the incremental cost utility ratio (ICUR) of the patients of the extension MMT clinics were -7074 yuan/QALY and -7162 yuan/LY.</p><p><b>CONCLUSION</b>The extension MMT clinic service is lower in cost, and better in cost-effectiveness and cost-utility.</p>

The impact of community-based organizations in HIV testing mobilization among men who have sex with men / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the impact of efforts of community-based organizations (CBO) in HIV testing mobilization and case finding among men who have sex with men(MSM).</p><p><b>METHODS</b>Results of HIV testing mobilization among MSM through CBOs in 15 program areas were collected and compared with corresponding HIV case reporting data to demonstrate the contribution of CBO-based HIV testing in HIV case finding among MSM from July 2008 to December 2011. Meanwhile,the proportion of screened HIV positives who received testing results notification,confirmatory test, following up and CD4 cell tests were analyzed and compared with those identified in medical institutions.</p><p><b>RESULTS</b>A total of 196 075 HIV tests were performed for MSM, as a result of mobilization efforts of CBOs. Cumulatively 7704 new HIV cases were identified, accounting for 51.7% (7704/14 914) of all newly diagnosed HIV cases infected via homosexual sex in the program areas.Among the newly diagnosed MSM HIV infections in the program areas,the proportion of infections detected through the mobilization of CBOs increased from 35.4% (609/1722) in 2008 to 63.7% (2371/3722) in 2010, and 58.3% (3024/5189) in 2011. Compared with those identified through medical institutions, newly diagnosed MSM infections detected though CBOs testing mobilization have higher rates of receiving screening testing results notification (97.3% (4441/4563) vs 92.8% (13 140/14 153)) , (84.6% (2559/3024) vs 79.8% (5589/7002)) and CD4 cell tests (66.1% (1999/3024) vs 52.9% (3705/7002)), and a lower rate of receiving confirmatory test (78.6% (3588/4563) vs 85.6% (12 115/14 153)).</p><p><b>CONCLUSION</b>CBOs can take their advantages in mobilizing MSM to receive HIV test, and MSM HIV cases detected through CBOs have become the main source of MSM HIV case finding in program areas.</p>

The application of National AIDS spending assessment in a county of Dehong prefecture, Yunnan province, China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To calculate the actual expenditures in a county of Dehong prefecture, Yunnan province, China by using the method of National AIDS Spending Assessment (NASA) in 2010.</p><p><b>METHODS</b>Data were collected through NASA data collection form based on adapted NASA classification in the county of Dehong prefecture from October to December, 2011, and complemented by semi-structured interview with 16 well trained programmatic and financial representatives in 8 spending units. Data were entered in Resource Tracking Software (RTS) V 2009.3.0, and SPSS 13.0 was used for data processing and analysis.</p><p><b>RESULTS</b>The NASA estimations showed that the county spent a total of ¥16 235 954 on HIV/AIDS in 2010. Public funds constituted 96.3% of the total expenditure (¥15 630 937), followed by Global Fund which accounted for 3.0% (¥484 585) and private sources which accounted for 0.7% (¥120 432). Findings based on NASA categories showed that AIDS spendings were mainly on 4 areas, and expenditure on Care & Treatment was ¥12 401 382 (76.4% of total expenditure), followed by Prevention which accounted for 14.3% (¥2 325 707), Program Management & Administration which accounted for 7.8% (¥1 268 523) and human resources which accounted for 1.5% (¥240 342). The most beneficial population group was People Living with HIV (PLHIV), accounting for 84.7% of total expenditure. (¥13 753 428), followed by 4.8% for high risk population, including female sex workers and their partners (¥297 333), injection drug users and their partners (¥293 143), men having sex with men and their partners (¥185 136) and 1.5% (¥241 429) for the general population.</p><p><b>CONCLUSION</b>The local funds for HIV/AIDS in this county was insufficient. The local government should increase corresponding funds based on central government funding. Care and treatment was the first spending priority in the county and the investment of prevention services needs to be increased. Prevention and treatment and care should be combined to ensure the effectiveness of comprehensive prevention and treatment of AIDS.</p>

Analysis of expenditure cost of intervention among men who have sex with men in certain city / 中华预防医学杂志

<p><b>OBJECTIVES</b>To learn the use of fund investment and actual expenditure cost among men who have sex with man (MSM) intervention in the city, in order to provide related evidences for carrying out the intervention effectively MSM.</p><p><b>METHODS</b>Financial records were used to collect the information about the fund source and allocation of the resource invested for the MSM intervention between 2006 and 2009. Key staff was interviewed to get related information. The activity-based costing method was adopted to analyze the actual expenditure of MSM intervention in different sites, and the allocation of the total cost to each activity, the intervention times in different sites and the unit cost in actual HIV testing person-times promoted by MSM intervention was then calculated.</p><p><b>RESULTS</b>Interventions through internet and in bar and bathhouse were conducted in the certain city. Total funds for MSM intervention between 2006 and 2009 were 4.441 million, 56.7% (¥2.530 million) of which were from international cooperation programs, whose direct cost covered 50.5% (¥2.243 million) of the total cost. The actual expenditure in interventions through Internet was ¥750 656 (16.9%), including direct expenditure ¥317 088 and indirect expenditure ¥433 568. The actual expenditure in interventions in bar was ¥2 061 846 (46.4%), including direct expenditure ¥1 114 423 and indirect expenditure ¥947 423. The actual expenditure in interventions in bathhouse was ¥1 628 751 (36.7%), including direct expenditure ¥811 474 and indirect expenditure ¥817 277. The person-times of receiving MSM intervention and the unit cost for promoting HIV test through the above 3 access all decreased. The average cost for one person-time intervention through internet and in bar and bathhouse decreased from ¥68.7 (1011 person-times), ¥67.3 (3282 person-times), ¥67.9 (3140 person-times) in 2006 to ¥40.9 (25 523 person-times), ¥30.2 (28 121 person-times), ¥17.5 (28 381 person-times) in 2009 respectively, and the cost for promoting one person-time HIV test decreased from ¥1789.2 (58 person-times), ¥1175.6 (188 person-times), ¥574.2 (312 person-times)per person time to ¥676.9 (394 person-times), ¥556.5 (1637 person-times), ¥316.5 (2237 person-times) respectively.</p><p><b>CONCLUSION</b>The unit cost of MSM intervention through internet and in bar and bathhouse decreased, as well as the cost for HIV test promotion per person-time in the city. Meanwhile, the intervention covered more and more people annually.</p>

Survey on contact tracing of newly reported HIV infections in 2009 in Dehong prefecture, Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore a new method for finding more HIV/AIDS.</p><p><b>METHODS</b>In September 2009, newly reported HIV-infected individuals from May to August, 2009 in Dehong prefecture were asked to participate in a survey which requested demographic characteristics, history of high-risk behaviors and contact information of individuals with whom they had high risky contacts. People with risky contacts with HIV-infected cases (index cases) were also approached to participate in this survey and HIV testing was provided.</p><p><b>RESULTS</b>A total of 342 HIV-infected individuals were newly reported and served as index cases from May to August, 2009. Among them, 47.1% (161/342) were transmitted by regular sexual partners. Through three-round surveys, 218 contacts were traced and among them, 84.9% (185/218) were traced by regular heterosexual partners. HIV positive rate of the tested was 34.7% (60/173) in the first-round tracing and 12.5% (1/8) in the second one. Among the 560 individuals (index cases and their high-risk contacts), the proportions of having regular heterosexual partners, non-regular and non-commercial sexual partners, commercial sexual heterosexual partners and men having sex men were 87.9% (492/560), 18.9% (106/560), 22.3% (125/560) and 0.3% (1/318), respectively, while the proportion of having never used condoms when having sex with the above four types sexual partners were 73.8% (363/492), 72.6% (77/106), 63.2% (79/125) and 0.0% (0/1), respectively.</p><p><b>CONCLUSION</b>As an epidemiological method for HIV/AIDS finding, contact tracing identified a large number of HIV infectors who were traced by newly reported HIV-infected individuals.</p>

Analysis of quality of life and its influencing factors of heroin dependent patients with methadone maintenance therapy in Dehong prefecture, Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the quality of life of heroin dependent patients with methadone maintenance therapy and its influencing factors.</p><p><b>METHODS</b>Totally 462 heroin dependent patients who were receiving methadone maintenance therapy in Mangshi, Ruili, Longchuan, Yingjiang, Lianghe of Dehong prefecture, Yunnan province were randomly selected using proportional stratified sampling and interviewed with the WHO Quality of Life-BREF (QOL-BREF) in order to understand their quality of life in the fields of physical, psychological, social relationships, and environmental function during 4 weeks ago before interviewing, and the influencing factors of the quality of life.</p><p><b>RESULTS</b>Among the 462 patients, 451 patients (97.6%) were male and 11 (2.4%) were female. Their average age was (37.80 ± 9.13) years old; 145 patients (31.39%) unmarried, 270 patients (58.44%) were married; 35.93% (166/462) of patients had primary school education, 37.23% (172/462) of patients had senior high school education. The patients had a score of 54.11 ± 6.74 for total quality of life and well being and a score of 14.31 ± 2.23, 13.28 ± 1.79, 13.90 ± 2.52, 12.63 ± 1.77 for physical, psychological, social relationships and environmental function, respectively. The quality of life for physical, psychological, social relationships and environmental function of the group of patients which ages between 30 to 40, unmarried, high middle school and above education, length of drug addiction more than 10 years before receiving treatment, treatment duration less than 6 months, incoming from temporary job were with lower score for total quality of life and well being. The quality of life for physical, psychological was lower for those aged between 16 and 30 when becoming first time drug user, which scores were 14.29 ± 2.25 and 13.22 ± 1.84, respectively. The quality of life for physical, psychological, social relationships of the group of patients which injecting drug only or injecting drug with other manners before receiving treatment were lower, which scores were 13.92 ± 2.25, 13.08 ± 1.67, 13.25 ± 2.60 for injecting drug only and 13.67 ± 2.52, 13.43 ± 1.71, 13.80 ± 2.56 for injecting drug with other manners.</p><p><b>CONCLUSION</b>Attending and keeping methadone maintenance therapy could improve the quality of life of heroin dependent patients. Age, marriage status, education, time of drug use, treatment duration may be the influential factors.</p>

Analysis of HIV/syphilis/HCV infection among drug users in 15 cities, China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the HIV infection rate and relevant behavioural characteristics among drug users (DUs) in the 15 cities of China-Gates HIV/AIDS Program.</p><p><b>METHODS</b>By literature review from the public security sector and expert consultations, the size of drug using population was estimated, questionnaire was used to survey relevant behavioural characteristics of DUs, and blood specimens were collected for HIV, syphilis and HCV testing.</p><p><b>RESULTS</b>In 2007, the number of registered DUs in the 15 cities was 176 004, while the estimated number was 477 989. DUs mainly used heroin and crystal meth. Of the survey subjects, 41.0% (2685/6155) had correct knowledge about HIV/AIDS, and Hangzhou 97.6% (410/420), Qingdao 85.5% (342/400), Wuhan 69.7% (308/442), Kunming 63.8% (255/400), Shanghai 45.4% (237/522), Xi'an 44.5% (178/400), Nanjing 38.8% (155/400), Beijing 36.5% (237/650), Guangzhou 29.5% (122/413), Haerbin 25.4% (114/447), Haikou 23.8% (96/402), Chongqing 22.4% (90/401), Sanya 20.0% (80/400), Tianjin 16.2% (41/253), Shenyang 9.8% (20/205), and the difference among the cities has statistical significance (χ(2) = 1482.833, P < 0.05). The rate of needle sharing at the last injection was 10.8% (665/6155), and Hangzhou 10.8% (45/420), Chongqing 26.4% (106/401), Guangzhou 2.6% (11/413), Shenyang 31.3% (64/205), Shanghai 0.4% (2/522), Kunming 10.8% (43/400), Beijing 10.6% (69/650), Tianjin 5.4% (14/253), Xi'an 3.3% (13/400), Wuhan 17.9% (79/442), Sanya 20.0% (80/400), Haikou 2.2% (9/402), Haerbin 8.5% (38/447), Nanjing 21.4% (86/400), Qingdao 1.5% (6/400), and the difference among the cities has statistical significance (χ(2) = 483.044, P < 0.05). Only 5.0% (8737/176 004) of DUs and 1.2% of HIV positive DUs participated in needle exchange. The HIV, syphilis and HCV infection rates were respectively 2.76% (155/5620), 3.38% (190/5620) and 32.35% (1818/5620). The HIV infection rates of different city was:Hangzhou 0.4% (1/273), Chongqing 7.5% (30/401), Guangzhou 2.9% (12/413), Shenyang 0.5% (1/205), Shanghai 0.32% (1/316), Kunming 16.25% (65/400), Beijing 2.6% (16/624), Tianjin 2.0% (5/253), Xi'an 1.25% (5/400), Wuhan 0.24% (1/411), Sanya 1.75% (7/400), Haikou 0.2% (1/402), Haerbin 1.1% (5/447), Nanjing 1.1% (3/275), Qingdao 0.5% (2/400), and the difference among the cities has statistical significance (χ(2) = 354.203, P < 0.05).</p><p><b>CONCLUSION</b>The HIV prevalence rate of IDUs in 15 cities slowly decreased although the HIV prevalence rate of IDUs in Chongqing and Kunming and other cities had surpassed the international warning level. The risk of sharing needles for HIV infection was dropped, and more attention should be paid to the potential risk of HIV transmission via unsafe sex due to the use of new drugs, such as amphetamine chloride.</p>

Cost-effectiveness of female sex worker interventions by using SEX 2.0 Tool in Dehong prefecture, Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To perform cost-effectiveness analysis of interventions in female sex workers in Dehong prefecture in China, with an aim of providing evidence for rational resource allocation in female sex worker interventions in the future.</p><p><b>METHODS</b>The data of expenses for female sex worker interventions in Dehong from 2005 - 2007 were obtained through questionnaire survey. Meanwhile, the data from baseline survey in 2004, from surveillance of female sex workers from 2005 through 2007 as well as from the special survey on sexual transmission in 2007 were collected. Intervention effectiveness was estimated by using SEX 2.0 Tool recommended by UNAIDS. The cost-effectiveness ratio is calculated as the total cost divided by the number of estimated non-HIV patients due to these interventions.</p><p><b>RESULTS</b>The total cost for female sex worker interventions is 916 400 RMB from 2005 through 2007, and a total of 3297 female sex workers were effectively intervened in these three years. Thus, the actual intervention cost for each female sex worker (unit cost) is 277.9 RMB. If all the intervention work is performed as required, the predicted unit cost for female sex worker intervention would be 500.5 RMB. During the period of 2005 through 2007, 69 female sex workers had been successfully prevented from HIV infection; therefore, the cost-effectiveness ratio is 13 282 RMB.</p><p><b>CONCLUSION</b>Intervention among female sex workers is highly cost-effective.</p>

HIV infection and KAP status among men who have sex with men in 14 Chinese cities / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the current status of HIV infection and HIV-related knowledge, attitude and practice (KAP) among men who have sex with men (MSM) in 14 cities in China.</p><p><b>METHODS</b>A cluster sampling method was administrated and 14 large or medium cities were selected. The respondent-driven sampling (RDS) was also used to conduct a questionnaire survey in 6101 MSM. Blood specimens were collected for HIV and syphilis testing.</p><p><b>RESULTS</b>A total of 6101 MSM were selected and investigated, with an HIV infection rate of 6.3% (384/6101) and a syphilis infection rate of 14.0% (854/6101). The proportion of MSM knowing correct HIV/AIDS knowledge was 59.7% (3644/6101); 6.2% (378/6101) and 11.2% (683/6101) of the respondents ever had buying sex or selling sex in the last six months respectively; the proportion of consistent condom-using each time while with male partners in the last month was 39.2% (2392/6101). The proportion of condom-using while with male partners was 65.2% (3978/6101) in the last time among MSM.</p><p><b>CONCLUSION</b>A high HIV infection rate was observed among MSM with limited HIV/AIDS awareness and high risk behaviors. It is necessary to initiate a rapid response to prevent HIV spreading in MSM.</p>

Cost-effectiveness analysis for integrated prevention of mother-to-child transmission of HIV / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the cost-effectiveness and economic efficiency of integrated prevention of mother-to-child transmission (PMTCT) of HIV in four high-incidence counties.</p><p><b>METHODS</b>Data of local resource investment and total cost for PMTCT in 4 counties in China from 2003 to 2006 were collected. Cost analysis and cost-effectiveness analysis were conducted. Average costs of a confirmed HIV case, a prevented case and a disability-adjusted life-year (DALY) saving were calculated.</p><p><b>RESULTS</b>Average cost of identifying one HIV-infected mother was yen5512. Costs of a pediatric HIV case prevention and per DALY saving were yen46 747 and yen1870 ($231), respectively, based on the total cost perspective.</p><p><b>CONCLUSION</b>The cost of integrated prevention of mother-to-child transmission of HIV was low. The PMTCT program was economical efficiency.</p>

Current situation and influential factors concerning the sexual transmission of HIV in Dehong prefecture, Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the current situation of the sexual transmission of HIV in Dehong prefecture, analyze the influential factors, and provide support for drafting pertinent preventive interventions in the future.</p><p><b>METHODS</b>We had analyzed the data of case report from 2005 to 2007, and the prostitutes surveillance data from 2003 to 2007. A special survey was conducted from October 26 to November 7, 2007. Totally 685 people including prostitutes, the clients of prostitutes, people who were HIV positive and their partners, key insiders were interviewed in order to better understand the influential factors related to sexual transmission of HIV.</p><p><b>RESULTS</b>Among 1636 cases reported from January 1 to September 20, 2007, 52% were infected through sexual transmission. Among 586 cases infected through sexual transmission, 40.6% had commercial sexual behavior and 28.6% had unmarried sexual behavior. And the average rate of condom use was below 30%. The prostitutes' surveillance data from 2003 to 2007 showed that the HIV positive rate in prostitutes was 3.3% - 5.5%. The rate of condom use in the last month was 29.4% - 84.4% during commercial sexual activity, but it was 9.5% - 34.8% with fixed sexual partners. Although the rate of HIV and AIDS-related knowledge among prostitutes was 95.0%, there were still many misunderstanding regarding certain aspects of HIV and AIDS awareness.</p><p><b>CONCLUSION</b>Sexual transmission has become one of the main transmission routes of HIV in Dehong prefecture. The main factors involved in the sexual transmission of HIV in Dehong prefecture might include the wide spreading of sexual services, cohabitation among unmarried couples, having multiple partners, casual sexual behavior, and the low rate of condom use.</p>

Analysis of the epidemiologic patterns of HIV transmission in Dehong prefecture, Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To uncover the transmission patterns of the HIV epidemic in Dehong prefecture.</p><p><b>METHODS</b>The reviewed case reports, data of sentinel surveillance, testing and special survey were analyzed by SAS 8.0 program. The transmission patterns were modeled by utilizing data including sizes of the whole population and the high risk groups, high risk behavior data from 1989 to 2007, and the population index such as sex ratio and fertility rate.</p><p><b>RESULTS</b>In 2005, case reports showed the proportion of people infected with HIV through sexual contact was 39.1%, and 46.9% in 2006. Among 1636 cases reported between January 1 to September 20, 2007, the proportion of people infected with HIV through sexual contact was 52%. From 1989 to 2007, the proportion of HIV infection among drug users was declining, while HIV infection through sexual contact was rising after standardizing the population tested/surveyed. The Asian Epidemic Model has shown that the proportions of incident HIV infections through sexual transmissions were 50.6%, 52.3% and 52.7% respectively from 2005 to 2007. Correspondingly, the proportions of incident cases by injecting drug user were 48.9%, 47.2% and 46.7% respectively during this period. Moreover, the Workbook method has shown that, among adults living with HIV in 2007, 50.3% were infected through injecting drugs and 48.4% through unsafe sexual activity.</p><p><b>CONCLUSION</b>The rapid rise in HIV infections through injecting drug in Dehong prefecture has been initially curbed. HIV epidemic has already witnessed a change from predominantly through drug injecting-related activity to an almost equally fuelled epidemic by sexual and drug-related transmission.</p>

Resource allocation analysis for international cooperation program for HIV/AIDS prevention and control / 中华预防医学杂志

<p><b>OBJECTIVE</b>To provide evidence for resource allocation and cooperation between domestic and international HIV/AIDS programs in China by analyzing the needs and current levels of resource input in provinces.</p><p><b>METHODS</b>National and provincial international cooperation program investment and allocation data from 2000 to 2006 were collected. Several factors in each province were analyzed through multiple regression analysis in order to determine whether they had a statistical correlation to the distribution of international HIV/AIDS program resources in China, including: the Gross Domestic Product (GDP), the number of accumulated people living with HIV/AIDS, and the number of accumulated people living with AIDS. Then the Z values were calculated at each provincial level and compared with related international investment. The resource allocation in different program areas were compared with the level of resource input by international and central government HIV/AIDS prevention and control programs through Chi-square test.</p><p><b>RESULTS</b>The international cooperation program investment at local level from 2000 to 2006 were 4893, 24 669, 50 567, 52 950, 112 143, 363 396 and 247 045 thousand RMB respectively, and at national level were 3007, 19 726, 29 035, 37 530, 77 500, 105 786 and 77 035 thousand RMB respectively. There was a statistical correlation between international HIV/AIDS program resource input and the accumulated number of people living with AIDS (R is 0.56 and 0.69 accordingly, and P < 0.01 both). However, there was no statistical correlation between international resource input and the GDP of each province. International HIV/AIDS cooperation programs did not invest in each province according to its practical needs (R = 0.066, P = 0.725). The international cooperation program investments and needs in different province could not meet completely. The ranks of Z value in Guangdong, Shandong and Jiangsu were 3, 5 and 6, but the ranks of international cooperation program in those provinces were 18, 13 and 28 respectively. The investment proportion for national investment in surveillance and testing, advocacy education and intervention, care and support, and others were 22.4%, 19.7%, 36.8% and 21.1% respectively in 2005, and for international cooperation program were 11.5%, 20.8%, 10.4% and 57.4%. For national investment in 2006 were 18.6%, 23.8%, 32.6% and 25.0%, and international cooperation program were 14.0%, 34.3%, 17.1% and 34.6% respectively. The Chinese government and international programs therefore had different priorities in 2005 (chi(2) = 35.09, P < 0.01) and 2006 (chi(2) = 9.26, P = 0.026).</p><p><b>CONCLUSIONS</b>International HIV/AIDS cooperation programs should be better integrated with national programs and combined with epidemic situation and GDP to decide the amount and areas of the investment in order to ensure that they supplement Chinese HIV/AIDS prevention and control activities effectively. The advantages that can be gained from technical support provided by international programs should be further emphasized in line with China's HIV/AIDS prevention and control priorities.</p>