性病门诊男性就诊者高危行为及HIV感染状况研究

发布时间：2018-02-27 09:22

本文关键词： 性病门诊男性就诊者艾滋病病毒随机应答技术　出处：《中国疾病预防控制中心》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的了解性病门诊男性就诊者艾滋病相关高危行为特征及HIV、梅毒、HCV抗体阳性率;使用随机应答技术比较分析问卷调查方法获得的高危行为结果的准确性,探讨随机应答技术的可行性,为艾滋病综合防治和科学干预提供信息和依据。研究方法采用横断面调查方式,在2016年4-12月使用常规问卷调查方法调查江苏省常州市、山西省太原市、陕西省西安市/咸阳市的性病门诊男性就诊者中HIV相关高危行为,以及求诊原因、患性病情况等行为特征和HIV感染状况。同时,平行利用随机应答技术(RRT)Simmons模型,调查最近3个月同性性行为、商业异性性行为、临时异性性行为和注射吸毒行为的发生情况。问卷调查结果的率和构成比的比较使用χ2检验,问卷调查结果和RRT调查结果的比较使用U检验。研究结果本研究共调查1091例性病门诊男性就诊者,其中江苏常州403人(36.9%),山西太原308人(28.2%),陕西西安/咸阳380人(34.9%)。平均年龄32.9±10.4岁,已婚占59.1%,本省户籍占86.6%,性病专科医院来源的占79.7%,综合医院占20.3%,因寻求性病诊疗服务就诊占41.2%,因高危行为后咨询检测就诊占58.8%。常规问卷调查结果显示,全部1091名调查对象中,过去3个月仅发生过商业异性性行为的比例为37.0%,仅发生过临时异性性行为的比例为20.0%,仅发生过同性性行为的比例12.8%,而注射毒品的比例为0.1%。发生过商业异性和临时异性性行为的比例为5.4%,发生过双性性行为的比例为2.4%,22.3%的调查对象否认最近3个月有任何高危行为。过去3个月发生过单纯商业异性性行为的调查对象,找到暗娼的方式以娱乐场所为主,占89.8%,发生商业异性性行为时从未使用过安全套的比例为26.5%;与临时异性性伴发生性行为时,从未使用过安全套的比例为47.2%;发生过单纯同性性行为的调查对象寻找同性性伴的方式以通过手机APP为主,占58.3%,在同性性行为时从未使用过安全套的比例为20.0%。总的HIV抗体阳性率为8.0%,梅毒阳性率为6.1%,HCV抗体阳性率为0.6%。有单纯同性性行为史和异性+同性性行为史的调查对象HIV抗体阳性率均较高,HIV抗体阳性率分别为41.4%和42.3%,远高于有单纯商业异性性行为史的3.2%和单独临时异性性行为史的0.9%。RRT调查结果显示,过去3个月发生过商业异性性行为的比例为43.3%,发生过临时异性性行为的比例为25.4%,发生过同性性行为的比例18.7%,而注射毒品的比例为1.4%。常规问卷调查结果关于四项高危行为发生的比例均低于RRT调查结果,商业异性性行为差异无统计学显著性(U=0.420,P=0.675),临时异性性行为(U=3.016,P0.05)和同性性行为(U=2.175,P0.05)有统计学显著性。30岁以上、已婚、本省户籍、以咨询检测为目的、过去一年未患性病、本次诊断患性病的求诊者,同性性行为结果,均是问卷调查结果低于RRT调查(P0.05),差异具有统计学显著性。研究结论性病门诊男性就诊者的高危行为特征:以商业异性性行为为主,其次为临时异性性行为和同性性行为。找到暗娼的方式仍以场所为主,找到同性性伴的方式以通过手机APP为主。调查对象中同性性行为特征人群的HIV抗体阳性率远高于商业异性性行为和临时异性性行为特征人群。RRT方法能够获得比常规问卷调查更高的高危行为情况,特别是在临时异性性行为和男男同性性行为方面,RRT方法的高危行为比例要显著高于常规问卷调查。但是,良好的调查环境、经验丰富的调查员和充分的沟通能够获得真实可信的高危行为信息。问卷调查获得的高危行为比例可能存在低估的情况,可以使用RRT方法对监测数据定期开展评估工作,以得到更加真实可信的高危行为特征。
[Abstract]:Objective: To study the characteristics of AIDS related high-risk behaviors syphilis and HIV, mstds, HCV antibody positive rate; accuracy of the use of randomized response technique comparative analysis of risk behavior questionnaire results, to evaluate the feasibility of randomized response technique, to provide information and basis for AIDS prevention and control and scientific intervention. A cross sectional study in 2016, 4-12 months using conventional method of questionnaire survey in Jiangsu Province, Changzhou City, Shanxi Province, Taiyuan City, the relevant high-risk behavior of male STD clinic treatment in Xianyang city who HIV Shaanxi city of Xi'an province and / treatment reasons, characteristics and status of HIV infection in STD patients such as behavior. At the same time, the use of randomized response technique (parallel RRT) Simmons model, recent survey 3 months of gay sex, commercial sex behavior, toxic sex behavior and the behavior of temporary injection suction The results of a questionnaire survey. The composition rate and compared using 2 test, compared with the survey results and the results of RRT U test. The results of this study investigated a total of 1091 cases of mstds in Jiangsu, 403 in Changzhou (36.9%), Shanxi Taiyuan 308 people (28.2%), Shaanxi / Xi'an Xianyang 380 (34.9%). The average age was 32.9 10.4 years old, married accounted for 59.1%, the province accounted for 86.6% of household registration, hospital department of venereology sources accounted for 79.7%, accounted for 20.3% of general hospital, for seeking STD services were accounted for 41.2%, due to the high-risk behavior after counseling and testing on diagnosis of 58.8%. routine survey results show that all 1091 the survey in the past 3 months only occurred in commercial sex behavior, the proportion is 37%, only had casual sex ratio of 20%, only the sex ratio of 12.8%, while the drug injection ratio of 0.1%. occurred Commercial sex and temporary sex ratio of 5.4%, had a bisexual behavior, the proportion is 2.4%, 22.3% of the respondents have denied any high-risk behavior 3 months recently. The survey over the past 3 months occurred purely commercial sex behavior, sex workers find ways to entertainment places, accounted for 89.8%. Commercial sex behavior, never used condoms at the rate of 26.5%; and the temporary heterosexual sex, had never used condoms at the rate of 47.2%; the survey had a simple sex for sexual partners by way of mobile phone APP, accounting for 58.3%, the sex is never the use of condoms as the ratio of 20.0%. HIV antibody positive rate was 8%, the positive rate of syphilis was 6.1%, the positive rate of HCV antibody was 0.6%. with pure sex and heterosexual sex history + history investigation object HIV The antibody positive rate is higher, the positive rate of HIV antibody was 41.4% and 42.3%, the 0.9%.RRT survey is much higher than that of pure commercial sex behavior, the history of 3.2% and a separate temporary heterosexual history shows that over the past 3 months had commercial sex ratio of 43.3%, had casual sex ratio 25.4%, sex ratio of 18.7%, while the drug injection ratio of 1.4%. conventional survey results about four the proportion of high-risk behaviors were lower than the RRT survey results, differences in commercial sex behavior, there were no statistically significant (U=0.420, P=0.675), temporary sex (U=3.016, P0.05) and sex (U=2.175, P0.05) were statistically significant.30 years old, married, the household registration, to counseling and testing for the purpose of not suffering from sexually transmitted diseases over the past year, the diagnosis of STD patients, homosexual behavior results are The questionnaire survey results below RRT (P0.05), the difference was statistically significant. Conclusion high risk behaviors of mstds: commercial sex behavior, followed by temporary heterosexual and homosexual behavior. To find the way to the field still prostitutes, find partners of the same way to through the mobile phone APP. The positive rate of HIV antibody population characteristics sex survey is much higher than that of commercial sex behavior and temporary sexual characteristics of heterosexual group.RRT than the conventional method can obtain the questionnaire for higher risk for the situation, especially in terms of temporary heterosexual sex and homosexual behavior, the proportion of high-risk behavior the RRT method was significantly higher than conventional questionnaire survey. However, a good environment, experienced investigators and sufficient communication to obtain reliable information for risk The proportion of high-risk behaviors that may be underestimated by questionnaires can be underestimated. RRT can be used to conduct regular assessment of monitoring data, so as to get more credible and high-risk behavior characteristics.

【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.91

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