将女用安全套纳入性服务场所妇女行为干预1年效果

One-year behavioral intervention with female condoms among female sex workers and its effectiveness

目的介绍在海南、广西4个城镇的性服务场所，为期1年的女用安全套加入男套干预的方法和过程，以及干预前后保护性行为的变化。方法通过出访性服务场所，讲授美国产女套的知识和使用方法、对需要者免费发放女套，并持续了解和帮助解决女套使用出现的问题。干预前、干预6个月及12个月后，对干预目标场所工作的妇女进行横断面问卷调查，评估干预效果。结果4个现场各次调查人数在73～160人之间，约占目标场所工作妇女的75％～80％；调查对象年龄均数范围26～34岁。整体看，4个现场干预前和干预后女套使用情况有一定差异。2次干预后调查，4个现场报告接受过于预的妇女比例约50％～70％。干预前，仅少数妇女听说过女套，干预后80％以上妇女听说过女套。约20％～50％妇女至少用过1次女套，其中50％以上用过2次或更多次。近10％妇女在调查前30天用过女套。在接受干预的妇女中，干预12个月后至少用过一次女套的妇女比例平均为54．9％；多次用女套的妇女比例为32．6％；调查前30天内用过女套的妇女占12．5％。近30％接受干预的妇女报告把女套当作备用的预防方法，有6％的妇女报告经常使用女套。基线时4个现场妇女调查前30天与所有类型性伴全部用安全套的比例均数不到40％，不用完全套的妇女接近1／4。干预后，各现场调查前30天全部性行为用安全套的妇女比例整体呈上升变化，完全不用安全套的妇女有所下降。妇女调查前30天用女套的性行为比例约2％，用男套的性行为比例约87％～90％。结论女套使用率远低于男套，但相当比例的妇女逐步将女套整合到预防行为中。加入女套有可能进一步减少无保护性行为。

Objective To describe methods, implementation and pre-/post-intervention changes of sexual behavior of a one-year intervention with female condom （FC） among women working at sex venues in four towns of Hainan and Guangxi Provinces. Methods FCs （made by Female Health Company） were provided freely with FC information, insertion skills and troubleshooting supports delivered through outreach to the sex venues by local health workers. Effects were evaluated by three serial cross-sectional surveys conducted in each study site before and at 6 and 12 months after intervention. Results Approximately 75%-85% of women working in the target sex venues varying from 73-160 participants for each survey at 4 sites, were investigated for evaluating intervention. The mean age ranged from 26 to 34 years old. Proportions of accepting intervention and using FC variing amongwomen from 4 sites. About 50% - 75% reported participated in intervention at two postintervention surveys. Few participants had ever known FC before intervention, but more than 80 % of participants were aware of FC after intervention. About 20% - 50% of participants reported using FC at least once, 50% of the users used more than once. Nearly 10% reported using FC last 30 days. Among the women who participated in FC intervention, 54.9 % reported using FC at least once, 32.6% used it more than once and 12.5% used FC in the last 30 days after one-year interven tion. About 30%of these women considered FC as a backup protection method, and 6%reported using FC regularly. The baseline survey showed that less than 40% of the participants always used condoms with all types of partners in the last 30 days, and nearly one fourth never used condoms. After intervention, the rate of always using con dom increased slightly, while the rate of never using condom decreased in the four sites. The mean proportion of FC use was about 2% in the last 30 days, while the proportions of MC use were about 87%-90%. Conclusion A notable proportion of study participants adopted FC in their sexual behaviors ofter one-year intervention, though the level of FC use was lower than that of MC use. Introduction of FC into intervention will possibly further reduce unprotected sex among the women working in sex places.