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目的:评价江苏省正在开展的大范围娱乐场所高危行为干预项目实施3年的效果,为全省防治策略调整提供依据。方法:选择苏南、苏中、苏北各2个项目县为代表,分别在2006年、2008年采用两阶段整群抽样法抽取城区娱乐场所女性服务人员(FSWs)进行问卷调查和血标本及宫颈分泌物标本采集。结果:2次横断面调查FSWs基本来自同质的群体,干预前FSWs艾滋病知识知晓率和最近一次安全套使用率分别为69.2%和72.5%,干预后达到89.4%和90.2%。FSWs自我保护意识和防病能力普遍提高,对艾滋病歧视性降低。梅毒感染率2008年为4.4%,较2006年略有下降,沙眼衣原体感染率从2006年的23.1%显著下降到2008年的10.7%。一些不正确的行为方式如性活动后立刻药液冲洗下身或经常服用抗生素来预防艾滋病性病等发生率在不断下降。多因素分析显示,本省籍、接待客人数量多、掌握及运用拒绝和协商技巧是安全套使用的促进因素,艾滋病知识知晓程度与安全套使用无统计学意义。结论:江苏省大范围开展娱乐场所艾滋病高危行为干预项目成效显著。
Objective: To evaluate the effect of 3-year high-risk behavior intervention projects in large-scale entertainment venues under way in Jiangsu Province, and provide the basis for the province’s strategy adjustment. Methods: Two project counties in southern Jiangsu, middle Jiangsu and northern Jiangsu were selected as the representative. Two groups of FSWs were sampled from urban areas in 2006 and 2008 respectively for questionnaire survey and blood samples and Cervical secretions specimen collection. Results: The FSWs from two cross-sectional surveys were basically from a homogeneous group. The knowledge of HIV / AIDS and the rate of condom use were 69.2% and 72.5% respectively before intervention and 89.4% and 90.2% respectively after intervention. FSWs generally raise awareness of self-protection and disease prevention and reduce discrimination against AIDS. Syphilis infection rate was 4.4% in 2008, a slight decrease from 2006, and the infection rate of Chlamydia trachomatis significantly dropped from 23.1% in 2006 to 10.7% in 2008. Some of the incorrect ways of doing things like reducing the incidence of HIV / AIDS and other sexually transmitted diseases immediately after sexual activity, such as lower body fluids or lower body weight, often taking antibiotics. Multivariate analysis showed that there was a large number of natives in the province, receiving a large number of guests, mastering and using rejection and negotiation skills as promoters of condom use, and AIDS awareness and condom use were not statistically significant. Conclusion: Jiangsu Province has carried out a large-scale HIV / AIDS risk behavior intervention program in entertainment venues with remarkable success.