云南女性性工作者规范化性病服务现况调查

Study on the standardized services of sexually transmitted infections among female sexual-workers

[目的]了解云南女性性工作者就诊时,接受不同医疗机构规范化性病诊疗的服务现状,为今后提供规范化性病诊疗服务研究提供一定基础。[方法]选取云南省9个全球基金艾滋病项目县为调查点,选择最近一年感染STDs后到医疗机构就诊的女性性工作者为调查对象。对调查对象进行面对面的现况调查,询问调查对象最近一次接诊时接受性病诊疗的规范化情况。[结果]最近一次就诊时,公立医院规范化程度最低是医生询问病史和妇科检查两项均全面,比例为74.8%,私人诊所中最低是医生开具化验单,比例为32.6%。医生询问病史全面的比例、医生询问病史和妇科检查两项均全面的比例,在公立医院和私人诊所之间存在统计学差异(P<0.05)。预防服务方面,公立医院和私人诊所最高的均是建议使用安全套,比例分别为47.5%和47.1%,最低的均是提供健康处方,比例分别为24.8%和12.3%。医生讲解性病艾滋病相关知识和提供健康处方在公立医院和私人诊所之间存在统计学差异(P<0.05)。[结论]云南女性性工作者接受不同医疗机构STDs诊疗服务规范化程度比较低,尤其是私人诊所。不同医疗机构诊疗过程中均存在不规范的操作,特别是缺乏预防服务的提供。

Objective To understand the situation of standardized services on sexually transmitted infections （STIs） among female sex workers （FSWs） in Yunnan and to provide evidence for future research. Methods 9 GF4/DFID project counties in Yunnan Province were chosen as study sites. FSWs infected with STIs and receiving treatments in health facilities were chosen as study subjects, Data about STIs standardized service were collected by face to face interview. Results The lowest standardized service for public hospital was that the history taking combined with physical examination 74.8%. The lowest proportion for private clinics was the laboratory examination which was 32.6%.In terms of prevention service, the highest proportion was the proposed using of condoms in public hospitals and private clinics. They were 47.5% and 47.1% respectively. And the lowest one was health prescriptions for public hospitals and private clinics, with 24.8% and 12.3% respectively. There were significant differences on promoting STIs related knowledge, the provision of health prescription （P〈0.05）. Conclusions Currently, the STIs standardized service was extremely low degree in Yunnan Province, especially in private clinics. There were non-standard operations such as the lack of prevention services.