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目的了解贵港市女性性工作者(Female sex workers,FSWs)人群中安全套的持续使用率以及影响安全套持续使用的可能因素,为FSWs人群开展针对性的艾滋病预防工作提供依据。方法按照国家艾滋病哨点监测要求,采取连续抽样的方法,在2014—2015年4—6月调查了2 079名女性性工作者,收集其人口学资料、安全套使用情况、注射吸毒情况、既往艾滋病检测情况和接受预防艾滋病服务情况等信息,数据采用SPSS 17.0软件进行分析。结果 FSWs人群年龄范围为15~62岁,其中16~50岁间者占96.68%,多为在婚,籍贯以本省为主(54.45%),民族以汉族居多(77.01%),文化程度以小学和初中为主。安全套持续使用率为74.89%,对可能影响安全套持续使用的因素进行方差分析发现,婚姻、民族、文化程度、场所档次、本次在本地工作时间、是否吸毒、性病史、既往HIV检测史、接受安全套宣传和发放/艾滋病咨询和检测服务、接受同伴教育服务情况这10个因素在持续使用安全套组和非持续使用安全套组的差异有统计学意义。对以上因素进行多因素logistic回归分析发现,相对于未婚状态而言,婚姻史(在婚、离异或丧偶)是阻碍安全套持续使用的因素(OR在婚=0.539,95%CI:0.330~0.882;OR离异或丧偶=0.281,95%CI:0.149~0.533);相对于高档场所来说,较低档的场所是阻碍安全套持续使用的因素(OR低档=0.116,95%CI:0.047~0.284;OR中档=0.225,95%CI:0.092~0.551);最近1年有性病史(OR=0.353,95%CI:0.215~0.578)和接受同伴教育服务(OR=0.117,95%CI:0.088~0.156)均是阻碍安全套持续使用的因素,而既往曾进行艾滋病检测(OR=2.616,95%CI:1.864~3.672)和接受安全套宣传和发放/艾滋病咨询和检测服务(OR=4.211,95%CI:2.479~5.154)为促进安全套持续使用的因素。结论贵港市FSWs安全套持续使用率(74.89%)低于我国部分地区;促进FSWs接受安全套宣传和发放/艾滋病咨询和检测服务及同伴教育服务,有望提高该人群的安全套持续使用率。
Objective To understand the continuous use rate of condom in the female sex workers (FSWs) population in Guigang and the possible factors that affect the continuous use of condoms, so as to provide the basis for targeted AIDS prevention in the population of FSWs. Methods According to the national AIDS sentinel surveillance, 2 079 female sex workers were surveyed from April to June 2014-2015 according to the continuous sampling method. Their demographic data, condom use, drug abuse and previous AIDS were collected Detection and acceptance of AIDS prevention services and other information, the data using SPSS 17.0 software for analysis. Results The age range of FSWs was 15-62 years old, of which 96.68% were between 16 and 50 years old. Most of them were married and mainly natives (54.45%), Han majority (77.01%), and primary education And junior high school based. The continuous use rate of condoms was 74.89%. An analysis of variance (ANOVA) on the factors that may affect the continuous use of condoms showed that there was a significant difference in marital status, ethnic group, educational level, location grade, current local working time, drug addiction, STD history, The 10 factors of condom promotion and distribution / HIV counseling and testing services and peer education services were statistically different between the continuous use of condom and non-continuous use of condom. Multivariate logistic regression analysis showed that marital history (marriage, divorce or widowhood) was a factor impeding the continuous use of condoms (OR = 0.539, 95% CI: 0.330-0.882; OR divorced or widowed = 0.281, 95% CI: 0.149-0.533). Relatively high-grade places, the lower-grade places were the factors impeding the continuous use of condoms (OR low grade = 0.116,95% CI: 0.047-0.284; OR (OR = 0.353, 95% CI: 0.215-0.578) and peer education services (OR = 0.117, 95% CI: 0.088-0.1566) (OR = 2.616, 95% CI: 1.864 to 3.672) and condom promotion and HIV / AIDS counseling and testing services (OR = 4.211, 95% CI: 2.479 ~ 5.154) is to promote the continued use of condoms. Conclusion The continuous use rate of condom in FSWs (74.89%) in Guigang City is lower than that in some parts of China. The promotion of condom promotion and issuance / AIDS counseling and testing services and peer education services for FSWs is expected to increase the continuous condom use rate in this population.