Department of Community Health Systems, School of Nursing, University of California , San Francisco, CA, USA.
I-TECH Mozambique, University of Washington , Maputo, Mozambique.
Glob Health Action. 2020 Dec 31;13(1):1769900. doi: 10.1080/16549716.2020.1769900.
Mozambique has for many years suffered from a high burden of HIV with an estimated prevalence of 11.1% among adults age 15-49 years. In response, Positive Health, Dignity, and Prevention (or Positive Prevention as it is known in Mozambique), was developed as a method of integrating HIV care and prevention via capacity building. Through comprehensive holistic care, HIV transmission is prevented while simultaneously promoting the health of people living with HIV/AIDS. Our initiative used a three-tiered approach, and included activities at national, provincial, and community levels. In order to change patient behavior and successfully train health-care workers in Positive Prevention, it was therefore considered necessary to work at multiple levels of influence. This ensured that the individual-level behavior change of PLHIV and health-care providers was maximized through supportive environments and policies. Related national-level achievements included the establishment of a Positive Prevention technical working group; the development of a Positive Prevention policy document; training national policy-makers on Positive Prevention; the development and distribution of a nationally approved Positive Prevention training package; the integration of Positive Prevention into existing Ministry of Health curricula; the development and approval of national data collection forms; and the drafting of a related national strategy. The framework and key activities of the Mozambique Positive Prevention Program may help to inform and assist others involved in similar work, as well as advancing country or local ownership of HIV/AIDS treatment, care and prevention efforts. By using a three-tiered approach, a supportive system was created. This was critical to both optimizing Positive Prevention provision and building long-term capacity. In order for related efforts to be successful in other settings, we encourage implementing partners to also work at multiple levels, with local ownership principles in mind, in order that Positive Prevention programs may have the greatest possible effect.
莫桑比克多年来一直受到艾滋病毒高负担的困扰，估计 15-49 岁成年人的流行率为 11.1%。作为回应，开发了积极健康、尊严和预防（或莫桑比克的积极预防），作为通过能力建设整合艾滋病毒护理和预防的一种方法。通过全面的整体护理，预防了艾滋病毒的传播，同时促进了艾滋病毒感染者和艾滋病患者的健康。我们的倡议采用了三层方法，包括在国家、省和社区各级开展活动。为了改变患者的行为并成功培训艾滋病毒感染者和艾滋病防治人员，因此认为有必要在多个影响层面开展工作。这确保了通过支持性环境和政策最大限度地改变艾滋病毒感染者和卫生保健提供者的个人行为。相关的国家级成果包括成立了一个积极预防技术工作组；制定了一项积极预防政策文件；对国家政策制定者进行了积极预防培训；开发和分发了国家批准的积极预防培训包；将积极预防纳入现有的卫生部课程；制定和批准了国家数据收集表格；并起草了一项相关的国家战略。莫桑比克积极预防方案的框架和主要活动可能有助于为参与类似工作的其他人提供信息和协助，并促进国家或地方对艾滋病毒/艾滋病治疗、护理和预防工作的自主权。通过采用三层方法，创建了一个支持系统。这对于优化积极预防服务和建立长期能力至关重要。为了使相关努力在其他环境中取得成功，我们鼓励实施伙伴也考虑到地方自主权原则，在多个层面开展工作，以便积极预防方案能够产生最大的效果。
