在性病门诊促进安全性行为的有利条件和障碍因素——18个性病门诊的经验  

Promotion of Safer Sex at STD Clinics in Shanghai - Perspectives of STD Physicians

作　　者：赵鹏飞[1] 钱汉竹[1] 谭美丽[2] 乐嘉豫[2] 

机构地区：[1]上海市计划生育科学研究所,200032 [2]上海市皮肤病性病医院

出　　处：《中国性病艾滋病防治》2000年第3期148-150,共3页Chinese Journal of Std & Aids Prevention and Control

基　　金：世界卫生组织人类生殖研究特别规划署资助

摘　　要：目的 探讨在性病门诊开展咨询和推广避孕套的影响因素。方法 对上海市18个性病门诊的18名医生进行了2个集中小组访谈。结果 揭示了有利条件和障碍因素。绝大多数医生(14/18)认为有必要在性病门诊发放避孕套。所有医生一致认为性病门诊是推广避孕套使用的最佳场所,但至今尚未找到发放避孕套的最佳模式,主要原因是政策上不允许将避孕套列为处方内容或在公立门诊出售避孕套,而免费发放又缺乏经费。所有性病门诊医生都意识到咨询的重要性和必要性,然而大多数门诊尚未开展正规的咨询,主要障碍是医生认为没有时间,门诊认为没有效益。结论 (1)卫生部门应从政策上支持建立提供整合性病服务的示范门诊;(2)取消在医院或门诊内销售避孕套的限制,将避孕套列入性病门诊特需和合法的处方项目,并同计生部门协商解决避孕套的免费发放或鼓励社会市场营销活动以保证社区内避孕套的持续供应。(3)为保证能充分提供有关性病的咨询,公立性病门诊应将咨询纳入性病常规服务的范围,培训中级人员专职负责提供咨询服务。Objective To investigate the perspectives of STD providers with regard to conducting counseling and promoting condom use at public STD clinics in Shanghai. Methods Two focus group discussions were held with 18 STD service providers from 18 public STD clinics in July 1998, during the baseline study phase of the project "promotion of safer sex at STD clinics in Shanghai". Results Both the enabling factors and barriers had been indicated. Most physicians (14/18) appreciated the need to distribute condoms at STD clinics, and all physicians agreed that STD clinics were the best places to promote condom use. However, the best mechanism for condom distribution is unclear because: (1) local health regulations prohibit the prescription and sale of condoms in public clinics and hospitals; and (2) free distribution of condoms was not often financially sustainable. All physicians agreed that counseling was an important component of STD prevention. However, counseling was uncommon in most clinics because: (1) doctors reportedly lack the time and skills to counsel clients, and (2) the sustainability of STD clinics in many areas of China depends on cost income- generating activities. Conclusion (1) Public health officials should support the establishment of model STD clinics that ensure the integrated provision of diagnostic services, STD treatment, counseling, and condom promotion; (2) Public health officials should also suspend local regulations that limit the availability of condoms in clinics and hospitals and; (3) To ensure adequate counseling, directors of public-sector institutions and STD programmes should designate and continuously train mid - level providers to be solely responsible for counseling activities.

关 键 词：安全性行为 避孕套 障碍因素 性病 

分 类 号：R759.01[医药卫生—皮肤病学与性病学]