CAJ | 학술논문

目的：通过不同干预方式对 MSM知识行为影响分析了解干预方式在人群中的作用，提出干预方式的完善和合理应用建议。方法：2009年至2012年连续4年采用自愿招募和滚雪球的方法，通过 VCT门诊和开展外展干预活动对第1次接受艾滋病咨询检测的 MSM进行问卷调查和血清学检测。将未接受过任何干预措施的设为未干预组，仅参与过同伴教育活动者则为同伴教育组，仅接受过安全套宣传和发放以及艾滋病咨询与检测者为宣教检测组，既接受过安全套宣传和发放以及艾滋病咨询与检测又参与过同伴教育活动者为综合干预组分别对收集信息进行分类分析。结果：1043例 MSM中未干预组351例，同伴教育组74例，宣教检测组218例，综合干预组400例。各组年龄分布有差异 P ＝0.033，同伴教育组的平均年龄较低。对于艾滋病知识而言，干预能够提高知识水平，尤其以综合干预组和宣教检测组为高，知识知晓率分别达到92.0％和91.3％。近半年内有同性性行为的人数综合干预组达到90.0％，宣教检测组为85.8％、同伴教育组为83.8％、未干预组为82.3％，存在显著差异（P ＝0.022）。最近1次同性肛交行为安全套使用和半年内使用频率各组间均存在显著差异（P ＜0.015）。最近1次同性肛交综合干预组安全套使用明显高于未干预组（P ＝0.001）。综合干预和宣教检测组在近6个月的同性肛交中安全套使用频率高于未干预组（P ＝0.004，P ＝0.034）。近6个月同性商业性性行为中安全套使用频率综合干预组高于未干预组（P ＝0.038）。最近1次与异性发生性行为时安全套的使用宣教检测组高于综合干预、同伴教育和未干预组（P ＝0.049， P ＝0.029，P ＝0.012）。近1年内在性病诊断治疗方面各组没有差异，血清学梅毒、HIV、HCV 检测结果各组间也无差异。结论：需要加强同伴教育员的能力和专业性。专业机构和社区活动共同干预对于 MSM人群的安全意识提高和重视性行为安全有着积极的意义，但如何有效提高安全性行为实施率仍然是亟待解决的重要课题。目的：通過不同榦預方式對 MSM知識行為影響分析瞭解榦預方式在人群中的作用，提齣榦預方式的完善和閤理應用建議。方法：2009年至2012年連續4年採用自願招募和滾雪毬的方法，通過 VCT門診和開展外展榦預活動對第1次接受艾滋病咨詢檢測的 MSM進行問捲調查和血清學檢測。將未接受過任何榦預措施的設為未榦預組，僅參與過同伴教育活動者則為同伴教育組，僅接受過安全套宣傳和髮放以及艾滋病咨詢與檢測者為宣教檢測組，既接受過安全套宣傳和髮放以及艾滋病咨詢與檢測又參與過同伴教育活動者為綜閤榦預組分彆對收集信息進行分類分析。結果：1043例 MSM中未榦預組351例，同伴教育組74例，宣教檢測組218例，綜閤榦預組400例。各組年齡分佈有差異 P ＝0.033，同伴教育組的平均年齡較低。對于艾滋病知識而言，榦預能夠提高知識水平，尤其以綜閤榦預組和宣教檢測組為高，知識知曉率分彆達到92.0％和91.3％。近半年內有同性性行為的人數綜閤榦預組達到90.0％，宣教檢測組為85.8％、同伴教育組為83.8％、未榦預組為82.3％，存在顯著差異（P ＝0.022）。最近1次同性肛交行為安全套使用和半年內使用頻率各組間均存在顯著差異（P ＜0.015）。最近1次同性肛交綜閤榦預組安全套使用明顯高于未榦預組（P ＝0.001）。綜閤榦預和宣教檢測組在近6箇月的同性肛交中安全套使用頻率高于未榦預組（P ＝0.004，P ＝0.034）。近6箇月同性商業性性行為中安全套使用頻率綜閤榦預組高于未榦預組（P ＝0.038）。最近1次與異性髮生性行為時安全套的使用宣教檢測組高于綜閤榦預、同伴教育和未榦預組（P ＝0.049， P ＝0.029，P ＝0.012）。近1年內在性病診斷治療方麵各組沒有差異，血清學梅毒、HIV、HCV 檢測結果各組間也無差異。結論：需要加彊同伴教育員的能力和專業性。專業機構和社區活動共同榦預對于 MSM人群的安全意識提高和重視性行為安全有著積極的意義，但如何有效提高安全性行為實施率仍然是亟待解決的重要課題。
목적：통과불동간예방식대 MSM지식행위영향분석료해간예방식재인군중적작용，제출간예방식적완선화합리응용건의。방법：2009년지2012년련속4년채용자원초모화곤설구적방법，통과 VCT문진화개전외전간예활동대제1차접수애자병자순검측적 MSM진행문권조사화혈청학검측。장미접수과임하간예조시적설위미간예조，부삼여과동반교육활동자칙위동반교육조，부접수과안전투선전화발방이급애자병자순여검측자위선교검측조，기접수과안전투선전화발방이급애자병자순여검측우삼여과동반교육활동자위종합간예조분별대수집신식진행분류분석。결과：1043례 MSM중미간예조351례，동반교육조74례，선교검측조218례，종합간예조400례。각조년령분포유차이 P ＝0.033，동반교육조적평균년령교저。대우애자병지식이언，간예능구제고지식수평，우기이종합간예조화선교검측조위고，지식지효솔분별체도92.0％화91.3％。근반년내유동성성행위적인수종합간예조체도90.0％，선교검측조위85.8％、동반교육조위83.8％、미간예조위82.3％，존재현저차이（P ＝0.022）。최근1차동성항교행위안전투사용화반년내사용빈솔각조간균존재현저차이（P ＜0.015）。최근1차동성항교종합간예조안전투사용명현고우미간예조（P ＝0.001）。종합간예화선교검측조재근6개월적동성항교중안전투사용빈솔고우미간예조（P ＝0.004，P ＝0.034）。근6개월동성상업성성행위중안전투사용빈솔종합간예조고우미간예조（P ＝0.038）。최근1차여이성발생성행위시안전투적사용선교검측조고우종합간예、동반교육화미간예조（P ＝0.049， P ＝0.029，P ＝0.012）。근1년내재성병진단치료방면각조몰유차이，혈청학매독、HIV、HCV 검측결과각조간야무차이。결론：수요가강동반교육원적능력화전업성。전업궤구화사구활동공동간예대우 MSM인군적안전의식제고화중시성행위안전유착적겁적의의，단여하유효제고안전성행위실시솔잉연시극대해결적중요과제。
Objectives:To understand the effect of intervention means through impact analysis of different intervention means to the knowledge and behavior of MSM population,and make a reasonable suggestion for inter-vention means.Methods:Voluntary recruitment and snowball method was adopted in four consecutive years from 2009 to 2012,and questionnaire investigation and serological detection was conducted by VCT clinics and outreach service among MSMaccepted HIV counseling and testing for the first time.All the attendees were divided into four groups,including the non -intervention group without any intervention means(NIG),the peer -education group only involved in peer education(PEG),the health education and testing group with both condom promotion as well as VCT(PTG),and the comprehensive group with three kinds of intervention means above(CIG).The information of each group was collected and analyzed respectively.Results:In 1043 attendees,there were 351 cases of NIG, 74 cases of PEG,218 cases of PTG and 400 cases of CIG.There was statistical difference between age distribution of four groups (P =0.033);the average age of the PEG was lower than that of other groups.Intervention improved the level of HIV /AIDS knowledge,especially in CIG and PTG.The awareness rates of AIDS knowledge were 92.0% and 91.3% respectively.There was statistical difference between the cases of homosexual behavior among four groups (P =0.022):the proportion of homosexual behavior in CIG was 90.0%,85.8% of PTG,83.8% of PEG,and 82.3% of NIG.There was significant difference of condom use with homosexual partners between four groups during the last anal sex and in the past six months (P <0.015).The rate of condom use in CIG was signifi-cantly higher than that of NIG during the last sex episode (P =0.001).The rates of condom use in CIG and PTG was higher than that of NIG with homosexual anal sex in the past six months (P =0.004,P =0.034),and the rates in CIG was higher than that of NIG with commercial homosexual sex in the past six months (P =0.038).The rates of condom use in PTG was higher than that of CIG (P =0.049),PEG (P =0.029),NIG (P =0.012)with heter-osexual sex in the last sex.There were no differences of STD diagnosis and treatment,the prevalence of syphilis, HIV and HCV infection between four groups.Conclusion:It is necessary to improve the capacity and their profes-sional skill of peer educators.The integrated intervention by professional institutions and community has an effect on the safety awareness and sexual behavior among MSMpopulation.It is an urgent and important issue to improve the proportion of safety sexual behavior.