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目的对静脉吸毒人群(IDU)开展社区外展服务及同伴教育行为干预并评估干预效果,探索建立适合清远市社区静脉吸毒人群的干预模式。方法在清远市清城区和连州市采用同伴推动抽样法(RDS)招募社区IDU为干预对象;分别于2009年4—6月对目标人群进行干预前问卷调查,7—10月采用社区外展服务和同伴教育方法开展艾滋病健康教育和行为干预,11—12月采用与干预前调查相同的问卷对目标人群进行干预后效果评估,评估内容包括艾滋病知识、态度、行为、获得自愿咨询检测(VCT)及性病转介服务等的变化情况。结果干预前后分别调查203、128人;调查对象艾滋病知识总知晓率从干预前的70.44%提高到干预后的85.94%(P<0.01);表示对感染了HIV的朋友或家人和以前一样交往的比例从39.90%提高到60.16%(P<0.01),认为“艾滋病将来可能威胁到您或您的家庭”的比例从59.11%提高到76.56%(P<0.01);最近1个月静脉注射吸毒率从100.00%下降为78.13%(P<0.01),最近1个月、最近1次与别人共用针具的比例分别从26.11%、15.27%下降为10.00%、7.00%,最近1年发生商业性性行为每次使用安全套的比例从33.73%提高到58.54%,干预前后比较差异均有统计学意义(P<0.01);获得艾滋病性病VCT、诊疗和转介服务的比例从0提高到100.00%。结论对社区IDU采取社区外展服务及同伴教育行为干预可显著提高该人群的艾滋病知识知晓率,促使其改变或减少高危行为,干预模式可行、有效。
Objective To intervene in the community outreach service and peer education behavior of IDUs and assess the effect of intervention, and to explore the establishment of an intervention model suitable for intravenous drug users in Qingyuan community. Methods Qinghai District and Lianzhou City, Qingyuan City, using peer-driven sampling (RDS) to recruit community IDU as the target of intervention; from April to June 2009 before the intervention of the target population questionnaire survey, July-October community outreach Services and peer education methods to carry out AIDS health education and behavioral interventions, 11-12 months, using the same questionnaire as pre-intervention survey to evaluate the effect of the target population after intervention, including AIDS knowledge, attitude, behavior, access to voluntary counseling and testing (VCT ) And STD referral services. Results Before and after the intervention, 203,128 people were investigated respectively. The total awareness rate of AIDS among surveyed subjects increased from 70.44% before intervention to 85.94% after intervention (P <0.01), indicating that the HIV / AIDS-infected friends or family members had the same communication as before The proportion increased from 39.90% to 60.16% (P <0.01), and the proportion of “AIDS may threaten you or your family in the future” increased from 59.11% to 76.56% (P <0.01) The rate of drug abuse dropped from 100.00% to 78.13% (P <0.01). In the recent 1 month, the share of the most recent needle sharing with others dropped from 26.11%, 15.27% to 10.00% and 7.00% The proportion of sexual behaviors using condoms increased from 33.73% to 58.54%, respectively, and the difference was statistically significant before and after intervention (P <0.01); the proportion of AIDS patients with VCT, treatment and referral services increased from 0 to 100.00% . Conclusion Community outreach services and peer education interventions can significantly increase the awareness rate of HIV / AIDS among the community population and help them to change or reduce high-risk behavior. The intervention model is feasible and effective.