上海市闸北区STD门诊对女就诊者安全性行为干预效果评价

Appraisal of the effect of interventions to promote safe sex behaviors among female outpatients at STD clinics in Zhabei District

目的探讨适合性传播疾病(STD)门诊对女就诊者理想的艾滋病(AIDS)干预方法。方法对STD门诊女就诊者随机分为4组:A组:实施门诊宣传教育;B组:实施电话随访“降低危险性行为”方案;C组:实施门诊讨论“降低危险性行为”方案;D组:实施门诊讨论“降低危险性行为”方案和实施技巧。然后调查干预前后性行为情况。结果有无婚外性行为(χ2=12.19,P<0.01)、婚外性伴数(t检验,P<0.05)、与丈夫/未婚夫性交方式(χ2=5.51,P<0.05)、与配偶安全套使用频率(t检验,P<0.01)、鼓励性伴/伙伴就医(χ2=12.56,P<0.01)等多项内容上,干预后与干预前比较,D组的效果比其它3组较为理想。结论采用医生-就诊者一对一面对面深入交流和咨询的方式并传授一定的与性伴交流技巧,对于促进性病门诊女性就诊者实施安全性行为是较为有利和有效的。

Objective To explore and develop feasible and effective measure to promote the safe sex behaviors among female outpatients at STD clinics. Methods Every subject was randomized into one of the four STD/AIDS education and intervention groups and their sex behaviors were investigated before and after the intervention. These four groups included health education at STD clinic（group A）, telephone follow-up on the implement ation of ＂reducing risk sex behavior plan＂ （group B）, discussion on ＂reducing risk sex behavior plan＂at clinic（ group C）, and discussion on ＂reducing risk sex behavior plan＂and its implement skill at clinic（group D）.Results More significant improvements were seen in Group D after the intervention than in other three groups in respect of non-marital sex behavior（x^2 = 12.19, P 〈 0.01 ）, the numbers of non-marital sex partners（t test, P 〈 0.05 ）, ways of sexual intercourse with husbands/fiances（x^2 = 5.51, P 〈 0.05 ）, the frequency of using condoms with spouses（t test, P 〈 0.01 ）and encouraging partners to seek medical care（x^2= 12.56, P 〈0.01）.Conclusion The effect of the intervention depends on effective communication between doctors and outpatients. It would be much helpful for the target population group to improve their sexual behavior if women doctors could teach the outpatients in a face-to-face way about appropriate sex behaviors and communication skills with their sex partners.