论文部分内容阅读
目的评价以防治性病为主的同伴综合干预对男男性行为人群(men who have sex with men,MSM)在改变高危行为、接受健康服务及控制性病和HIV感染方面的效果。方法通过滚雪球法招募在常州市主要公共活动场所和互联网等的MSM人群。采用现场流行病学现场干预实验方法,在基线调查基础上,在MSM人群中开展以定点性病门诊提供免费或低廉的性病诊疗服务为主要形式的同伴综合干预。一年半后进行干预效果评估。问卷调查内容主要包括对象的一般人口学资料、行为状况和接受干预服务状况,同时采集血液和尿样样本以检测HIV、梅毒、淋球菌和生殖道沙眼衣原体。用SPSS 13.0软件进行χ2检验、t检验和Fisher′s确切检验,均以P<0.05为差异有统计学意义。结果经过一年半的项目实施后,干预后与干预前相比,调查对象接受健康服务以及性病诊疗均有显著性提高(P<0.01)。最近6个月有过肛交行为者由63.90%下降至51.15%(P<0.01),有过性交易者由13.16%下降至7.76%(P<0.05);最近一次男性肛交使用安全套者由80.67%下降至72.47%(P<0.05)。近半年性虐待由6.65%下降至1.81%(P<0.05)。HIV和梅毒(ELISA阳性)感染率干预前后差异无统计学意义,但现症梅毒(TRUST阳性)、淋球菌和生殖道沙眼衣原体感染则显著性下降(P<0.05)。结论依托免费定点性病门诊开展以防治性病为主的同伴综合干预模式,可促进MSM人群降低高危性行为并主动进行性病和HIV的检测咨询与治疗,有效地控制HIV和梅毒感染。
Objective To evaluate the effect of prevention and treatment of STD-based companion interventions on men who have sex with men (MSM) in changing high-risk behaviors, receiving health services and controlling sexually transmitted diseases and HIV infection. Methods The snowball method was used to recruit MSM populations in Changzhou’s major public activity venues and the Internet. On the basis of the baseline survey, field epidemiological on-the-spot interventional experimental methods were used to carry out comprehensive companion interventions in MSM population with free or low cost STD clinics as the main form. One and a half years after the intervention effect evaluation. The questionnaire mainly consisted of the general demographic data, behavioral status and intervention service status of the subjects. Meanwhile, blood and urine samples were collected to detect HIV, syphilis, Neisseria gonorrhoeae and genital C. trachomatis. SPSS 13.0 software χ2 test, t test and Fisher’s exact test, all P <0.05 was considered statistically significant. Results After one year and a half of the project implementation, there was a significant increase (P <0.01) in the subjects receiving health services and STD clinics after intervention compared with before intervention. The number of transsexual traders dropped from 13.16% to 7.76% (P <0.05) in the last 6 months from 63.90% to 51.15% (P <0.01), while those who used condoms for male anal intercourse recently increased from 80.67% To 72.47% (P <0.05). Nearly half of sexual abuse decreased from 6.65% to 1.81% (P <0.05). There was no significant difference in HIV and syphilis (ELISA positive) infection rates before and after intervention, but the prevalence of syphilis (TRUST positive), Neisseria gonorrhoeae and genital tract Chlamydia trachomatis infection significantly decreased (P <0.05). Conclusion Relying on the free designated STD clinic to carry out prevention and treatment of STD-based companion comprehensive intervention model can promote MSM populations to reduce high-risk behaviors and active STD and HIV testing counseling and treatment to effectively control HIV and syphilis infection.