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目的探索针对男男性行为者(MSM)人群特征的有效艾滋病预防服务及规范性病诊疗促进方法。方法建立疾病预防控制中心(CDC)主导与MSM志愿者骨干实施相结合的MSM人群艾滋病性病防治组织模式,以核心同伴宣传(POL)干预方法为主,结合网络宣传、外展服务等进行MSM人群艾滋病、性病预防性服务和规范性病诊疗活动。2006年12月、2007年7月、2008年1月分别采用应答者驱动招募法(RDS)对MSM人群进行基线、中期及期终评估招募调查,对调查结果进行比较分析。结果基线调查201人,中期200人,期终203人。基线、中期、期终调查比较,过去6个月接受过安全套免费发放的分别为54.7%、69.5%、69.0%,接受艾滋病检测服务的为12.9%、36.0%、54.2%,艾滋病健康咨询服务为21.9%、38.0%、45.1%,接受过同性朋友预防艾滋病宣传的为28.9%、56.0%、45.3%,差异均有统计学意义,上升趋势显著(P<0.05);患性病期间,发生性行为使用安全套的分别为58.6%、76.7%、79.6%,差异有统计学意义(χ2=7.041,P=0.030),变化趋势显著(χ2=5.935,P=0.015);性伴通知、就诊方式差异无统计学意义。结论CDC主导与MSM志愿者骨干实施相结合的以POL干预为主,结合外展、网络宣传等,有效提高了MSM人群艾滋病预防性服务覆盖面和性病期间安全套使用率,是适合MSM人群特点的一种有效预防服务和行为干预手段,但在如何针对MSM人群特点,更有效地促进性伴通知、检查治疗,提高规范就医比例上应继续进行探索。
Objective To explore effective AIDS prevention services and normative diagnosis and treatment promotion for men with MSM. Methods To establish a prevention and treatment of AIDS STD in MSM population based on the combination of CDC and MSM volunteers. The core peer advocacy (POL) intervention method was used to conduct MSM crowd combining with network publicity and outreach services AIDS, STD preventive services and normative disease clinics. In December 2006, July 2007 and January 2008, respondents-driven recruitment (RDS) was used to conduct baseline, mid-term and end-term evaluation recruitment survey of MSM population respectively, and the results of the survey were compared and analyzed. Results The baseline survey of 201 people, mid-200, the end of 203 people. Baseline, interim, and end-of-term surveys conducted showed that condoms received 54.7%, 69.5% and 69.0% of free condoms in the past 6 months respectively, 12.9%, 36.0% and 54.2% of those receiving HIV testing services, and AIDS health counseling services 21.9%, 38.0% and 45.1%, 28.9%, 56.0% and 45.3%, respectively. The difference was statistically significant (P <0.05). Sexually transmitted diseases The difference was statistically significant (χ2 = 7.041, P = 0.030), the change trend was significant (χ2 = 5.935, P = 0.015). The difference of the way of treatment between the sex partners and the condom was 58.6%, 76.7% and 79.6% respectively Statistical significance. Conclusion CDC dominated the backbone of MSM volunteers combined with the implementation of POL intervention, combined with outreach, online publicity, etc., effectively improve the MSM population coverage of HIV prevention and sexually transmitted diseases during the condom use rate is suitable for MSM population characteristics Effective preventive services and behavioral interventions. However, we should continue to explore ways to address the characteristics of MSM population, promote sexual partners more effectively, check the treatment and improve the standard of medical treatment.