服务小姐性病群体治疗研究

Evaluation of mass treatment for STD with oral azithromycin among commercial sex workers in China

目的 : 研究在中国性服务小姐中开展定期群体治疗性病的效果。方法 : 在福州招募 14 9例服务小姐 ,每月给其口服阿奇霉素和针对性服用灭滴灵 ,连续 3个月 ,观察干预前后淋球菌、衣原体和滴虫感染检出率的变化。结果 : 衣原体和滴虫感染检出率从干预前的 2 7.5 %和 3.4 % ,下降到干预后的5 .9%和 1% ,淋病由于检出率较低 (2 % ) ,干预效果不明显。多数 (95 % )不愿意接受定期服药方法 ,4 5 .5 %愿意用安全套。 91.1%希望正规医院能为她们定期体检。结论 : 采用阿奇霉素定期群体预防性治疗性病对控制性服务小姐的衣原体感染有一定效果 ,但多数小姐不愿接受 ,除担心有药物反应外 ,尚有增加经济负担和耐药性等问题。其对淋病的干预效果以及能否在中国持续开展值得进一步研究。仅靠预防用药不戴安全套在长期的商业性活动中有可能再感染性病 ,建议在群体性病治疗的同时不能忽视推广使用安全套。

Objective:To evaluate the effectiveness of r egular mass treatment among commercial sex workers (CSWs) in China. Met hods: One hundred and forty-nine CSWs in the city of Fuzhou were recr uited in the study. Participants were received monthly azithromycin (1g) for thr ee months and some of them with metronidazole. The positivity rates of N eisseria gonorrhoeae,Chlamydia trachomatis and Trichomonas vagi nalis were compared before and after mass treatment. Results: The number of participants presented at the first,second and third follow-up visit was 131,92 and 101,respectively. The prevalence of chlamydial infection decreased from 27.5% to 5.9%,and trichomoniasis from 3.4% to 1%. Sinc e the detection rate of gonorrhea was low (2%),the effect of intervention was n ot obvious. The majority (95%) of participants would not like to use this method for preventing STD in the future,45% would like to use condom and 91.1% hoped they could get regular physical examination. Conclusion : The mass treatment with azithromycin has some impact on chlamydial infection. CSWs would not like to use the drug routinely because of the fear of side effec ts and the expensive cost of the drug. Other issue,which,should be considered is the drug resistance. The intervention effect of mass treatment on gonorrhea nee ds to be further investigated. CSWs may be reinfected during the sex activities if they only take prophylactic medicine without use of condom. It is suggested t hat the promotion of condom use among CSWs should not be neglected while the mas s treatment is conducted.