亚洲四个国家重点人群艾滋病毒服务的财政可持续性:一项混合方法研究。

IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES
Sexual health Pub Date : 2025-05-01 DOI:10.1071/SH24210
James Tapa, Matthew Kusen, Felicity Young, Mike Merrigan, Jason J Ong
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引用次数: 0

摘要

重点人群及其性伴侣占亚太地区新增艾滋病毒感染者的98%。尽管国内对艾滋病项目的资助有所增加,但随着外部捐赠项目逐渐减少,对关键人群服务的可持续性的担忧仍然存在,这可能会逆转进展并导致新的感染。本研究旨在通过不同的利益相关者视角,包括采购程序的限制、预算分配制度和政治意愿,了解这些国家为关键的人口主导的艾滋病毒规划提供国内资金的结构、政治和体制障碍。方法采用混合方法,在2022年,有60名参与者完成了在线调查,145名参与者参加了四个国家的关键信息访谈。利益相关者根据其组织(政府、主要人群主导、非政府(NGO)和多边)进行分类,每个国家确定了30个利益相关者。针对相同的受访者进行定量和定性数据收集。结果访谈对象包括60名政府机构工作人员,42名重点人群主导组织工作人员,31名非政府组织工作人员,12名多边组织工作人员。对于这项调查(n =60),答复来自主要人群(35%)、政府(32%)、非政府组织(23%)和多边组织(10%)。关于为关键人群主导的艾滋病毒服务增加国内资金的时间表,45%的与会者认为需要5-10年才能在不依赖外部捐助者的情况下扩大这些服务,25%的人认为需要10年以上,5%的人认为需要0 - 3年。每个国家几乎所有政府和主要人口主导组织的受访者都同意政府资助或购买与艾滋病毒相关的各个领域的社区服务,包括与治疗和抗逆转录病毒药物(92%)、艾滋病毒自检(95%)、预防措施(80%)和减少耻辱规划(92%)的联系。虽然大多数人支持政府资助社区服务/非政府组织提供关键人群艾滋病毒服务,但28.3%的人认为现有的法律和政策已经到位,突出了实施差距,而知识和购买仍然很高。本研究强调了在设计和决定从国际外部捐助者支持向以人口为主导的关键艾滋病毒规划的国内预算过渡的时间表时,与主要国家利益攸关方确定现实时间表的重要性。报告还强调指出,虽然人们对主要干预措施的支持和理解是众所周知的,但这些干预措施缺乏持续的资金,而这些干预措施对于到2030年消除艾滋病这一公共卫生威胁至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Financial sustainability of HIV services for key populations in four countries in Asia: a mixed-methods study.

Background Key populations and their sexual partners account for 98% of new HIV infections in the Asia-Pacific region. Despite increased domestic funding for HIV programs, concerns persist about the sustainability of services for key populations as external donor programs wind down, potentially reversing progress and contributing to new infections. This study aims to understand structural, political and institutional barriers to domestic funding for key population-led HIV programming in these countries through diverse stakeholder perspectives, including limitations of procurement processes, budget allocation systems and political will. Methods A mixed methods approach was utilized, with 60 participants completing an online survey and 145 participating in key informant interviews across four countries in 2022. Stakeholders were categorized according to their organization (government, key population-led, non-government (NGO), and multilateral), with 30 stakeholders per country identified. The same respondents were targeted for quantitative and qualitative data collection. Results Key informant interviews included 60 staff from government organizations, 42 from key population-led organizations, 31 from NGOs, and 12 from multilateral organizations. For the survey (n =60), responses were from key population-led (35%), government (32%), NGOs (23%) and multilateral organizations (10%). Regarding the timeline for increased domestic financing for key population-led HIV services, 45% of participants thought it would take 5-10years to expand them without reliance on external donors, 25% thought more than 10years and 5% thought between 0 and 3years. Almost all government and key population-led organization respondents in each country agreed on government funding or purchasing of community-based services across various HIV-related areas, including linkage to treatment and antiretrovirals (92%), HIV self-testing (95%), PrEP (80%), and stigma-reduction programs (92%). Although most supported the government funding community-based services/NGOs for delivering essential key population HIV services, 28.3% believed that existing laws and policies are in place for such funding, highlighting implementation gaps while knowledge and buy-in remain high. Conclusions This study underscores the importance of identifying realistic timelines with key national stakeholders when designing and deciding timelines for transitioning from international external donor support to domestic budgeting for key population-led HIV programming. It also highlights that although buy-in and understanding of key interventions is well known, there is a lack of sustained funding for these interventions that are essential to ending AIDS as a public health threat by 2030.

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来源期刊
Sexual health
Sexual health 医学-传染病学
CiteScore
2.30
自引率
12.50%
发文量
121
审稿时长
6-12 weeks
期刊介绍: Sexual Health publishes original and significant contributions to the fields of sexual health including HIV/AIDS, Sexually transmissible infections, issues of sexuality and relevant areas of reproductive health. This journal is directed towards those working in sexual health as clinicians, public health practitioners, researchers in behavioural, clinical, laboratory, public health or social, sciences. The journal publishes peer reviewed original research, editorials, review articles, topical debates, case reports and critical correspondence. Officially sponsored by: The Australasian Chapter of Sexual Health Medicine of RACP Sexual Health Society of Queensland Sexual Health is the official journal of the International Union against Sexually Transmitted Infections (IUSTI), Asia-Pacific, and the Asia-Oceania Federation of Sexology.
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