性服务妇女使用女用安全套预防艾滋病干预模式研究  

A research on the intervention mode- promoting the use of female condom among sex workers

作　　者：周月姣[1] 杨进业[1] 聂黎[2] Margaret R.Weeks 刘伟[1] 农丽萍 崔岩[1] 谭广杰[1] 廖苏苏[2] 李江虹 闭素章 

机构地区：[1]广西壮族自治区疾病预防控制中心,南宁530028 [2]中国医学科学院基础医学研究所 北京协和医学院基础学院流行病与卫生统计学系,北京100005 [3]The Institute for Community Research [4]广西凭祥市疾病预防控制中心,532600

出　　处：《应用预防医学》2013年第6期325-330,共6页Applied Preventive Medicine

基　　金：广西卫生厅自筹经费课题(Z2010040);中国南方性服务场所和性服务妇女艾滋病预防干预研究(RO1MH077541)

摘　　要：目的探索在性服务妇女中开展女用安全套使用预防艾滋病经性途径传播干预模式，为开展女套干预提供经验。方法本研究是将女套加入到现有男套使用中的干预，分女套引入干预和常规干预两个阶段。引入干预是在小组、个人、社区3个层面宣传女套知识与讲授正确使用方法；常规干预是将女套使用教育与发放纳入疾控中心在性服务妇女中开展的常规预防工作中，继续推进女套干预，同时进一步在社区广泛宣传女套知识。在干预前、干预6、12、24个月进行了4次横断面调查，以评估干预效果。结果干预前只有29．7％的妇女听说过女套但没有人用过，干预后90．0％的妇女听说过女套；用过1次以上女套妇女的比例从干预6个月时的19．0％上升到干预后12、24个月的31．6％、29．O％，在干预6、12、24个月3个时点调查时有27．6％、37．8％、36．3％的妇女在调查前半年把女套作为备用或经常使用的预防方法；2／3妇女自我报告接受过干预，接受干预程度越高的妇女使用过女套比例越高。妇女最近1个月与客人坚持使用安全套比例从干预前77．3％提高到3次调查时的87．5％、83．5％、84．6％；约有2／3以上的妇女在调查前1个月内有过被拒绝男套使用的经历，当要求被拒绝后，有3．0％～6．O％的妇女改用了女套。结论经过两年干预，性服务妇女安全性行为比例提高，相当比例的妇女逐步将女套整合到预防行为中，女套加入男套中的干预在不同程度上减少了妇女的无保护性行为，将女套整合到常规工作中的干预模式是可行的，效果也是明显的，但干预时需加强对工作人员的培训和考虑相关影响因素。Objective To explore an intervention mode- promoting the use of female condom among female sex workers （FSWs） and protecting them from infecting HIV, as well as provide experience to scale up the use of female condoms accordingly. Methods During the research, female condoms were added to the existing intervention with the use of male condoms. Two stages - introducing female condoms to the intervention （namely introductiot~ of intervention） and conventional intervention were applied in the study. For the introduction of intervention, we mainly carried out public education about female condoms and told female sex workers how to correctly use them among groups, individuals and communities; for the conventional intervention, introduced female condoms to CDC＇ s （Center for Disease Control） regular HIV prevention and control aiming at women sex workers, promoting the use of female condoms during the intervention activities as well as making further public education about female condoms in the communities. Four cross-sectional surveys to assess the effectiveness of intervention were carried out respectively before the study, and in the 6th, 12th, 24th month during the research. Results Before the intervention, only 29.7% of women heard about female condoms but nobody used them, while 90% of women had heard of female condoms after the intervention. The rate of sex workers using female condoms for one time at least increased from 19% in the 6th month of the intervention to 31.6%, 29.0% respectively in the 12th and 24th month of the study. Investigation in the 6th, 12th, and 24th month of the intervention showed that 27.6%, 37.8% and 36.3% respectively of women reported that they considered female condoms as a backup or frequently method of prevention for six months. 2/3 of women personally reported that they had received this intervention service. The more they received such intervention, the more they used female condoms. Before the intervention, 77.3% of women could keep on with condom use all the time whe

关 键 词：性服务妇女 女用安全套 干预 模式 

分 类 号：R512.911[医药卫生—内科学]