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目的:在广西艾滋病高发区一般人群中评价包皮环切术推广的效果,为推广包皮环切术提供参考依据。方法:在广西贺州、钦州市招募590例固定社区居民,填写知情同意书,进行基线调查后运用各种宣传材料和方式进行现场干预,问卷采用一对一现场问卷调查。如果研究对象愿意接受手术且无手术禁忌证,则安排其到课题组指定的医院进行手术。在干预后第6个月、9个月进行随访,了解相关包皮环切预防艾滋病知、信、行变化情况。结果:一般人群第1、2次随访相对于干预前,手术原因、手术益处、手术并发症知晓率、手术接受意愿以及手术率均有提高,差异均有统计学意义(P<0.05),两次随访之间比较差异均无统计学意义(P>0.05)。知道包茎或包皮过长是手术原因从干预前66.1%分别提高至第1、2次随访的81.9%、79.8%;知道手术可预防艾滋病及性传播疾病从干预前28.0%分别提高至第1、2次随访的77.4%、78.6%;知道疼痛、出血、感染是手术并发症从干预前29.5%、19.3%、39.3%分别提高至第1次随访72.5%、58.2%、59.4%以及第2次随访75.0%、57.0%、63.0%;手术接受意愿从干预前35.3%分别提高至第1、2次随访的59.6%、61.3%;手术率在第1、2次随访时分别提高到12.7%、16.1%。结论:包皮环切术的推广对广西艾滋病高发区一般人群包皮环切预防艾滋病的知、信、行的干预效果显著,适宜在一般人群中应用。推广材料和方式的改进可考虑着重宣传艾滋病、包茎或包皮过长的危害和手术安全性相关知识。
Objective: To evaluate the effectiveness of circumcision in the general population with high HIV prevalence in Guangxi and to provide a reference for the promotion of circumcision. Methods: 590 fixed community residents were recruited in Hezhou and Qinzhou, Guangxi. The informed consent forms were filled in. After the baseline survey, various kinds of publicity materials and methods were used to intervene on site. The questionnaire was conducted on a one-on-one questionnaire. If the subject is willing to undergo surgery and no contraindications to surgery, arrange for them to go to the designated hospital for surgery. At the 6th month and the 9th month after the intervention, follow-up was conducted to find out the changes of circumcision circumstance, AIDS-related information and communication. Results: The first and second follow-up of general population were significantly higher than pre-intervention, the reason of operation, the benefit of operation, the rate of operative complications, the willingness to accept operation and the rate of operation, the differences were statistically significant (P <0.05) There was no significant difference between the follow-up visits (P> 0.05). Know that phimosis or prepuce is the cause of surgery from 66.1% before intervention increased to 81.9%, respectively, the first and second follow-up of 81.9%; know that surgery can prevent AIDS and sexually transmitted diseases increased from 28.0% before intervention to 1, 77.4% and 78.6% of the patients were followed up for 2 times. Knowing the pain, bleeding and infection, the complications of surgery increased from 29.5%, 19.3% and 39.3% before the intervention to 72.5%, 58.2% and 59.4% of the first follow-up respectively, The follow-up was 75.0%, 57.0% and 63.0% respectively. The willingness to accept the operation increased from 35.3% before intervention to 59.6% and 61.3% respectively during the first and second follow-up. The operative rate increased to 12.7% 16.1%. Conclusion: The promotion of circumcision has a significant effect on the circumcision prevention of HIV / AIDS in the general population in high-risk areas of Guangxi, and is suitable for general population. Improvements in outreach materials and modalities can focus on promoting awareness of the dangers of HIV, phimosis or prepuce and surgical safety.