100安全套推广项目(1)

ChinaCUPExperience,2003中国-WHO100%安全套推广项目:策略和经验China-WHO100%condomuseprogram:strategyandexperience赵鹏飞世界卫生组织驻华代表处DrProfZHAOPengfeiWHOCHINAChengdu,Dec17-192003ChinaCUPExperience,2003Chronologyof100%CUPinChinaMOHagreedtopilotStep1:twopilotsitesSteptwo:twonewsitesStep3:developmentofNationalguide-selectiveexpansion(UNFPA,WBHealth9,China-UK)•NationaldisseminationseminarofChina100%CUP-1stQuarter2004•Nationalscalingupinpartnership20002001200220032004andbeyondChinaCUPExperience,2003性工作者Sexworkers年轻人youth其他others医/技人员?Science/tech会议/疗养人员mtgparticipants流动人口农民Floatingpop商人businessmen军人Police/military政务管理工作人员Publicservants100%安全套使用项目提供阻断HIV性传播的机会StoppingHIVTransmissionThrough100%CUP100%CUP安全百分百ChinaCUPExperience,2003100%安全套使用项目?Whatis100%CUP?•100%的性工作者用套100%ofsexworkers-sexualrelations•100%的性工作时间里用套100%ofthetimeofsexwork•100%的场所推广用套100%ofentertainmentestablishments三个百分百Three100%ChinaCUPExperience,2003100%安全套使用项目要素understanding100%CondomUseProgramme依赖政府牵头的多部门合作-强力实施当地有政策BasedonreinforcementofGovernmentPOLICIES(Law,regulation,decrees,etc..):目标是场所而非性工作者targetingEEs规范环境,确保场所合作给弱势人群赋权monopolizingenvironment&empoweringSexWorkersMonitoringcondomuseandSTIcases监测安全套使用和STI病例数确保行为的安全,无疾病传播Ensuringsafety(‘NOCONDOM-NOSEX’)ChinaCUPExperience,2003中央有关文件政府五项承诺FivecommitmentsatUNGASS2003.9ChinaCUPExperience,2003100%安全套项目的评估Evaluationof100%CondomUseProgramme过程Process结果Outcome影响Impact评估EVALUATION安全套销量e.g.condomsales安全套使用率e.g.condomuserate性病/艾滋病感染率e.g.STI/HIVprevalence指标INDICATORSChinaCUPExperience,2003实施步骤SixstepstostartaCUP1.评估当地HIV的危险因素和潜在性的危险因素AppraisalofHIVrisk/potentialrisk2.组织建立领导小组,项目办公室和督导和评估小组Organizations-leadinggroup,PMO,M&Eteam3.举办政策倡导会,发布会等advocacyefforts-mtg,bulletins,etc4.项目计划(改善安全套供应,STI监测门诊)Programplanning/policyformation5.实施（政策落实,评估指标)Operation(implementationofpolicy,indicators)6.督导和评估MonitoringandevaluationChinaCUPExperience,2003100%使用安全套项目的效果，武汉Impactof100%CUP,China60.575.782.888.594.530.421.822.115.314.56.57.72.901.820304050607080901002001.10.2002.1.2002.4.2002.7.2002.10.2003.1.0510152025303540YearYearChinaCUPExperience,2003100%使用安全套项目的效果，江苏Impactof100%CUP,Jiangsu84.474.989.192.317.921.113.720304050607080901002001.11.2002.6.2002.11.2003.4.0510152025303540YearChinaCUPExperience,2003100%使用安全套项目的效果，湖南Impactof100%CUP,Hunan0501001502002503003502002年2003年项目开展前后同期STI报告数比较最近一次安全套使用率0.00%50.00%100.00%使用率6.50%63.30%80.60%86.10%88.40%2002年92003年32003年62003年92003年ChinaCUPExperience,2003100%使用安全套项目的效果，海南Impactof100%CUP,Hainan安全套使用率Condomuseatlastsexbysexworker:17%/2002.9,65%/2003.9性病感染率STIratesamongsexworkers:2002.92003.9衣原体Chlamydia11%6.6%梅毒Syphilis8%4%淋病Gonorrhea4%2.5%HIV0%0%ChinaCUPExperience,2003经验和体会Lessonslearned政府牵头,卫生为主,公安支持,其他配合Govn’tleads,healthcoordinates,policesupports,EEscooperate持续倡导Advocatingbenefitsofstakeholders引导媒体Involvingmassmedia推广‘安全’不误导‘卖淫合法’Beingrealisticbutnotcreatingfalsehopeof‘legalizingsexwork’辐射作用‘Spillingeffect’(Goodreputation,praisedbyupperauthority,othercities/countiestofollow)ChinaCUPExperience,2003100%CUP与社会关注问题CUPandcontroversialissues–CUP与公安执法workingwithpolicepossibleandeffective–性工作增加?increaseofSW?–青少年不良影响?negativeimpactonyouthnotobserved–社会/媒体的态度community/mediaattitudeChinaCUPExperience,2003合作程度的评估AssessinglevelsofEEcooperationLevel1:口头承诺verbalindicationofsupportLevel2:允许挂图allowingcondompostersLevel3:同意现场干预existingon-siteeducation-IEC/BCC/outreacheffortsLevel4:保障安全套供应EnsuringcondomavailabilityLevel5:确保无‘不安全’行为Ensuring‘nocondomnosex’ChinaCUPExperience,2003为什么100%CUP有效WhyCUPeffective?政策支持Supportingpolicy综合策略Comprehensiveapproach广泛覆盖Highcoverage投入少见效快（可持续可推广）Acheapandrapidstrategy(sustainable,replicable)ChinaCUPExperience,2003下一步推广项目计划Nextstepinpartnership完成国家推广指南制定Finalizingnationalguide(2003.12)阶段性推广计划:(4个省,UNFPA/计生系统,Future’sGroup(China),SIDA,世界银行WB,卫九项目,欧盟EU,UNDP领导开发项目)Expansioninlinewithexistingprojects以127个国家的艾滋病综合防治示范区为平台逐步推广覆盖到全国ChinaCAREs其他othersChinaCUPExperience,2003“I’mnotsellingsex.I’msellingcondomsandofferingfreedemonstrations.”Sexworkerempowered