利用微信公众号对MSM开展艾滋病精准干预的效果评价

Effect evaluation of precise AIDS intervention on MSM by using We Chat official account

目的利用微信公众号对男男性行为者(MSM)开展艾滋病干预并进行效果及可行性评价。方法在上海某区自愿咨询检测门诊连续招募并完成基线调查的MSM被随机分为干预组及对照组,分别接受1年、双盲的微信公众号"精准干预"和"常规干预",并完成观察终点问卷。结果基线时,200名MSM参与问卷调查,年龄为17~60岁,汉族占95.0%,79.0%未婚,上海户籍为20.0%,大专及以上81.0%;最近6个月195人发生过非商业男男性行为,人次数中位数为7(1~44)人次,16.9%从未使用安全套,41.5%每次坚持用;干预组及对照组(各100人)在年龄、文化程度、婚姻状态差异无统计学意义;干预组及对照组各艾滋病知识核心条目知晓率分别为21.0%~62.0%和19.0%~63.0%;两组艾滋病知识知晓率、性行为特征差异均无统计学意义。观察终点时,干预组和对照组失访率分别为17.0%和21.0%,随访对象中,分别有45.8%和50.6%查阅了全部图文信息(P>0.05);干预组和对照组分别发生2例和3例HIV血清抗体阳转(P>0.05);两组艾滋病核心知识知晓率分别为34.9%~90.4%和27.8%~82.3%,干预组有5个艾滋病知识条目知晓率高于对照组。最近6个月,干预组的MSM性伴数(P=0.05)及男男性行为人次数(P=0.05)均少于对照组;未发现两组MSM的安全套使用比例差异有统计学意义(P>0.05)。结论微信公众号精准干预可提高MSM艾滋病知识知晓率、减少性伴人数,但对安全套使用行为改变并不明显,需进一步观察该干预方式的长期效应。

Objective To evaluate the effect of AIDS intervention on men who have sex with men(MSM)by using We Chat official account to prevent HIV infection.Methods The MSM recruited continuously and completed the baseline survey in a VCT clinic in a district of Shanghai were randomly divided into two groups with one for precise intervention and another for routine intervention as a control via use of 1-year double-blind We Chat official account.Then,the results of the survey were analyzed.Results 200 MSM,aged between 17-60 years,participated in the baseline survey.95.0%were Han;79.0%were unmarried;20.0%had resident registration in Shanghai;81.0%were college graduates and above.There were no significant differences in age,education,and marital status between the two groups(100 persons each).In the past 6 months,195 people ever had a non-commercial male sex,with the median number of 7(1-44).19.0%never used condom,and 40.5%had consistent condom use of each sex.The awareness rates of the core HIV/AIDS knowledge were 21.0-62.0%for intervention group and19.0-63.0%for the control.There was no significant difference in the knowledge rate and sexual behavior between the two groups at the baseline.After one year of the intervention,the loss to follow-up rates in the intervention group and the control group were 17%and 21.0%.Among the MSM followed up,45.8%of the intervention group and 50.6%of the control group checked all the information during the study(P>0.05),and 2 and 3 cases of HIV serum antibody positive conversion occurred in each,respectively(P>0.05).The awareness rates of AIDS core knowledge in the intervention group and the control group were 34.9-90.4%and 27.8-82.3%,respectively.The awareness rate of 5 AIDS knowledge items in the intervention group was higher than that in the control group.In the past 6 months,the number of MSM sexual partners(P=0.00)and the number of homosexual acts(P=0.04)in the intervention group were less than those in the control group.However,no statistical difference was found in the proportion of condoms use between the two groups(P=0.33).Conclusion The We Chat official account can be used to improve the AIDS knowledge awareness rate among MSM and reduce the number of their sexual partners.However,the change in condom use was not significant and the long-term effects of this intervention need to be further observed.