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目的了解影响浦东新区低中档暗娼人群(FSW)安全套使用的因素,及艾滋病病毒(HIV)、梅毒的感染情况,为调整该人群的干预方案提供依据。方法将浦东新区按照合并前的两个行政区划分为南片(原南汇区)和北片(原浦东新区)。用方便抽样,分别在南、北片低中档高危场所内招募FSW,参加一对一、面对面的问卷调查(包括人口学特征、行为、干预等信息)和HIV及梅毒螺旋体的血清学检测。结果南、北片各有400名和406名FSW完成问卷调查及血清学检测。北片FSW的平均年龄为(31.8±7.5)岁,南片为(34.9±7.9)岁;北片FSW的文化程度在初中及以上者占80.0%,南片为61.3%;北片未婚者比例为27.6%,南片为15.0%。FSW来自低档场所的比例,南片为70.8%,北片为55.9%。此次调查中,有1名FSW为HIV抗体阳性,24名FSW(南、北片分别为18人和6人)感染梅毒。南、北片FSW近一个月商业性行为坚持用套的比例分别是55.3%和61.1%。在调查前30天商业性行中,北片FSW坚持使用安全套的可能性是南片FSW的2.783倍[95%可信区间(CI):1.696~4.566];接受外展干预次数较多的FSW更可能坚持用安全套[比值比(OR)=2.097,95%CI:1.450~3.034];且接受干预平均时间在5分钟以上的FSW,更可能在商业行中坚持使用安全套(OR=1.351,95%CI:1.137~2.658)。结论浦东新区中低档FSW的HIV、梅毒呈低流行,但安全套使用比例仍有待提高;片区和干预是影响FSW安全套使用的重要因素,FSW的社区干预需兼顾社区、片区特点。
Objective To understand the factors influencing the use of condoms in low and mid-class FSWs in Pudong New Area, as well as the prevalence of HIV and syphilis and provide the basis for adjusting intervention programs for this population. Methods According to the two administrative districts before the merger, Pudong New Area is divided into Nanpian (formerly Nanhui District) and Beipiao (formerly Pudong New Area). Using convenient sampling, FSW were recruited in the low-middle and high-risk places in the south and north areas respectively. One-on-one and face-to-face questionnaires (including demographic characteristics, behaviors and interventions) and serological tests of HIV and Treponema pallidum were conducted. Results 400 and 406 FSW patients in the south and north regions completed the questionnaire and serological tests. The average age of FSW in the north was (31.8 ± 7.5) years old and (34.9 ± 7.9) years in the south, while that of the FSW in the north was 80.0% in the junior high school and above, 61.3% in the south and 27.6% in the north %, South piece is 15.0%. The proportion of FSW coming from low-end places was 70.8% for the South and 55.9% for the North. In this survey, 1 FSW was HIV positive and 24 FSW (South and North were 18 and 6, respectively) were infected with syphilis. In the past month, the proportions of commercial behaviors persisted in the past month in the South and North regions were 55.3% and 61.1% respectively. In the commercial 30 days prior to the survey, FSW in the north was 2.783 times [95% confidence interval (CI): 1.696-4.566] in FSW adherence to condom use in the north sector and FSW with more outreach interventions (Odds ratio (OR) = 2.097, 95% CI: 1.450-3.034]; and FSWs that received an average of more than 5 minutes of intervention were more likely to stick with condoms in commercial banks (OR = 1.351, 95% CI: 1.137 ~ 2.658). Conclusion HIV and syphilis in middle and low grade FSW in Pudong New Area are low prevalence, but the proportion of condom use still needs to be improved. Area and intervention are important factors that affect the use of FSW condom. FSW community intervention should take into account the characteristics of community and area.