深圳市宝安区男男性接触者艾滋病卫生服务利用情况分析

Health service utilization of HIV/AIDS intervention among men who have sex with men in Baoan District,Shenzhen

目的了解深圳市宝安区男男性接触者（MSM）人群对艾滋病卫生服务项目的了解和利用情况,为今后卫生服务资源的合理分配和利用提供理论依据。方法通过志愿者采用＂滚雪球＂抽样方式,在男同会所和宝安区疾控中心艾滋病自愿咨询检测（VCT）门诊选取调查对象进行匿名自填问卷调查,调查内容包括MSM人口学特征、性行为特征、艾滋病知识知晓及需求情况、对艾滋病卫生服务项目的利用情况等,采用logistic回归分析卫生服务项目利用情况对高危性行为发生情况及HIV感染率的影响。结果 142名调查对象中,85.2%（121/142）了解VCT服务,76.0%（92/142）知道疾病预防控制中心是免费检测机构;艾滋病知识总知晓率为87.3%（124/142）,调查对象最希望了解的艾滋病知识是如何预防,占57.7%（82/142）;卫生服务项目总覆盖率为100.0%,其中网络宣传覆盖率为80.3%（114/142）,VCT服务覆盖率为57.7%（82/142）。60.6%（86/142）的调查对象曾发生过无保护性肛交;63.4%（90/142）的调查对象曾经和异性发生过性行为,其中仅有32.2%（29/90）的调查对象每次都使用安全套。调查对象HIV阳性率为15.1%（21/139）。多因素logistic回归分析结果显示,是否接受过安全套/宣传资料发放是是否发生无保护性肛交的影响因素（OR=2.55,95%CI为1.19～5.44）,是否咨询过医生是HIV感染的影响因素（OR=3.07,95%CI为1.43～6.61）。结论深圳市宝安区MSM人群对艾滋病卫生服务项目利用情况欠佳,今后需加大艾滋病卫生服务项目的宣传力度,提供更适合该人群需要的卫生服务项目,降低HIV感染率。

Objective To determine the level of knowledge held by men who have sex with men（ MSM） regarding the utilization of health service program on HIV/AIDS in Baoan District,Shenzhen,so as to provide theoretical basis for the rational allocation and utilization of public health resources in the future. Methods Anonymous questionnaires were used to investigate the demographic characteristics,sexual behavior characteristics,knowledge awareness and demand for AIDS and the service utilization on AIDS intervention for MSM in the club of MSM and Voluntary Counseling Testing（ VCT） clinic in Baoan District using the snowball sampling method. Multivariable logistic regression was used to analyze the effect of health service utilization on the occurrence of high risk sexual behavior and HIV infection. Results Of142 participants,85. 2%（ 121 /142） knew the free HIV VCT service and 76. 0%（ 92 /142） knew the place to take the free testing. The overall awareness rate of AIDS was 87. 3%（ 124 /142）; 57. 7% of them wanted to know how to prevent AIDS. The overall coverage of service programs was 100. 0 %,the coverage of internet propaganda was 80. 3%（ 114 /142）,and VCT service coverage was 57. 7 %（ 82 /142）. Of all the participants,60. 6%（ 86 /142） had unprotected annual intercourse,63. 4%（ 90 /142） had sexual intercourse with females,but only 32. 2%（ 29 /90） used condoms every time. The HIV infection rate was15. 1%. In the multivariable logistic regression model,whether consulting physicians（ OR,3. 07; 95%CI,1. 43- 6. 61） and whether accepting free condom or brochure（ OR,2. 55; 95% CI,1. 19- 5. 44）were the influencing factors for infecting HIV and whether had umprotected annual intercourse,respectively.Conclusion The utilization of HIV / AIDS health services was not good enough among MSM in Baoan District,Shenzhen. HIV / AIDS intervention service propaganda should be intensified and more suitable service programs,provided for MSM to reduce the HIV infection.