健康教育对改变性病患者性行为和提高避孕套使用的效果研究

The Effectiveness of Education Intervention in Changing Sex Behavior and Promoting Condom Use among Male STDs Patients in Shanghai.,

目的:评价以观看录像为主的健康教育对改变性病患者性行为和提高避孕套使用的效果;为性病/艾滋病的防治工作提供科学依据。方法:对某性病诊所的2266例男性性病患者,采用结构式问卷获取基线资料后,随机分为常规治疗组(对照组);常规治疗加观看录像组(简称录像组)及常规治疗加观看录像并参加小组讨论组(简称录像加讨论组)。录像内容是性病及其预防知识和避孕套的正确使用方法。小组讨论围绕录像内容解答对象疑问。第1次调查2～3周后(即对象前来复查时),询问对象性行为和避孕套使用情况。结果:与对照组相比,录像加讨论组和录像组的对象倾向于推迟开始性生活。在两次调查期间,对照组中42.89％,录像组中27.25％,录像加讨论组中30.11％的对象有过性生活(P<0.001)。多元Logistic逐步回归分析显示两次调查期间是否有性生活与干预水平、年龄、文化程度和婚姻状况有关。录像组和录像加讨论组有性行为的危险性约为对照组的50％;年龄较大、文化程度较高和未婚者有性行为的危险性较低。在调查期间有过性生活的对象中,观看录像的两个干预组70％以上每次性生活都使用了避孕套,而在对照组中只有约1/3对象使用。对照组近50％的对象未使用避孕套,而录像组和录像加讨论组只有13.24％和8.54％(P<0.001)。

Objective:To examine the effectiveness of video -based patient education intervention on promoting condom use and changing sexual behavior among male patients with sexually transmitted diseases (STDs) attending a large STDs clinic in Shanghai. Methods; Video - based interventions designed to promote safer sex behaviors were evaluated in a randomized study of male STDs patients. Subjects (n =2,266) were randomly assigned to one of three groups: control ( only regular treatments ), rideo viewing and video viewing followed by participation in an interactive group session led by a trained facilitator( video plus group) . At first visit,subjects were interviewed collecting baseline data,-second interview was conducted 2 ~3 weeks after first visit to measure their changes in sexual behavior and condom use. Results;Compared with control group, patients assigned to video group and video plus groups appeared to delay sex intercourse, and were more likely to use cpndom once sex intercourse occurred . During the period between two interviews,42. 89% of subjects in the control group,27. 25% in the video group,and 30. 11% in the video plus groups had sex intercourse (P<0.001). Stepwise logistic regression analysis showed that having sex intercourse was associated with intervention level, patients' age, education level and marriage status respectively. Patients in the video and video plus groups were nearly 50% less likely to have sex intercourse than those in the control group. Elder,well - educated and unmarried patients appeared lower odds - ratios of having sex intrcourse. Of subjects who had sex intercourse during the period between two interviews, more than 70 percent of subjects in the two intervention groups always used condoms,while only about one -third patients always used condoms in the control group. And nearly half patients in the control group never used condoms,but only 13. 24% in the video group and 8. 54% in the video plus group never used condom (P < 0. 001). Stepwise logistic regression analysis showed that condom use was associated with intervention level, education level and previous condom use. The probabilities of condom use among patients in the video group and video plus group were significantly higher than that of those in control group,the odd ratios in the video group being 4. 848 and video plus group being 6. 092 as compared with that of control group. Patients with higher education level were more likely to use condom ( OR = 1. 790) . The condom use in previous condom users was 2. 246 times higher than that of non - user prior to first interview. Conclusion:This study proved that video -based interventions could come into the significant effects on sexual behavior change and condom use. The video viewing is an inexpensive, feasible, practical and acceptable approach for STD prevention. Efforts should be made exploring how the video - based interventions could be integrated into STD clinic settings and family planning services. The manifold health interventions should be explored to meet the needs of varied people.