上海市高危女性艾滋病性病知识与相关危险行为调查

Study on knowledge and related high risk behaviors of HIV/STD among female sex servants in entertainment industry in Shanghai

目的了解上海市娱乐场所高危女性艾滋病性病知识知晓情况与相关危险行为状况。方法选择徐汇区某个街道美容美发、KTV、桑拿按摩三类行业进行调查并确定高危场所，从中选择9家高危场所中的所有服务小姐进行问卷调查和深入访谈，收集该群体的人口学特征；艾滋病性病相关知识、性行为、自我防护意识、安全套使用情况等资料。结果调查的街道三类行业共有115个服务场所，调查确认高危场所有52家（45．2％）。深入调查的9家服务场所中共有服务小姐138名，126名完成访谈，访谈率为91．3％。访谈的人中发廊27名、KTV房81名、桑拿按摩室18名，平均年龄24岁（17～39岁），61．9％为外地人。97．6％听说过性病，94．4％听说过艾滋病；知道艾滋病三大传播途径的人均超过85．7％，但有32．5％的小姐错误地认为“能从外表判断艾滋病病毒感染者”。42．9％的人提供性服务，其中有53．7％的小姐每天至少接待1名客人，46．3％的小姐每天接待两个及以上的客人；68．5％的小姐与客人发生性行为时用安全套，13．0％的人如果客人加钱而愿意放弃使用安全套。63．0％的小姐自己到药店购买安全套，11．1％的安全套由计划生育部门免费提供，9家高危娱乐场所均未安装安全套自动售货机。发放了卫生服务联系卡和体检通知单110份，只有1人上社区卫生服务中心接受免费健康体检。经对比分析，中、小型场所中服务小姐艾滋病感染危险性高于大型场所。结论上海市高危娱乐场所服务小姐存在经性感染和传播艾滋病的高危行为，因此应针对这一人群实施有效的行为干预，在娱乐场所推广100％安全套项目。并改善卫生服务。

Objective To explore the knowledge and related high risk behaviors of HIV/STD among female sex servants. Methods One street in Xuhui District in Shanghai was selected. All the beauty salons, KTV and massage and sauna settings in this street were investigated to find out high risk places. All of the female sex workers from nine high risk entertainment places were deeply interviewed by face to face and investigated by questionnaires. Their information about demographic characters, AIDS knowledge, sex behavior, self-protection and condom use etc. was collected. Results There were 115 entertainment places. Of these 115 entertainment places in the street, 52 places were considered as high risk places, making up 45.2%. Of these 138 female sex servants in 9 entertainment places, 126 were interviewed, with the success rate amounting to 91.3%, among which, 27 were from beauty salon, 81 from KTV and 18 from plunge bath and sauna settings. 97.6% and 94.4% of female sex servants had heard of STD and AIDS respectively. More than 85.7% of them knew the three routes of transmission of AIDS, but 32.5% of them mistakenly considered HIV patient could be judged by appearance. 42.9 % of the subjects engaged in commercial sex activities, 53.7% of which received at least 1 consumer per day and 46.3 % of which received at least 2 consumers per day. 68.5 % of them used condom when engaging in commercial sex activities, but there were still 13.0 % giving up using condoms when the consumers paid additional money. 63.0% of them went to pharmacy to buy condoms. Only 11.1% of them got condoms freely by birth control department. There weren ＇ t fix condoms vender machine in all these 9 high risk entertainment places. 110 health service cards and health check-up notices were sent to the subjects and free examination was provided, but only one person went to the community health service center and accepted free examination. Through compared analysis, the risks of infecting HIV in middle and small entertainment places were higher than the big ones. Conclusion AIDS related sexual infected and transmitting high risk behaviors are common among female sex servants in Shanghai. It is high time that middie and small high risk entertainment places should be regarded as the key intervention places and effective high risk behavior intervention measures should be taken to prevent AIDS, particularly the implementation of 100% condom use program at all entertainment places. Health service should be improved at these places.