吸毒人群包皮环切预防艾滋病推广效果评价

Evaluation on effect of promotion of male circumcision for HIV/AIDS prevention among male drug users

目的评价包皮环切(MC)预防艾滋病在广西吸毒人群中的推广效果。方法采用整群抽样的方法抽取广西南宁市、柳州市4个美沙酮门诊共490名艾滋病病毒(HIV)阴性的男性吸毒者为研究对象,基线调查后1个月进行MC预防艾滋病宣传和干预,愿意手术且无手术禁忌症者则实施MC,干预后第9个月随访,了解研究对象对MC预防艾滋病知、信、行的变化情况。结果干预后,与基线比较,吸毒人群中MC接受意愿从56.1%上升到66.1%(χ2=9.769,P=0.002),手术率从0上升到22.8%(χ2=125.662,P=0.000);知晓MC可以预防艾滋病及其他性传播疾病从29.2%上升到70.5%(χ2=160.499,P=0.000),知晓MC可以保护性伴生殖卫生与健康从33.7%上升到随访的68.1%(χ2=111.148,P=0.000),知晓MC可以预防生殖器炎症或肿瘤从33.1%上升到63.2%(χ2=85.502,P=0.000)。结论 MC预防AIDS的推广可提高吸毒人群对MC的知晓情况、手术意愿和手术率。

Objective To evaluate the effect of promotion of male circumcision for HIV/AIDS prevention among male drug users in Guangxi, China. Methods Cluster sampling method was used to recruit 490 HIV/AIDS negative male drug users from four methadone clinics in Guangxi. After a baseline survey, an education program about the knowl- edge of circumcision to prevent HIV/AIDS was carried out and the subjects who were willing to undergo surgery were provided free circumcision. After nine months, we followed up the subjects to collect the information on the change of their knowledge, willingness and behavior. Results After the intervention, drug users＇ willingness for circumcision increased from 56.1% to 66.1% and the rate of surgical circumcision rose from 0% to 22.8% .with statistically significant diffences （ P 〈 0.05 ）. The perception of circumcision could prevent HIV/AIDS and other sexually transmitted disea- ses increased from 29.2% to 70. 5% （X2 = 160. 499,P = 0. 000） and that of circumcision could protect sexual parmers reproductive health increased from 33.7% to 68. 1% （X2 = 111. 148, P = 0. 000 ）, moreover that of circumcision could prevent genital inflammation or tumors increased from 33.1% to 63.2% （X2 = 85. 502, P = 0. 000）. Conclusion The promotion on male circumcision for HIV/AIDS prevention significantly improved the knowledge, willingness and surgery rate of MC in drug users.