中国四川彝族和藏族女青年性及避孕行为的干预比较

A Comparative Intervention on Sexual and Contraceptive Behaviors Among Female Youth of Yi and Zang Minority Nationalities in Sichuan,China

目的：（1）了解通过干预后，四川彝族和藏族青少年的性及避孕行为的改变情况；（2）寻找一条改善少数民族青少年性及避孕行为的可行途径。方法：采用流行病学干预调查（基线和评估）和定性访谈（集体访谈-FGDs、个人深入访谈）相结合的方法，于21304年12月至2006年5月先后在基线和评估调查中定量调查了600（彝藏各300）和567（彝族285、藏族282）名15—29岁女性青少年；其中，基线和评估调查时还分别进行了2组（12人）FGDs、4人接受了个人深入访谈。项目实施期间对受试人群进行了6个多月的干预。措施包括：IEC材料的发放、现场教育、咨询，以及对提供者／计划生育管理者和受试者所在社区相关人群的培训。受试者分别来自四川西昌市郊的两个彝族乡和康定的两个藏族乡。定量调查和定性访谈分别采用问卷和访谈提纲。结果：与基线调查时相比，评估调查结果显示，彝族和藏族女青年的性和避孕行为在以下方面发生了改变：（1）了解性知识（性、性行为、安全性行为等）的对象分别增加了350％（彝族）和947．6％（藏族）；她们中，较深入全面了解性知识的对象分别增加了553和3，550个百分点。（2）本项目人群的避孕措施使用率分别上升了330．7％（彝族）和231．7％（藏族）；其中，安全套的使用者分男q增加了163．7和180．7个百分点；使用安全套的原因由单纯避孕逐步改变为为避孕和防病（HIV／MDS／STDs）相结合；此外，认为安全套是一种最适合未婚女青年在发生性行为时使用的一种避孕措施的对象增加了79．7和172．7个百分点。（3）比较深入了解人流副反应的对象上升了268．1％（彝族）和168．6％（藏族）。（4）比较全面了解性病／艾滋病知识知道艾滋病的各种传播途径的对象分别增加了310．1％（彝族）和861．5％（藏族）；而清楚艾滋病三条传播途径的人数则分别增加了356．9和657．6个百分点。结论：（1）有效干预确能改善少数民族女青年的性和避孕行为；（2）由于文化和经济水平的差异，藏族女青年较彝族女青年的性及避孕行为容易改变；（3）用于干预的IEC材料必须从少数民族中来再回到他们中去，才能真正受欢迎、起作用。

Objective： （ 1 ） To Learn changes of sexual and contraceptive behaviors of Yi and Zang minority youth after intervention; （2） To find a way to improve sexual and contraceptive behaviors of minority youth. Methodology： An epidemiologieal intervention investigation （baseline and evaluation surveys} plus a qualitative interview {FGDs and IDIs} were adopted. During Dec 2004 and May 2006, 600 female youth {300 Yi and 300 Zang} and 567 {285 Yi, 282 Zang} who aged 15 ~ 29 were investigated in baseline and evaluation survey respectively. At the same time, 2 FGDs { 12 youth}, 4 IDIs were also conducted in the two surveys, respectively. Over 6 months intervention was implemented between the two surveys. Intervention includes： development and distribution of IEC materials, outreach education sessions, counseling, and variety of trainings which providers/FP managers and part of the relevant people in the study areas were participated in. Target group of the project came from two Yi mi- nority townships in Xichang, and two Zang minority townships in Kangding. Questionnaires and guidelines were used for quantitative surveys and qualitative interviews. Results： Comparison of the evaluation survey with the baseline, data shows, sexual and contraceptive behaviors of Yi and Zang female youth have been changed in following aspects： （ 1 ） number of youth who understand sexuality （sex, sexual behaviols, safe sex, etc. ） have increased to 350% （Yi） and 947.6% （Zang） ; Among them, number of youth who have relatively deep understand sex increased 553 per cent and 3,550 per cent respectively; （ 2） contraceptive use rate increased by 330.7% （Yi） and 231.7% （Zang）. Among them, number of youth who used condom increased 163.7 and 180.7 per cent respectively. And most of the condom users use condom is not just for contraception but also for prevention of STDs/HIV/AIDS. In addition, the subjects who think condom should be the most suitable method for female youth has increased 79.7 and 172.7 per cents respectively; （3） the subjects who understand side effects of induced abortion increased 268.1% （Yi） and 168.6% （Zang） ; and （4） Youth who relatively well understand basic knowledge of sexuality increased 310.1% （Yi） and 861.5% （Zang） ; while the subjects who knows the mode of HIV transmission increased 356.9 and 657.6 per cent respectively. Conclusion： （1） Sexual and contraceptive behaviottrs can be improved by effective intervention; （2） Comparison of zang minority with Yi minority, sexual and contraceptive behaviours is more easier to be changed due to the differences of education and economic levels; （3） IEC materials used in intervention should come from minority youth and them be used among them. It then can be welcomed by minority youth and be effective.