绵阳市MSM人群艾滋病预防服务及规范性病诊疗促进效果

Analysis of AIDS Prevention Service for MSM Group and Promotion Effectiveness of Standardize Treatment for STD

目的探索针对男男性行为者(MSM)人群特征的有效艾滋病预防服务及规范性病诊疗促进方法。方法建立疾病预防控制中心(CDC)主导与MSM志愿者骨干实施相结合的MSM人群艾滋病性病防治组织模式,以核心同伴宣传(POL)干预方法为主,结合网络宣传、外展服务等进行MSM人群艾滋病、性病预防性服务和规范性病诊疗活动。2006年12月、2007年7月、2008年1月分别采用应答者驱动招募法(RDS)对MSM人群进行基线、中期及期终评估招募调查,对调查结果进行比较分析。结果基线调查201人,中期200人,期终203人。基线、中期、期终调查比较,过去6个月接受过安全套免费发放的分别为54.7%、69.5%、69.0%,接受艾滋病检测服务的为12.9%、36.0%、54.2%,艾滋病健康咨询服务为21.9%、38.0%、45.1%,接受过同性朋友预防艾滋病宣传的为28.9%、56.0%、45.3%,差异均有统计学意义,上升趋势显著(P<0.05);患性病期间,发生性行为使用安全套的分别为58.6%、76.7%、79.6%,差异有统计学意义(χ2=7.041,P=0.030),变化趋势显著(χ2=5.935,P=0.015);性伴通知、就诊方式差异无统计学意义。结论CDC主导与MSM志愿者骨干实施相结合的以POL干预为主,结合外展、网络宣传等,有效提高了MSM人群艾滋病预防性服务覆盖面和性病期间安全套使用率,是适合MSM人群特点的一种有效预防服务和行为干预手段,但在如何针对MSM人群特点,更有效地促进性伴通知、检查治疗,提高规范就医比例上应继续进行探索。

[Objective]To explore the effective AIDS preventive service and promoted method of standardize treatment of sexual diseases for the group of Man having sex with men （MSM）. [Methods]The type of organization of MDS and venereal disease prevention and treat- ment for MSM group, which was dominated by Center for Disease Prevention and Control （ CDC ） combined with MSM volunteer backbone operation, was established. It provided AIDS preventive service and activities of standardize treatment of sexual diseases for MSM group with Popular Opinion Leander （POL） dominant, associated with network propagandizing and outside- exhibition service. Respond Driven Sampling （ RDS ） was employed to conduct baseline, midterm and final evaluation of the recruitment survey for MSM group in December 2006, July 2007 and January 2008, respectively, and the investigated results were compared and analyzed. [ Results ] Totally 201 people were investigated in baseline, 200 in midterm and 203 in final period. Compared baseline, midterm and final period investigation： over the past 6 months, the rate of having received the free condoms was 54.7%, 69.5%, 69.0%, respectively; the rate of having AIDS testing services was 12.9%, 36.0%, 54.2%, respectively; the rate of having AIDS health counseling services was 21.9%, 38.0%, 45.1%, respectively ; the rate of receiving same - sex friend publicity was 28.9%, 56.0%, 45.3%, respectively. The overall differences were signif- icant, and upward trend was obvious （ P 〈 0. 05）. Over the time suffering from venereal disease, the rate of using the condoms in sexual behavior was 58.6%, 76.7%, 79.6%, respectively. The difference was significant （ X^2 = 7.041 ,P = 0.030 ）, and variation tendency was significant （ X^2 = 5.935,P=0.015 ） ; The notification to sexual partner, treatment methods made no significant difference. [ Conclusion ] The interventions of POL-dominant combined with network propagandizing and outside - exhibition etc which are under CDC dominant combined with MSM volunteer operation, effectively increase the coverage of AIDS preventive service and venereal disease and usage of condom during the time suffering from venereal disease for MSM group. It is an effective preventive service and behavior intervention for MSM group. But it is still necessary to explore on how to much more effectively promote the notification to sexual partners according to MSM group characters, examination and treatment, and increasing the rate of norms for medical treatment.