三种男用避孕套使用不良结局比较及影响因素分析

Study of the Adverse Outcomes and its Determinants for Use of Three Kinds of Male Condom in Shanghai

目的:了解中国已婚夫妇对使用避孕套的态度及其影响因素,同时比较三种表面类型不同的男用避孕套在已婚夫妇使用中的不良结局。方法:运用交叉设计研究方法探讨三种男用避孕套（光滑型、颗粒型、螺纹型）在已婚夫妇中的使用不良结局（避孕套破裂、滑脱、阴道出血和阴道疼痛）。数据分析采用条件和非条件Logistic回归分析法。结果:488对夫妇在四个月中使用了7482只避孕套。57.2％妻子和52.7％丈夫能认识到避孕套在家庭中预防性病、艾滋病的作用。使用不方便、影响性快感,价格因素是影响避孕套使用的主要原因。使用不良结局:意外妊娠发生率为0,避孕套破裂率1.20‰,滑脱率4.01‰,阴道出血率3.34‰,阴道疼痛率9.36‰。条件Logistic回归分析没有显示避孕套类型与使用不良结局有关,两分类变量Logistic回归分析发现颗粒型比光滑型避孕套发生使用不良结局的危险高;丈夫避孕套知识得分低者发生使用不良结局的危险性高。结论:已婚夫妇中避孕套使用的不良结局发生率较低,与其稳定的性生活模式有关,结果不适合推广到其他人群。颗粒型避孕套是否使不良结局的发生率提高,需进一步研究。

ve: To study the willingness of condom use of married couples in Shanghai so as to compare the adverse outcomes (breakage, slippage, vaginal bleeding and vaginal pain) for use of three kinds of male condom (smooth, nipple, ribbed). Methods: Crossover study design was applied in the study in Shanghai, China, from March 1999 to March 2000. The methods of was used as statistics analysis methodconditional Logistic regression and non-conditional Logistic regression. Results: Four hundred and eighty eight couples consumed 7 482 condoms with low breakage rate (1. 20‰) and low slippage rate (4. 01‰) during 4 months. The cumulative vaginal bleeding rate and vaginal pain rate was 3. 34‰ and 9. 36‰ re-spectively. No unwanted pregnancy occurred. After controlling confounders dichotomous response Logis-tic regression analyses showed nipple condom, compared with smooth one, had higher risks of adverse out-comes. Couples in which husbands had low condom knowledge scores had higher risks of adverse out-comes. More than half of subjects (57. 2% of wife and 52. 7% of husband) realized condom's important function of preventing STD and AIDS of condom. Inconvenience, reducing sexual excitement and price were major complainants toward condom. Conclusion: The low rate of adverse outcomes of condom in married couples is associated with their sex behavior model and the result of this study is not applicable in other groups. Whether the use of nipple condom will enhance adverse outcomes still needs further study.