背景:许多具有高风险性行为或注射行为的人使用具有不同身份的减少伤害服务,因此在客户端数据库中被计数不止一次。这种做法导致所服务的客户数量和这些服务的有效覆盖范围的统计不准确。这项研究旨在确定减少伤害服务的客户的双重计算水平,包括针头和注射器程序,避孕套分发,艾滋病毒检测和咨询,和美沙酮在伊朗五个城市的维护。
方法:在2020年9月至3月之间,我们的研究包括1630名客户,115名减害中心工作人员,以及伊朗五个城市减少危害领域的30名专家。减少伤害服务的客户被问及在去年使用不同身份在同一中心或不同中心多次使用减少伤害服务。中心工作人员和减少伤害的专家小组验证了从客户答复中得出的重复计算的估计。
结果:从客户端合成数据,工作人员,和专家,使用减少伤害服务的客户重复计算的最终估计是:艾滋病毒检测10%(95%置信区间[CI]0-15),针头和注射器计划17%(95%CI8.5-20),避孕套分发计划13%(95%CI3-19),艾滋病毒/性传播感染咨询10%(95%CI0-16),美沙酮维持率7%(95%CI2-10)。
结论:对伊朗减少伤害服务的客户进行双重计算是相当大的。需要纠正客户通过减少伤害服务获得的数据,以进行重复计算,以改善计划计划,客户人口规模估计,和有效的资源分配。
Many people with high-risk sexual or injection behaviors use harm reduction services with different identities and are therefore counted more than once in client databases. This practice results in inaccurate statistics on the number of clients served and the effective reach of these services. This study aimed to determine the levels of double counting of clients of harm reduction services, including needle and syringe programs, condom distribution, HIV testing and counseling, and methadone maintenance in five cities in Iran.
Between September and March 2020, our study included 1630 clients, 115 staff of harm reduction centers, and 30 experts in the field of harm reduction in five cities in Iran. Clients of harm reduction services were asked about using harm reduction services multiple times at the same center or at different centers in the last year using different identities. Estimates of double counting derived from client responses were validated by panels of center staff and experts in harm reduction.
Synthesizing data from clients, staff, and experts, the final estimates of double counting of clients using harm reduction services were: HIV testing 10% (95% confidence interval [CI] 0-15), needle and syringe programs 17% (95% CI 8.5-20), condom distribution programs 13% (95% CI 3-19), HIV/STI counseling 10% (95% CI 0-16), and methadone maintenance 7% (95% CI 2-10).
Double counting of clients in harm reduction services in Iran is substantial. Data on clients reach by harm reduction services need to be corrected for double counting to improve program planning, client population size estimation, and efficient resource allocation.