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目的探讨女性性工作者(Female sex workers,FSWs)的个人特征、健康相关因素对计划行为理论(Theory of Planned Behavior,TPB)五要素的影响。方法运用TPB设计问卷,对2009年7月-2010年6月武汉市和随州市低档场所的FSWs进行面对面的问卷调查,内容包括个人特征、健康相关因素及与安全套使用行为相关的TPB五要素;对TPB五要素情况与个人特征、健康相关因素进行χ~2检验,计算OR值。结果最近1个月商业性行为安全套使用率为74.93%(272/363)。与>25岁年龄段比较,≤25岁的FSWs更倾向使用安全套,差异有统计学意义(χ~2=7.32,P=0.007);与初中及以下文化程度比较,高中及以上文化程度的FSWs更倾向使用安全套,差异有统计学意义(χ~2=3.88,P=0.049);与无其他工作经验的FSWs比较,有其他工作经验的FSWs更倾向于使用安全套,差异有统计学意义(χ~2=27.23,P<0.000);与从业时间>1年比较,从业时间≤1年的FSWs在商业性性行为过程中更倾向于使用安全套,差异有统计学意义(χ~2=30.31,P<0.000),做过流产与未做过流产比较,近半年做过妇科检查与未妇科检查比较,抽血检查与未抽血比较,差异均有统计学意义(χ~2=23.58,P<0.000;χ~2=6.94,P<0.008;χ~2=32.19,P<0.000)。文化程度(OR=2.92,95%CI=1.71~4.99)、是否有过其他工作经验(OR=5.76,95%CI=3.06~10.85)、从业时间(OR=0.19,95%CI=0.11~0.33)是知觉行为控制的影响因素,是否做过流产(OR=1.77,95%CI=1.11~2.82)、妇科检查(OR=6.26,95%CI=3.38~11.58)及抽血检查(OR=2.30,95%CI=1.38~3.83)与知觉行为控制之间呈相关性。结论个人特征及健康相关因素除直接作用于行为外,还会通过影响TPB的各要素间接作用于行为,在应用TPB理论进行该人群的安全套使用行为分析或制定干预措施时,应考虑研究对象的内部一致性。
Objective To explore the influence of health related factors on the five elements of the Theory of Planned Behavior (TPB) of female sex workers (FSWs). Methods Using the TPB design questionnaire, we conducted a face-to-face survey on FSWs in Wuhan and Suizhou from July 2009 to June 2010, including personal characteristics, health-related factors and five elements of TPB related to condom use. On the TPB five factors and personal characteristics, health related factors χ ~ 2 test, calculate the OR value. Results The rate of using commercial sex condom in the last month was 74.93% (272/363). Compared with the 25-year-old age group, FSWs ≤25 years old were more likely to use condoms, the difference was statistically significant (χ ~ 2 = 7.32, P = 0.007); Compared with junior high school and below, FSWs (Χ ~ 2 = 3.88, P = 0.049). Compared with FSWs without other work experience, FSWs with other working experience were more likely to use condoms with a statistically significant difference ~ 2 = 27.23, P <0.000). Compared with 1-year practice time, FSWs with less than 1 year of working time preferred condom use in commercial sexual behavior, the difference was statistically significant (χ ~ 2 = 30.31, P <0.000), did abortion compared with those who did not make abortion, gynecological examination and gynecological examination done in the past six months, blood tests and no blood test, the differences were statistically significant (χ ~ 2 = 23.58, P <0.000; χ ~ 2 = 6.94, P <0.008; χ ~ 2 = 32.19, P <0.000). (OR = 2.92, 95% CI = 1.71 ~ 4.99), other working experience (OR = 5.76,95% CI = 3.06 ~ 10.85), working time (OR = 1.77, 95% CI = 1.11-2.82), gynecological examination (OR = 6.26,95% CI = 3.38-1.558) and blood sampling (OR = 2.30 , 95% CI = 1.38 ~ 3.83) and control of perceived behavior was correlated. Conclusion In addition to the direct effect of personal characteristics and health related factors on behavior, but also through the impact of various elements of TPB indirectly affect the behavior of the population in the application of TPB theory of condom use behavior analysis or interventions should be considered when the study Internal consistency.