女性性工作者性病艾滋病综合干预策略应用效果的系统评价

Meta-analysis on the efficacy of STD /AIDS prevention and control strategies for female sex workers

目的：系统评价我国性病/艾滋病防治综合干预策略在女性性工作者人群中实施的效果.方法：计算机检索2013年以前Pubmed,万方数据库、CNKI数据库发表的女性性工作者性病/艾滋病预防干预的文献,筛选至少有前后对照的干预项目.用Stata12.0进行统计分析.结果：共纳入38篇文献,纳入文献有一定的发表偏倚.Meta分析结果显示,“性交可以传播性病/艾滋病”的知晓率,纳入18篇文献,汇总后的知晓率差异为干预后高于干预前（mean ES=0.102,95％ CI,0.073-0.132）.“安全套可以预防性病/艾滋病传播”的知晓率,纳入31项研究,干预后的知晓率较干预前高21.9％,95％ CI为0.165 ～0.272.回答“最近一次使用安全套”为是的频率：干预后比干预前上升了18.5％,95％ CI为0.138 ～0.232.“选择去正规医院就诊性病/艾滋病”的频率：干预后比干预前提高了20.7％（95％ CI为0.103～0.311）.“性病/艾滋病的感染率”,干预后较干预前平均降低8.1％（95％CI-0.120,-0.040）.结论：性病/艾滋病综合干预策略对提高女性性工作者的知识水平、安全性行为和正确就医行为,以及降低性病/艾滋病感染率方面具有一定的效果.

Objectives： To evaluate the efficacy of STI/AIDS prevention and control strategies for female sex workers in China. Methods： Based on the principles and methods of Cochrane systematic reviews, we searched literature from Pubmed, Wangfang and CNKI before 2013 relating to the STD/AIDS prevention and control strategies for female sex workers, and included only those researches with pre and post intervention comparison. Stata 12. 0 was applied to do the data analysis. Results： A total of 38 studies were included. Some of them have publication bias. Meta - analysis results showed that the awareness rate of knowledge that ＂STI/AIDS could be transmitted through sexual in- tercourse＂ was improved after intervention （ mean ES = 0. 102,95% CI, 0. 073 - 0. 132）. Thirty - one studies were chosen to evaluate the awareness rate of knowing ＂condom use could prevent STD/AIDS＂, and the rate increased by 21.9% after the intervention （95% CI：0. 165 -0. 272）. Comparing pre and post intervention, the rate for choosing to better hospital for the treatment of STD/AIDS was improved by 20. 7% （95% CI：0. 103 -0. 311 ）. The infection rate for STD/AIDS decreased by 8. 1% （95%CI： -0. 120, -0. 040）. Conclusion： Current evidence indicated that comprehensive STD/AIDS prevention and control strategies were effective for female sex workers.