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目的了解艾滋病单阳配偶对女用安全套的可接受性,并探索影响艾滋病单阳配偶女用安全套可接受性的因素。方法根据单纯随机抽样计算样本量,2013年5—12月选择湖南省邵阳市、四川省眉山市和乐山市,年龄在18~50岁之间的艾滋病单阳家庭,采用前瞻性观察性研究设计和日志形式记录艾滋病单阳家庭3个月内女用安全套使用过程,并于使用前和使用3个月后进行问卷调查,了解夫妻双方对女用安全套的态度、使用经历和使用意愿等信息,并利用logistic回归模型分析影响女用安全套可接受性的主要因素。结果共调查了89个艾滋病单阳家庭,其中以男方阳性为主,占66.3%(59/89);HIV感染者和阴性配偶的平均年龄分别为(38.5±8.6)、(37.6±8.3)岁;学历以初中为主,占41.0%(73/178),职业以农民为主,占42.1%(75/178),家庭月收入以2 000~2 999元为主,占32.6%(29/89)。86.5%(77/89)的HIV感染者是经异性途径感染HIV。调查对象研究实施前3个月性行为频次以2~3次/月为主,占44.9%(40/89);研究实施前3个月内安全套坚持使用率为86.5%(64/74)。研究期间85.4%(76/89)的单阳家庭使用了9只及以上女用安全套,每次性行为均使用安全套的比例达到了100.0%。试用后有58.4%(52/89)单阳家庭双方表示愿意接受并继续使用女用安全套。多因素分析结果显示,既往发生过强迫性性行为(OR=5.82)、女方为HIV感染者(OR=3.79)、使用安全套时在阴茎涂抹润滑剂(OR=3.57)、对培训的技能能完全理解(OR=3.31)、≥20年婚龄者(OR=2.85)和首次使用经历负性事件接受女用安全套的可能性更高(OR=7.14)。结论艾滋病单阳家庭对女用安全套具有一定程度的可接受性,可以对高危单阳配偶家庭采取女用安全套推广措施以完善预防艾滋病配偶间传播策略。
Objective To understand the acceptability of female condoms by single male spouse of AIDS and to explore the factors influencing the acceptability of female condoms of single male spouse of AIDS. Methods Based on the simple random sampling method, a single-yang family aged 18-50 was selected from Shaoyang City in Hunan Province, Meishan City and Leshan City in Sichuan Province from May to December in 2013. The prospective observational design And diary records of the use of condoms within three months of single positive HIV families and questionnaires before and three months after use to find out the attitude, experience and willingness of the couple to use the condom. And use logistic regression model to analyze the main factors affecting the acceptability of female condom. Results A total of 89 monophasic AIDS families were investigated, of which 66.3% (59/89) were predominantly male. The average age of HIV-infected and negative mate were (38.5 ± 8.6) and (37.6 ± 8.3) years respectively (41.0% (73/178)), mainly peasants, accounting for 42.1% (75/178), monthly family income was mainly 2 000-2999 yuan, accounting for 32.6% (29 / 89). Eighty-five percent (77/89) of HIV-infected patients were HIV-infected by the heterosexual route. In the first 3 months before the implementation of the study, the frequency of sexual behavior was 2 to 3 times per month, accounting for 44.9% (40/89). Condom use was 86.5% (64/74) within 3 months before the implementation of the study. During the study period, 85.4% (76/89) of single-Yang families used 9 or more female condoms and 100.0% of them used condoms each time. After the trial, 58.4% (52/89) of single positive families expressed their willingness to accept and continue to use female condoms. Multivariate analysis showed that compulsive sexual behaviors (OR = 5.82) and female HIV-infected women (OR = 3.79) were found. Penis was lubricated with a condom (OR = 3.57) (OR = 3.31), ≥20 years of age at marriage (OR = 2.85), and first-time women receiving condoms under negative events (OR = 7.14). Conclusion AIDS single positive family has a certain degree of acceptability to female condom, and it can take female condom promotion measures for single-spouse family with high risk to improve the strategy of preventing spousal transmission of AIDS.