对城市娱乐场所小姐开展性病干预服务模式探讨

Investigation of STD intervention modes among female sex workers in China

目的探讨在中国城市娱乐场所小姐中开展性病干预服务模式并进行评估。方法每月由性病门诊医务人员以外展服务形式,向福州市18家娱乐场所的149名小姐提供性病预防治疗服务,全部现场监服阿奇霉素和灭滴灵,连续3个月。结果61.7%的小姐干预前有生殖道感染症状,干预后下降到43.6%。衣原体和滴虫感染检出率从干预前27.5%和3.4%,下降到干预后5.9%和1.0%。91.1%的小姐希望在开展宣传教育的同时提供方便、规范的性病服务。结论医务人员走出门诊为娱乐场所小姐提供以性病预防治疗为主的健康服务受到欢迎。其中采用给所有小姐定期口服阿奇霉素的方法,对控制娱乐场所小姐的衣原体感染有较好效果,但有一定局限性。今后应探索将性病预防治疗与行为干预(健康教育、咨询和安全套促进)相结合的综合干预模式。

Objective To investigate modes of STD interventions among female sex workers in massage parlors or night clubs.Methods One hundred and forty nine sex workers in Fuzhou city working in massage parlors or night club were recruited in the study.Presumptive treatment of monthly azithromycin(1g) and metronidazone for three months was given to the participants through ourtreach efforts.Results The majortiy(61.7%) had symptoms of STIs at the initial visit and 43.6% had symptoms after the interventions.The prevalence of chlamydia infection decreased from 27.5% to 5.9%,and trichomoniasis from 3.4% to 1% after the interventions.91.1% participants hoped they could get regular physical examination in addition to health education.Conclusion Preventive service including presumptive treatment for STI through outreach efforts was well accepted by female sex workers.Regular treatment with azithromycin had some impact on chlamydial infection control.The effect of combination of presumptive treatment with behavioral interventions including health education,counseling and condom promotion will be further investigated in the future.