结合计划生育服务开展性病/艾滋病预防的效果评估

Evaluation on the Effectiveness and Feasibility of Integrating STI/HIV Counseling with Existing Family Planning Services in Shanghai

目的 :评估发放宣传折页和提供咨询两种干预方法对提高育龄夫妇 STI/HIV/避孕套知识水平、改变对待 STI/AIDS病人的不良态度及增加避孕套使用意愿的效果 ,探讨结合计划生育开展 STI/HIV预防的有效方案。方法 :选取上海市 7个区 1 4个街道的 40 5对育龄夫妇 ,分为咨询干预组 (1 99对 )和折页发放组 (2 0 6对 )。基线调查后 ,咨询组进行咨询的同时提供免费避孕套并演示用法 ,折页组发放折页的同时提供免费避孕套 ,干预后一个月进行随访 ,以此评估干预效果。结果 :1 .基线无差异的两组 ,干预后咨询组夫妇 STI/AIDS/避孕套知识综合得分分别提高了 2 0 %和 2 4% ,折页组仅提高 2 %和 3% ;咨询组有93%的丈夫和 76 %的妻子消除了对 STI病人的偏见 ,73%的丈夫和 78%的妻子转变了歧视 AIDS病人或害怕与其接近的态度 ;避孕套使用意愿丈夫提高了 6 8% ,妻子提高了6 4% ;折页组对待 STI/AIDS病人的态度及避孕套使用意愿三项指标干预前后均无差别。2 .干预后得分及对待 STI/AIDS病人的态度主要与干预方式有关 ;避孕套使用意愿则受干预方式和获取方便程度的影响。结论 :1 .良好的咨询既能显著提高知识水平又能使不良态度得到明显转变 ;2 .提供有效咨询和增加可获得性是推广避孕套使用的重要因素 ;3.

Objective:To assess the impact of pamphlet distribution and counseling on STI/HIV/condom knowledge, attitudes towards STI/AIDS patients and condom use intention of married couples in Shanghai and explore the effective way of integrating STI/HIV prevention with family planning services. Methods: Four hundred and five married women aged 20~39 and their husbands were recruited from 14 family planning stations at 7 administrative districts of Shanghai. They were randomly divided into two groups, the counseling intervention (CI) group with 199 couples and the pamphlet distribution (PD) group with 206 couples. For the PD group, only pamphlets containing information on STI/AIDS/ condom were distributed and condoms given free of charge, whereas for the CI group, they were provided with not only full counseling on STI/AIDS/condom and free condoms, but also followed by demonstration of correct condom use. The two modes of interventions were conducted following the baseline survey, and the follow up data were collected one month later. Results: 1. There was no statistical difference between the two groups on STI/AIDS/condom knowledge level, attitudes towards STI/AIDS patients and condom use intention at the baseline. 2. The follow up findings indicated that: ① A significant enhancement in knowledge level was observed in the CI group, with 20% increase for husbands and 24% for wives. While for the PD group, only slight increase was observed: 2% for husbands and 3% for wives; ② 93% husbands and 76% wives of the CI group changed their negative attitudes towards STI patients, and for AIDS patients, the percentages were 73% and 78%, respectively; ③ 68% husbands and 64% wives of the CI group expressed their intention for condom use; ④ For the PD group, however, there was no difference between the baseline and follow up data on attitudes towards STI/AIDS patients and condom use intention. 3. The knowledge scores and attitudes towards STI/AIDS patients are mainly influenced by the means of intervention. While the intention of condom use was influenced not only by means of intervention but also by condom availability. Conclusions: 1. Good counseling can not only greatly enhance people's STI/AIDS/ condom knowledge level but also apparently change their negative attitudes towards STI/AIDS patients; 2. Effective counseling and condom availability are two important factors that influence condom use intention; 3. It is both effective and feasible to integrate counseling with the routine procedure of family planning services, hence is worth being scaled up in Shanghai or even nationwide.