基于分级管理模式的烟台市男男同性性行为人群队列小组同伴教育艾滋病干预效果研究  

The effect of peer education in groups on AIDS in a cohort of men who have sex with men in Yantai based on hierarchical management model

作　　者：薛建 程晓松[1] 尹士珍[2] 冷启艳[1] 于相冬 姜聚军 于潇 王丽丽 XUE Jian;CHENG Xiaosong;YIN Shizhen;LENG Qiyan;YU Xiangdong;JIANG Jujun;YU Xiao;WANG Lili(Yantai Center for Disease Control and Prevention,Yantai,Shandong 264003,China;不详)

机构地区：[1]烟台市疾病预防控制中心,山东烟台264003 [2]滨州医学院 [3]栖霞市疾病预防控制中心

出　　处：《中国预防医学杂志》2023年第5期435-440,共6页Chinese Preventive Medicine

基　　金：烟台市科技计划项目(2021MSGY040)。

摘　　要：目的 建立前瞻性烟台市男男同性性行为人群(men who have sex with men,MSM)队列,基于“疾病预防控制中心-社会组织志愿者骨干-小组”分级管理模式进行小组同伴教育,评价艾滋病干预效果。方法于2021年1月,由烟台彩虹工作组30名MSM志愿者通过同伴驱动抽样方法各招募9名MSM组建30个小组,建立300人的MSM队列。每季度开展一次以小组为形式的同伴教育,于基线和第9个月均开展在线问卷调查和人类免疫缺陷病毒(human immunodeficiency virus,HIV)抗体检测。采用SPSS 17.0软件进行统计学分析。结果 研究对象以20~29岁(49.33%)、未婚(82.00%)、大专以上学历(58.00%)为主,共288人完成了随访,队列保持率为96.00%。接受安全套宣传和发放、同伴教育、性病检查、艾滋病咨询检测等干预措施的比例上升,艾滋病知识知晓率由55.67%提高到97.92%;最近半年同性性伴数呈减少趋势,与同性固定性伴、同性临时性伴、异性性伴性行为最近半年坚持100.00%使用安全套的比例分别由73.66%、75.67%和28.12%提高到78.57%、85.88%和54.55%;群交性行为发生率由11.33%的比例下降至4.17%。共3例HIV抗体转阳,HIV新发感染率为1.46/100人年。结论 基于分级管理模式的烟台市MSM队列小组同伴教育艾滋病干预效果较好,应进一步完善该干预模式,降低MSM HIV新发感染率。Objective To establish a prospective cohort of men who have sex with men(MSM) in Yantai, to conduct peer education in groups based on the hierarchical management model of “CDC-volunteers from social organizations-groups”, and to evaluate its effect on AIDS intervention. Methods In January 2021, using respondent-driven sampling method, 30 MSM volunteers from the Yantai Rainbow Working Group recruited 9MSM each to form 30 groups, which added up to a 300-member MSM cohort. Regular peer education in groups was carried out once a quarter. A on-line questionnaire survey and HIV antibody test were carried out at both baseline and the ninth month. Statistical analysis was performed using SPSS 17. 0 software. Results The participants were mainly 20-29 years old(49. 33%), unmarried(82. 00%), with a college degree or above(58. 00%). A total of 288 participants(96%) completed the follow-up questionnaire. The proportion of people who received inventions including condom publicity and distribution, peer education, examination for sexually transmitted diseases, AIDS counseling and testing increased. The awareness rate of AIDS knowledge increased from 55. 67% to 97. 92%. The number of homosexual partners in the prior 6 months showed a decreasing trend.The proportions of respondents reporting 100% consistent condom use with regular male sex partners, casual male sex partners, and female sex partners increased from 73. 66%, 75. 67%, and 28. 12% to 78. 57%,85. 88%, and 54. 55%, respectively. The incidence of group sex decreased from 11. 33% to 4. 17%. Three people were HIV positive, with the incidence of HIV infection being 1. 46/100 person-years.Conclusions The peer education in groups based on hierarchical management model may achieve satisfactory effect on AIDS intervention in the Yantai MSM cohort. This intervention model should be further improved to reduce the HIV infection rate in MSM population.

关 键 词：艾滋病 男男同性性行为人群 队列 干预性研究 

分 类 号：R512.91[医药卫生—内科学]