Micro-planning at scale with key populations in Kenya: Optimising peer educator ratios for programme outreach and HIV/STI service utilisation
Micro-planning at scale with key populations in Kenya: Optimising peer educator ratios for programme outreach and HIV/STI service utilisation
复制标题
DOI：
10.1371/journal.pone.0205056
复制
发表时间：
2018-11-01
期刊：
影响因子：
3.7
通讯作者：
Steen, Richard
中科院分区：
文献类型：
--
作者：
Bhattacharjee, Parinita;Musyoki, Helgar;Steen, Richard
自2013年以来，同伴教育与微观规划一直是肯尼亚扩大关键人口艾滋病毒/性传播感染方案的组成部分。微观规划加强了同伴网络内的社区凝聚力，并确定了方案投入、进程和外联目标，包括同伴教育者的工作量。我们评估了外展方案的绩效--与一个PE负责的KPs平均数量（KPs：PE比率）的关系--以及对艾滋病毒/性传播感染服务利用率的影响。分析了2013年10月至2016年9月期间来自全国从事女性性工作者（FSW）和男男性行为者（MSM）工作的执行伙伴的季度方案监测数据。预期所有执行伙伴都将遵循国家准则，并在金伯利进程方案技术支助股的支助下，接受对私营部门的微观规划培训。我们研究了KP：PE比率与定期外展接触、安全套分发、降低风险咨询、STI筛查、HIV检测和KP报告的暴力行为之间的相关性。2012年，肯尼亚对金伯利进程进行了人口规模估计。从2013年到2016年，金伯利进程方案扩大到85%的FSW（PSE 133 675）和90%的MSM（PSE 18 460）。总体而言，女性性工作者的平均KP：PE比率从147降至91，男男性行为者从79降至58。较低的KP：PE比率，FSW高达90：1，MSM高达60：1，与更经常的外展接触显著相关（p
Peer education with micro-planning has been integral to scaling up key population (KP) HIV/STI programmes in Kenya since 2013. Micro-planning reinforces community cohesion within peer networks and standardizes programme inputs, processes and targets for out-reach, including peer educator (PE) workloads. We assessed programme performance for outreach-in relation to the mean number of KPs for which one PE is responsible (KP:PE ratio)-and effects on HIV/STI service utilisation. Quarterly programmatic monitoring data were analysed from October 2013 to September 2016 from implementing partners working with female sex workers (FSWs) and men who have sex with men (MSM) across the country. All implementing partners are expected to follow national guidelines and receive micro-planning training for PEs with support from a Technical Support Unit for KP programmes. We examined correlations between KP: PE ratios and regular outreach contacts, condom distribution, risk reduction counselling, STI screening, HIV testing and violence reporting by KPs. Kenya conducted population size estimates (PSEs) of KPs in 2012. From 2013 to 2016, KP programmes were scaled up to reach 85% of FSWs (PSE 133,675) and 90% of MSM (PSE 18,460). Overall, mean KP: PE ratios decreased from 147 to 91 for FSWs, and from 79 to 58 for MSM. Lower KP: PE ratios, up to 90:1 for FSW and 60:1 for MSM, were significantly associated with more regular outreach contacts (p