铁路工地流动人口艾滋病健康教育和行为干预效果评价

Effect evaluation of health education and behavioral intervention on AIDS among migrant workers in railway construction sites

目的评价行为干预对铁路建筑工地流动人口在改变艾滋病知识、态度和行为方面的效果。方法整群抽取合肥市某铁路施工企业在外施工的2个工地的流动人口进行干预研究。在基线调查的基础上对干预对象进行为期4～5个月的小媒介宣传和同伴教育等综合干预,之后再随访调查。结果通过对比干预前943名和干预后随访到的671名建筑工地流动人口有关艾滋病的知识、态度和行为,发现行为干预在不同程度上使建筑工地流动人口对艾滋病传播途径、预防知识等知晓率普遍提高,自我保护意识明显增强;因恐惧和歧视心理而采取消极态度者分别由9.8%、10.5%降至6.3%、3.5%(P值均<0.05);承认最近3个月内有过非婚性行为者的比例由干预前的24.8%下降到3.8%(P<0.01);最近一次非婚性行为使用安全套者由干预前的41.9%提高到64.3%(P<0.05),但在最近3个月内非婚性行为安全套使用频率干预前后比较未见显著性差异。结论行为干预对建筑工地流动人口在预防和控制艾滋病方面是有效的措施;但要长期地改变民工与STI/AIDS有关的高危性行为应建立长效的行为干预机制。

Objective To evaluate the effect of behavioral intervention on changing knowledge, atti- tude and practice （KAP） about AIDS among the migrant workers in railway construction sites. Methods Health education and behavioral intervention on AIDS were carried out among the migrant workers for 4 to 5 months, who were clusteredly sampled from two railway construction sites, in the forms of mini- media, peer education and so on. Questionnaire survey was conducted among them before and after the intervention. Results The results showed that the knowledge awareness of the migrant workers on the transmission routes, preventions of AIDS and self-protection consciousness increased significantly by comparing the indexes of 943 pre-intervention with those of 671 post-intervention workers. After inter- vention procedures, the rate of those workers who would adopt negative attitudes towards the HIV infected persons because of fear and discrimination was decreased from 9.8 % and 10.5 % to 6.3% and 3.5 % （both P （0.05） ; the rate of those workers admitting having non-marital sex in three months recently decreased from 24.8 o,6 to 3.8 % （ P 〈0.01 ） ; the rate of those workers. Using condoms most recently when having non-marital sex raised from 41.9 % to 64.3 % （ P 〈 0.05）. There was no statistical significance in the use of condoms in the three months recently between pre-intervention and post-intervention groups. Conclusions The behavioral intervention based on the construction sites for migrant workers was an effective measure in AIDS prevention and control. However, a continual and unremitting effort should be made to change migrant worker＇s high risk sexual behavior on STI/AIDS for good.