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目的当前,青少年对生殖健康服务的需求越来越高,本研究将对中国青少年生殖健康服务利用的现状及影响因素进行分析。方法本研究人群为中国15～24岁未婚青少年。数据来源于北京大学人口研究所中国青少年生殖健康可及性政策发展研究项目中“2009年中国青少年生殖健康全国抽样调查”的数据。应用描述性分析和logistic回归模型进行分析。结果调查样本涉及全国25省、自治区、直辖市的40县市的22 288例青少年。在最近一年时间内,青少年的治疗需求率为27.35%,但服务需求的实现率仅46.11%。回归分析显示,女性、有性经历的、校外流动的、居住在城镇的、生殖健康知识较高的、家庭收入较高的青少年的治疗实现率较高(OR值分别为1.82,1.64,1.70,1.22,1.05,1.31～1.43)。青少年自感“问题不严重”、“害怕被嘲笑”和“不知道哪里看”也是影响其最终获取医疗服务的重要因素。结论中国青少年生殖健康服务需求较高,但整体治疗服务实现率不足一半。男性、在校生、农村和家庭收入较低的青少年是服务利用的弱势群体,应给予更多的关注。医护人员应提高对青少年生殖健康问题的重视程度,减轻青少年的就医压力,促进青少年对生殖健康服务利用。
Objectives At present, the demand for reproductive health services by young people is getting higher and higher. This research will analyze the status quo and influencing factors of utilization of reproductive health services for adolescents in China. Methods The study population was 15 to 24 years old unmarried adolescents in China. Data from Peking University Population Research Institute of China adolescent reproductive health accessibility policy development research project “2009 China adolescent reproductive health national sample survey ” data. Descriptive analysis and logistic regression models were used for analysis. Results The survey sample involved 22,288 adolescents in 40 counties and cities in 25 provinces, autonomous regions and municipalities in China. In the recent year, adolescent treatment demand rate was 27.35%, but service demand was only 46.11%. Regression analysis showed that the treatment success rates of female, sexual migrant, floating-living urban residents who had high reproductive health knowledge and whose family income was higher were higher (OR = 1.82,1.64,1.70, 1.22, 1.05, 1.31 ~ 1.43). “Self-esteem among adolescents”, “not serious problems”, “fear of being ridiculed”, and “do not know where to look” are also important factors that affect their eventual access to medical services. Conclusions There is a high demand for reproductive health services for adolescents in China, but the overall treatment service delivery rate is less than half. Men, school-age children, rural residents and families with lower incomes are the disadvantaged groups that should be used for their services. More attention should be paid to them. Health care workers should pay more attention to the issue of reproductive health of adolescents, reduce the pressure on adolescents for medical treatment, and promote the utilization of adolescent services in reproductive health.