云南和四川部分地区吸毒人群的性病艾滋病防治需求评估的定性研究  

QUALITATIVE RESEARCH ON HIGH RISK BEHAVIORS AND INFLUENCING FACTORS AMONG DRUG USERS IN SICHUAN AND YUNNAN PROVINCES

作　　者：陈虹[1] 程峰[1] 李建华[2] 张灵麟[3] 胡虹 张建新[3] 程何荷 万绍平[3] 张勇 杨志伟 William Stewart 沈洁[1] 

机构地区：[1]中国疾病预防控制中心中英性病艾滋病防治合作项目办公室 [2]云南省药物依赖防治研究所,昆明650228 [3]四川省疾病预防控制中心四川省中英性病艾滋病防治合作办公室,成都610041 [4]云南省艾滋病防治领导小组办公室云南省中英性病艾滋病防治合作办公室,昆明650021 [5]英国国际发展部中英性病艾滋病防治合作项目办公室,北京100050

出　　处：《中国药物依赖性杂志》2004年第2期139-145,共7页Chinese Journal of Drug Dependence

基　　金：中英性病艾滋病防治合作项目

摘　　要：目的 :了解目标地区吸毒人群的性病艾滋病防治需求 ,为制定符合当地的有效干预措施提供科学依据和建议。方法 :2 0 0 1年 3月 - 2 0 0 2年 4月 ,采用《性健康需求评估》实施方案中的定性访谈方法 ,分别在云南、四川选取大、中、小 6个试点地区 ,对当地吸毒人群进行深入访谈。每个地区分别对 5名市 /县 /区 /社区公安部门的关键人物进行定性访谈 ,每个点对 10名吸毒者的家庭成员进行个别访谈。结果 :(1)两省部分地区的吸毒者绝大部分使用的毒品为海洛因 ,其中有相当一部分人合并多药滥用 ,大城市较中、小城市严重 ;(2 )在注射毒品者中普遍存在共用注射器的状况。但不同地区共用注射器的比例有所不同 ;(3)注射器来源主要是私人诊所和药店 ;(4 )相当数量的注射毒品者不知道如何正确消毒注射器 ;(5 )不同地区的吸毒者均有不同程度的不安全性行为 ;(6 )社会歧视和耻辱感是导致戒毒后复吸率高的重要因素之一 ,也是阻碍开展降低危害工作的重要社会文化因素。结论 :通过开展针对目标人群的性健康需求评估 ,可为当地开展有针对性的干预工作提供方向、方法以及接触目标人群的方法与途径。性健康需求评估为研究与干预搭建桥梁。Objective: To understand the high risk behaviors of drug users and the influencing factors in the pilot sites, so as to provide scientific evidence and suggestions for the development of effective interventions suitable to the unique local situation. Methods: Qualitative interview method in the Protocol for Situational Analysis of Sexual Health(SASH) was adopted to conduct individual in-depth interviews with 101 drug users from Yunnan and 100 drug users from Sichuan in 6 pilot sites that respectively represented large cities, medium sized cities and small cities from March 2001 to April 2002. In addition, structured interviews were conducted with 5 key informants in each pilot site from the public security bureau (PSB) at municipal, county, district and community levels; and individual interviews were conducted with family members of 10 drug users in each pilot site. Results: (1) Most drug users in Yunnan and Sichuan took heroin; and a large proportion of them also used heroin together with other psychotropic substances and drugs. Drug use was more prevalent in large cities; (2) Syringe sharing was common among IDUs in the two provinces, but the proportion of syringe sharing varied in different pilot sites; (3) IDUs bought syringes mainly from private clinics and pharmacies; (4) Many IDUs did not know how to correctly disinfect syringes; (5) Drug users in different pilot sites were more or less engaged in unsafe sexual behaviors; (6) Social discrimination and stigma was one of the key factors that facilitated the post detox relapse, and also one of the important socio-cultural factors that hindered harm reduction. Conclusion: The implementation of SASH for target populations can identify the direction and methods for development of specific interventions according to local situations, as well as the approaches and channels for accessing target populations. SASH can bridge research into intervention.

关 键 词：云南 四川 吸毒人群 性病 艾滋病 防治措施 干预措施 

分 类 号：R512.91[医药卫生—内科学] R759[医药卫生—临床医学]