对FSW大规模实施预防艾滋病标准化行为干预的效果分析

Effectiveness evaluation of large-scale standardized interventions in AIDS-related behaviors among female sex workers

目的评估对暗娼(FSW)大规模实施预防艾滋病标准化行为干预的效果,为进一步推广FSW标准化干预模式提供依据。方法采用统一的干预核心内容、干预技术,由专业人员、业主、同伴教育者开展干预,并发放宣传材料和安全套,提供自愿咨询和检测服务。同时在干预前,干预后的每一年,对FSW连续3次进行问卷调查和HIV血清学检测。结果 2008年到2010年,共调查FSW 11 957人。干预后,3年来FSW最近1次与客人性交的安全套使用率持续提高:58.6%、80.1%、89.7%(χ2=1 062.56,P<0.01);过去1个月与客人性交的安全套坚持使用率持续提高:26.1%、41.6%、60.8%(χ2=940.35,P<0.01);出现性病症状的比例持续减少:34.5%、29.9%、17.6%(χ2=303.89,P<0.01),正确求医的比例持续提高:30.1%、43.9%、48.1%(χ2=80.57,P<0.01);近1年接受HIV检测的比例持续提高:21.7%、30.6%、35.2%(χ2=182.21,P<0.01);HIV感染率保持在较低水平:0.45%、0.15%、0.68%。结论大规模实施FSW艾滋病标准化行为干预取得了较好的成效,可以向更多的地区推广。

Objective To evaluate the effectiveness of large-scale standardized interventions in AIDS-related behaviors among females sex workers（FSW） in order to provide evidence for further promotion of standardized intervention model among them. Methods The same intervention technique with standardized core contents was implemented by professionals, employers and peer educators, publicity materials and condoms were distributed and voluntary counselling and testing（VCT） services were provided. Meanwhile, FSW received questionnaire surveys and HIV tests three times consecutively each year before and after the intervention. Results From 2008 to 2010, 11 957 FSWs were investigated. After the intervention, the rate of condom use in the latest sexual intercourse with clients among FSW increased, which was 58.6 % 80.1% and 89.7 %, respectively （X^2 = 1 062.56, P〈0.01） ; the rate of condom use in the sexual intercourse with clients in the past one month also increased which was 26.1%, 41.6 % and 60.8%, respectively （X^2 =940.35 ,P〈0. 01） ; the rate of developing sexually transmitted diseases（STD） symptoms decreased from 34. 5 % to 29.8 % and then to 17.6 % ; the proportion of taking correct health seeking behavior increased from 30.1% to 43.9% and finally to 48.1% （Xz =80.57,P〈0.01）; the proportion of accepting HIV detection in the recent one year increased from 21.7 % to 30.6 ~ and then to 35.2 % （X2= 182.21 ,P〈0.01）; HIV infection was kept at a lower level, which was 0.45 %, 0.15 % and 0.68%. Conclusion Large-scale standardized interventions in AIDS-related behaviors among FSW achieve good effectiveness, which can be expanded to other regions.