性服务妇女使用女用安全套预防艾滋病干预模式研究

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目的探索在性服务妇女中开展女用安全套使用预防艾滋病经性途径传播干预模式,为开展女套干预提供经验。方法本研究是将女套加入到现有男套使用中的干预,分女套引入干预和常规干预两个阶段。引入干预是在小组、个人、社区3个层面宣传女套知识与讲授正确使用方法;常规干预是将女套使用教育与发放纳入疾控中心在性服务妇女中开展的常规预防工作中,继续推进女套干预,同时进一步在社区广泛宣传女套知识。在干预前、干预6、12、24个月进行了4次横断面调查,以评估干预效果。结果干预前只有29.7%的妇女听说过女套但没有人用过,干预后90.0%的妇女听说过女套;用过1次以上女套妇女的比例从干预6个月时的19.0%上升到干预后12、24个月的31.6%、29.0%,在干预6、12、24个月3个时点调查时有27.6%、37.8%、36.3%的妇女在调查前半年把女套作为备用或经常使用的预防方法;2/3妇女自我报告接受过干预,接受干预程度越高的妇女使用过女套比例越高。妇女最近1个月与客人坚持使用安全套比例从干预前77.3%提高到3次调查时的87.5%、83.5%、84.6%;约有2/3以上的妇女在调查前1个月内有过被拒绝男套使用的经历,当要求被拒绝后,有3.0%~6.0%的妇女改用了女套。结论经过两年干预,性服务妇女安全性行为比例提高,相当比例的妇女逐步将女套整合到预防行为中,女套加入男套中的干预在不同程度上减少了妇女的无保护性行为,将女套整合到常规工作中的干预模式是可行的,效果也是明显的,但干预时需加强对工作人员的培训和考虑相关影响因素。 Objective To explore the intervention mode of sexual transmission of AIDS prevention among women with sexually transmitted diseases through female condom use and to provide experience for the intervention. Methods This study is to add female sets to the existing use of male sets of intervention, divided into female sets of intervention and routine intervention in two stages. The introduction of interventions is to promote the knowledge and teaching of the correctness of the package at the three levels of the group, the individual and the community. The routine intervention is to integrate the use of education and delivery into the CDC’s routine prevention work among women with sexual services. Female intervention, while further widespread female community knowledge in the community. Prior to the intervention, 4 cross-sectional surveys were performed 6, 12, and 24 months to assess the effect of the intervention. Results Before the intervention, only 29.7% of the women heard of female sets but no one used them. 90.0% of the women heard about the sets of women after the intervention. The percentage of women who used more than one set of women in the intervention ranged from 19.0% Up to 31.6% and 29.0% of the 12,24 months after the intervention. 27.6%, 37.8% and 36.3% of the women surveyed at the 3,6,12,24 points of intervention in the first six months of the survey as the first half of the survey Alternate or frequently used prevention methods; 2/3 of women reported self-reported interventions and the higher the percentage of women who used the same sets of women, the higher the level of intervention was. The percentage of women who consistently used condoms with their clients in the recent 1 month increased from 77.3% before intervention to 87.5%, 83.5% and 84.6% at 3 surveys. About two-thirds of women had had intercourse during the first month before the survey Refused to use the experience of male sets, when the request was rejected, 3.0% to 6.0% of women switched to female sets. Conclusions After two years of intervention, the proportion of women in sexual service increased their safety behaviors. A considerable proportion of women gradually integrated the girl’s group into preventive behavior. The intervention of the girl group in the male model reduced women’s unprotected sex to varying degrees, Interventions to integrate women’s clothing into routine work are both feasible and effective, but interventions need to be strengthened to train staff and to consider the relevant factors.
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