CAJ | 학술논문

2013年云南省暗娼艾滋病高危行为调查分析
2013년운남성암창애자병고위행위조사분석
An analysis of high risk behaviors among female sex workers in Yunnan province in 2013

万方数据

中华预防医学杂志中華預防醫學雜誌 중화예방의학잡지
CHINESE JOURNAL OF
2014年 12期 1057-1062 ,共6页

张祖样%宋丽军%罗红兵%梅静远%卢冉%肖民扬%贾曼红

장조양%송려군%라홍병%매정원%로염%초민양%가만홍

获得性免疫缺陷综合征%危险因素%横断面研究穫得性免疫缺陷綜閤徵%危險因素%橫斷麵研究
획득성면역결함종합정%위험인소%횡단면연구
Acquired immunodeficiency syndrome%Risk factors%Cross-sectional studies

目的：了解2013年云南省暗娼艾滋病高危行为现况。方法于2013年4—6月，对云南省16个州（市）129个县（区）的暗娼进行横断面调查。暗娼规模接近200名的县采用普查法；对于暗娼规模明显超过200名的县，采用概率抽样法抽取样本量200名。共调查25574名，通过一对一问卷调查，收集人口学及高危行为等相关信息，采用χ2检验对不同档次场所暗娼的高危行为进行比较，采用logistic回归对其影响因素进行分析。结果在调查的25574名暗娼中，高、中、低档场所暗娼艾滋病知识知晓率分别为98．8％（92／7401）、98．6％（150／10995）、96．0％（281／6655），低档场所暗娼艾滋病知晓率较高、中档低（ P值均＜0．01）；高、中、低档场所暗娼最近1个月商业性性行为每次使用安全套的比率分别为93．4％（6307／6755）、93．8％（10109／10782）、90．4％（6053／6697），低档场所暗娼安全套使用率较高、中档低（ P值均＜0．01）。多因素logistic回归结果显示：低档场所（与低档场所暗娼相比较，中档场所：OR ＝1．56，95％CI：1．36～1．79；高档场所：OR ＝1．36，95％CI：1．16～1．59）、30岁及以上（OR＝0．77，95％CI：0．69～0．85）、云南籍（OR＝0．88，95％CI：0．77～1．00）、少数民族（OR＝1．32，95％CI：1．16～1．50）、初中及以下文化程度（OR＝0．61，95％CI：0．49～0．75）、已婚（OR＝0．81，95％CI：0．71～0．92）、同居（OR ＝0．70，95％CI：0．51～0．96）、离异或丧偶（OR ＝0．81，95％CI：0．65～1．02）、本地工作时间不足6个月（OR＝1．74，95％CI：1．34～2．27）、有吸毒行为（OR＝1．65，95％CI：1．11～2．46）、未接受过艾滋病干预服务（OR＝2．91，95％CI：2．36～3．58）、不知晓艾滋病知识（ OR＝4．50，95％CI：3．48～5．82）的暗娼坚持使用安全套的比例较低。调查对象报告未使用安全套的主要原因是对方不愿意使用，占47．6％（270／567）。调查对象的总体吸毒率为1．0％（264／25567），其中，中档场所暗娼的注射吸毒比例较高为0．6％（70／11141）。低档场所暗娼性病患病率为1．2％（85／6934），较高、中档高（P值均＜0．01）；96．7％（24717／25574）的暗娼得到过艾滋病的干预服务，21．6％（57／264）的吸毒暗娼获得美沙酮维持治疗和接受过清洁针具交换服务。结论云南省低档场所暗娼的艾滋病高危行为较严重，尤其是少数民族、文化程度较低、年龄较大的暗娼以及新流入暗娼和吸毒暗娼，今后应加强该人群的干预力度。
목적：료해2013년운남성암창애자병고위행위현황。방법우2013년4—6월，대운남성16개주（시）129개현（구）적암창진행횡단면조사。암창규모접근200명적현채용보사법；대우암창규모명현초과200명적현，채용개솔추양법추취양본량200명。공조사25574명，통과일대일문권조사，수집인구학급고위행위등상관신식，채용χ2검험대불동당차장소암창적고위행위진행비교，채용logistic회귀대기영향인소진행분석。결과재조사적25574명암창중，고、중、저당장소암창애자병지식지효솔분별위98．8％（92／7401）、98．6％（150／10995）、96．0％（281／6655），저당장소암창애자병지효솔교고、중당저（ P치균＜0．01）；고、중、저당장소암창최근1개월상업성성행위매차사용안전투적비솔분별위93．4％（6307／6755）、93．8％（10109／10782）、90．4％（6053／6697），저당장소암창안전투사용솔교고、중당저（ P치균＜0．01）。다인소logistic회귀결과현시：저당장소（여저당장소암창상비교，중당장소：OR ＝1．56，95％CI：1．36～1．79；고당장소：OR ＝1．36，95％CI：1．16～1．59）、30세급이상（OR＝0．77，95％CI：0．69～0．85）、운남적（OR＝0．88，95％CI：0．77～1．00）、소수민족（OR＝1．32，95％CI：1．16～1．50）、초중급이하문화정도（OR＝0．61，95％CI：0．49～0．75）、이혼（OR＝0．81，95％CI：0．71～0．92）、동거（OR ＝0．70，95％CI：0．51～0．96）、리이혹상우（OR ＝0．81，95％CI：0．65～1．02）、본지공작시간불족6개월（OR＝1．74，95％CI：1．34～2．27）、유흡독행위（OR＝1．65，95％CI：1．11～2．46）、미접수과애자병간예복무（OR＝2．91，95％CI：2．36～3．58）、불지효애자병지식（ OR＝4．50，95％CI：3．48～5．82）적암창견지사용안전투적비례교저。조사대상보고미사용안전투적주요원인시대방불원의사용，점47．6％（270／567）。조사대상적총체흡독솔위1．0％（264／25567），기중，중당장소암창적주사흡독비례교고위0．6％（70／11141）。저당장소암창성병환병솔위1．2％（85／6934），교고、중당고（P치균＜0．01）；96．7％（24717／25574）적암창득도과애자병적간예복무，21．6％（57／264）적흡독암창획득미사동유지치료화접수과청길침구교환복무。결론운남성저당장소암창적애자병고위행위교엄중，우기시소수민족、문화정도교저、년령교대적암창이급신류입암창화흡독암창，금후응가강해인군적간예력도。
Objective To understand the high risk behaviors of female sex workers ( FSWs) in Yunnan province in 2013.Methods A cross-sectional investigation was conducted during April to June, 2013 in Yunnan province, census was used to the investigation where the number of FSWs was close to 200, while probability sampling was used where the number of FSWs was obviously over 200.A total of 25 574 cases were investigated, and data on demography and risk behaviors were obtained by questionnaires one by one.Results A total of 25 574 cases were investigated, AIDS awareness among FSWs in high-level places, middle-level places and low-level place were 98.8%( 92/7 401 ) , 98.6%( 150/10 995 ) , and 96.0%(281/6 655).FSWs from low-level place had a lower rate than those from the other two types of places(P<0.01).The rate of condom use each time when having sex with clients within the recent one month among FESs from high-level places, middle-level places and low-level place were 93.4%(6 307/6 755), 93.8%(10 109/10 782) and 90.4%(6 053/6 697), and the FSWs working in low-level place had a lower rate than those from the other two types of places(P<0.01).Multi-factor logistic regression analysis showed that the following had a lower rate of condom use: the FSWs working in low-level place(OR=1.56,95%CI:1.36-1.79;OR=1.36,1.16-1.59), over 30 years old(OR=0.77, 95%CI:0.69-0.85), Yunnan citizen (OR=0.88, 95%CI:0.77-1.00), minority(OR=1.32, 95%CI:1.16-1.50), under senior high school (OR=0.61, 95%CI:0.49-0.75),married(OR=0.81,95%CI:0.71-0.92), living together(OR=0.70, 95%CI:0.51-0.96), divorced or lost spouses(OR=0.81,95%CI:0.65-1.02), worked less than 6 months in local areas(OR=1.74, 95%CI:1.34-2.27), drug users(OR=1.65, 95%CI:1.11-2.46), had not accepted HIV interventions(OR=2.91,95%CI:2.36-3.58), had no knowledge about AIDS(OR=4.50, 95%CI:3.48-5.82 ) .The main reasons for not using condoms were the clients′unwilling to use, which accounted for 47.62%( 270/567 ) .The total rate of drug use was 1.0%( 264/25 567 ) and the FSWs working in middle-level places had the highest rate of injecting drugs, which accounted for 0.6%( 70/11 141).The FSWs working in low-level places had a higher rate than those who worked in high-level places and middle-level places in venereal diseases, which accounted for 1.2%(85/6 934)(P<0.01).The rate of receiving effective interventions was 96.7%(24 717/25 574), the rate of accepting treatment and clean needles among drug users was 21.6%(57/264).Conclusion High risk behaviors were serious among the FSWs who worked in low-level places, especially among the olders, the minorities, people who had lower educational level, the new-comer and drug users, which indicated that more attention needs to be paid among these populations.