医学ppt课件大全防治艾滋病的挑战

The Challenges for HIV/AIDS Prevention 防治艾滋病的挑战 Global Health Action, U.S.A National Population and Family Planning Commission, China June 12-13, 2004, Nanjing, China 美国全球卫生行动组织 中国国家人口和计划生育委员会 六月 12日 13日 中国 南京 What can be done about the HIV/AIDS epidemic? 艾滋病流行 , 我们能做什么 ? HIV prevention 预防艾滋病 Care and support for HIV-infected people 对艾滋病患者的关爱和支持 Build capacity to continue the fight against HIV/AIDS 构建持续对抗艾滋病的能力 HIV/AIDS Prevention 艾滋病的防治 Strong Leadership 强有力的领导机制 Community involvement 社区参与 Behavior change 行为改变 Safe blood supply 安全血液供应 Reducing stigma 减少羞辱 HIV/AIDS Prevention 艾滋病的防治 Creating supporting environment 创建支持环境 Preventing mother-child HIV transmission 预防母婴传染 Voluntary testing and counseling 自愿检测和咨询 Treatment of sexually transmitted infection 性病治疗 Building capacity 提高能力 Strong Leadership 强有力的领导机制 From UNGASS Declaration of Commitment UNGASS 承诺的宣言 Leadership by Governments in combating HIV/AIDS is essential; 政府的领导至关重要 The efforts of Government should be complemented by the full participation of civil society, the business community and the private sector 政府的努力 ,必须结合民间社团 , 工商业界和个 人来共同参与完成 HIV/AIDS Prevention 艾滋病的防治 Information/education/communication 宣传 /教育 /交流 Mass media 大众传媒 School-based AIDS education 学校为基础的 AIDS教育 Peer counseling for sex workers 在性工作者中开展同伴咨询 HIV/AIDS Prevention 艾滋病的防治 95% of the HIV infections prevalent in Africa are attributable to unsafe sex 非洲 95%的艾滋病感染是由不安全的性为 造成 25% in Eastern Europe 25%的感染者在东欧 90% or more in parts of South America and the developed countries of Western Pacific 90% 或更多的感染者在南美和西太平洋 地区的发展中国家 AIDS Cases by Mode of Exposure (US through June 2001) 艾滋病案例分类表（美国 2001年 6月） Behavior Change 行为改变 Promote behavior changes that reduce risk of HIV infection and transmission 提倡行为改变 , 减少 HIV感染和传染的风 险 Create normative environments that sustain change 建立正常的可持续改变的环境 Strategies for Individual Level Behavior Change 针对个人的战略 Provide information about HIV 提供 HIV相关信息 “HIV prevention counseling” for risk reduction “HIV 防治咨询 ”来降低风险 Training for negotiating abstinence and condom use 禁欲和避孕套使用商谈的培训 Use models for decision making around risk behaviors 用示范来做风险行动的决定 Provide opportunity to learn HIV status testing 利用检测提供的机会来了解 HIV状况 HIV Prevention 艾滋病防治 Abstinence 禁欲 Be Faithful 忠实 use a Condom 使用避孕套 Blood Safety血液安全 It is estimated that between 5% and 10% of all HIV infections worldwide have been acquired through transfusion of contaminated blood and blood products 估计全世界有 5% -10% 的感染是通 过输入受污染的血和血制品造成的 Goals of Voluntary HIV Testing and Counseling 自愿检测和咨询的目标 Prevention of HIV transmission 预防 HIV传播 “Normalization” of HIV 将 HIV正常化 Challenging stigma through promoting awareness 通过广泛开展宣传挑战羞辱 Early uptake of prevention and treatment services 早期预防和治疗服务 Medical services 医疗服务 Emotional and social support 情感和社会支持 Legal advice; future planning 法律建议和远景规划 The Challenges 挑战 Lack of safe donors and unsafe blood donations 缺乏安全献血者以及不安全的献血 Lack of screening 缺乏监测 Inappropriate testing 不当检测 Blood used inappropriately or incorrectly 不当用血 Reducing Transfusion-Associated HIV Transmission 降低输血感染 Prevent unnecessary transfusions 防止不必要的输血 Blood banking 血库 Recruit low risk blood donors 招募低风险的献血者 Screen blood for HIV 艾滋病血液筛选 The appropriate and rational use of blood 适当合理用血 Mother-Child HIV Prevention 母婴艾滋病防治 Mother-Child HIV transmission (MTCT) is the largest source of HIV infection in children below the age of 15 years 母婴之间传染是 15岁以下儿童感染艾滋病的主 要来源 AIDS epidemic has claimed the lives of nearly 3 million children, and another 1 million are living with HIV today AIDS 已夺去近 300万儿童的生命 , 另有 100万HIV感染者 Nine out of ten of all HIV-infected babies have been born in Africa 十分之九的 HIV感染的婴儿生于非洲 About 12 million women of childbearing age are HIV-positive 大约一千二百万育龄妇女呈 HIV阳性 Mother-Child HIV Prevention 母婴艾滋病防治 Antenatal care 产前护理 Voluntary counseling/education and testing 自愿咨询 /教育和测试 Antiretroviral drug treatment 抗逆转录药品治疗 Safe delivery 安全分娩 Safe infant feeding 安全婴儿喂养 Continuing care for women and their families 对妇女及其家庭后续护理 Positive and non-judge-mental attitudes of health workers 卫生保健人员积极和不带评判的心态 Barriers to HIV Prevention 预防 HIV的障碍 Individual level个人层次 Ignorance无知 Denial否认 Attitude of helplessness 无助的态度 Incapacity to change behavior 无行为改变能力 Lack of power in relationships 联系乏力 Lack of income-generating skills 缺少创收技能 Addiction: drugs/sex 沉溺于毒品 /性 Community level社区层次 Stigma羞辱 Lack of supplies供给缺乏 Lack of trained personnel 缺乏训练有素的人员 Cultural expectations 文化期望 Lack of guidelines 缺乏指导 Mistrust of governments 不信任政府 Lack of leadership 缺乏领导机制 Unsafe medical practices 不安全的医疗实践 Care and Support for Persons Infected with HIV 对艾滋病感染者的关爱和支持 Major components: 主要部分 : Psychosocial support 社会心理支持 Palliative care 抚慰关怀 Prevention of opportunistic infection tuberculosis 预防机会感染如肺结核 Antiretroviral therapy 抗逆转录治疗 Integrating STD/HIV Services into Reproductive Health Settings STD/HIV和生殖健康服务相结合 What Do We Mean by Integration? Managers can view the integration of STD/HIV services into reproductive health settings as a continuum running from an informal to a more formal combination of two or more services 结合意味着什么 ? 管理着者可以把 STD/HIV服务结合到生 殖健康看作一个持续地从一个非正式到 更正式将两个或更多服务结合在一起的 过程 Integrating STD/HIV Services into Reproductive Health Settings STD/HIV和生殖健康服务相结合 Family planning and other reproductive health programs can play a significant role in addressing the HIV prevention and care needs of women 计划生育和生殖健康服务在预防 HIV和关 心妇女需求方面能起重大作用 Existing reproductive health services provide an idea opportunity to address womens broader sexual health need 现有的生殖健康服务为强调妇女广泛的 性健康需求提供了一个理想的机会 Principal Focus 原则性着重点 A client focus 服务对象为重点 A provider and service delivery focus 服务提供者为重点 An organizational focus 组织为重点 A program focus 项目为重点 Integration at the Service Delivery Point 服务提供者为重点的结合 Integration means delivering two or more types of services (previously provided separately) as a single, coordinated and combined service 结合意味着将提供两种或多种形式的服 务 (以前提供优服务时是分开的 )当作一种 ,相互协调及合并的服务 The integration of HIV/STI prevention into family planning counseling can be considered a key aspect of informed choice 将 HIV/性传播感染预防结合到计划生育 咨询可以看做是知情选择的关键部分 Integrating STD/HIV Services into Reproductive Health Settings STD/HIV和生殖健康服务相结合 Integrated counseling helps clients to: 结合咨询将帮助服务对象 : Make informed, realistic, and achievable sexual and reproductive health decisions 做出知情的 , 现实的 , 可达到的性和生殖健康决定 Explore and assess their own risk of infection, and initiate preventive health behaviors 探索和评估他们受感染的风险 , 启动预防性的健 康行为 Integrating STD/HIV Services into Reproductive Health Settings STD/HIV和生殖健康服务相结合 Negotiate safer sexual behavior, and prevent infection 协商安全的性行为 , 预防传染 Make treatment choices that meet their personal and sexual health needs 做满足他们个人的和性健康需求的治疗选择 Clarify concerns related to sexuality 明确有关性行为的考虑 Improve their sexual and reproductive health knowledge, and promote sharing of that information 增进性和生殖健康知识 , 提倡共享信息 How Managers to Do to Integrate Activities 管理者如何开展结合活动 Analyzing the Strategic Issues 分析战略性的问题 Assessing the Magnitude of the STD/HIV Problem 评估 STD/HIV问题的机制 Assessing the Level of Risk Among Clients 评估服务对象的风险水平 Assessing Whether STD/HIV Services are Already Available 评估 STD/HIV服务是否已经存在 Assessing the Consequences of Integrating Services 评估结合服务的后果 How Managers to Do to Integrate Activities 管理者如何开展结合活动 Selecting Appropriate STD/HIV Strategies 挑选适宜的 STD/HIV战略 General population 一般人群 Specific groups 特殊人群 General Population一般人群 Providing access to condoms at affordable prices 提供支付得起的避孕套的途径 Providing prompt and appropriate services for the management of STDs 对 STD管理提供及时和适宜的服务 Establishing syndromic diagnosis and treatment programs 建立症状诊断和治疗项目 Promoting responsible sexual behavior through IEC activities 通过宣传 ,教育和交流提倡负责任的性行为 Specific Groups特殊人群 Introducing STD/HIV risk assessment as part of detection and treatment services and establishing referral systems for STD laboratory diagnosis and treatment 将 STD/HIV风险评估作为检查和治疗的一部分 , 为 STD实验室诊断和治疗建立引荐系统 Promoting frequent visits to health services by people at risk of acquiring and transmitting STDs/HIV 向易获得和传播 STD/HIV的危险人群提倡经常去接 受健康服务 Providing targeted education and service delivery activities for people at high risk 对高危人群提供有针对性的教育和服务 Providing screening services to help prevent and treat maternal and congenital syphilis and neonatal blindness 提供检测服务以帮助预防和治疗母性及遗传性的梅 毒和新生儿失明 How Managers to Do to Integrate Activities 管理者如何开展结合活动 Assessing the Operational Issues 评估操作性问题 Operational similarities and differences between providing your existing services and STD/HIV activities 在提供现有的服务和开展 STD/HIV活动是 操作的相似性和不同处 Service delivery settings you currently use and whether they are appropriate for implementing STD/HIV activities 现有服务场所对于开展 STD/HIV是否合 适 Assessing the Operational Issues 评估操作性问题 Reproductive health services you currently offer 所提供的现有生殖健康服务 Range of STD/HIV services that might be appropriate for you to integrate into your existing services 适合结合进现有服务的 STD/HIV服务范 围 How Ma