广西艾滋病高发区一般人群对包皮环切术认知宣教初步研究

Benefits of promoting male circumcision among the general population in the high HIV prevalence areas of Guangxi Province

目的:在广西艾滋病高发区一般人群中评价包皮环切术推广的效果,为推广包皮环切术提供参考依据。方法:在广西贺州、钦州市招募590例固定社区居民,填写知情同意书,进行基线调查后运用各种宣传材料和方式进行现场干预,问卷采用一对一现场问卷调查。如果研究对象愿意接受手术且无手术禁忌证,则安排其到课题组指定的医院进行手术。在干预后第6个月、9个月进行随访,了解相关包皮环切预防艾滋病知、信、行变化情况。结果:一般人群第1、2次随访相对于干预前,手术原因、手术益处、手术并发症知晓率、手术接受意愿以及手术率均有提高,差异均有统计学意义(P<0.05),两次随访之间比较差异均无统计学意义(P>0.05)。知道包茎或包皮过长是手术原因从干预前66.1%分别提高至第1、2次随访的81.9%、79.8%;知道手术可预防艾滋病及性传播疾病从干预前28.0%分别提高至第1、2次随访的77.4%、78.6%;知道疼痛、出血、感染是手术并发症从干预前29.5%、19.3%、39.3%分别提高至第1次随访72.5%、58.2%、59.4%以及第2次随访75.0%、57.0%、63.0%;手术接受意愿从干预前35.3%分别提高至第1、2次随访的59.6%、61.3%;手术率在第1、2次随访时分别提高到12.7%、16.1%。结论:包皮环切术的推广对广西艾滋病高发区一般人群包皮环切预防艾滋病的知、信、行的干预效果显著,适宜在一般人群中应用。推广材料和方式的改进可考虑着重宣传艾滋病、包茎或包皮过长的危害和手术安全性相关知识。

Objective： To evaluate the effect of promoting male circumcision among the general population in the high HIV prevalence areas of Guangxi Province.Methods： We interviewed 590 male residents from Hezhou and Qinzhou areas of Guangxi Province and conducted intervention using male circumcision promotion materials and various methods.If the subjects were willing and had no contraindication,they were referred to the appointed hospitals to receive circumcision.We conducted follow-up visits at 6 and 9 months after intervention for the changes in the subjects＇ knowledge,attitude and practice related to male circumcision.Results： The male circumcision knowledge,willingness and operation rate were significantly improved after intervention（P0.05）,but with no significant difference between the two follow-up visits（P0.05）.The number of those who knew that phimosis and redundant prepuce were the reasons for circumcision increased from 66.1% at baseline to 81.9% and 79.8% at the two follow-up visits;those who knew that circumcision could prevent AIDS and sexually transmitted diseases increased from 28.0% to 77.4% and 78.6%;those who knew that surgical complications could be pain,bleeding and infection increased from 29.5%,19.3% and 39.3% to 72.5%,58.2% and 59.4% at the first follow-up and 75.0%,57.0% and 63.0% at the second;those who were willing to receive circumcision increased from 35.3% at baseline to 59.6% and 61.3% at the two follow-up visits;and the rate of surgery increased from zero to 12.7% and 16.1%.Conclusion： The promotion of male circumcision among the general population in the high HIV prevalence areas of Guangxi Province significantly improved their knowledge,attitude and practice related to AIDS prevention.And the promotion activities should focus on the publicity of AIDS knowledge,risks of phimosis and redundant prepuce,and safety of circumcision.