临海市女性性工作者预防艾滋病知识、行为的干预研究

发布时间：2018-03-18 20:05

本文选题：艾滋病　切入点：女性性工作者　出处：《南华大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的了解临海市女性性工作者艾滋病相关知识、安全套使用自我效能及安全套使用等情况，并探讨其影响因素，开展综合性干预措施，评价干预效果，为进一步调整针对该人群的有效干预模式提供科学依据。方法将临海市区各娱乐场所按高、中、低档次分层，采用分层抽样中的按比例抽样法确定研究场所，抽中的娱乐场所采用方便抽样法抽取研究对象，2012年6月份选择各娱乐场所中女性性工作者在岗人数最多的时间段，对场所内所有在岗且未处于工作状态的女性性工作者进行一对一调查，调查内容包括艾滋病相关知识、安全套使用自我效能、安全套使用情况等；基线调查完成后对所有场所进行为期4个月的综合性干预，并在干预结束一个月之后进行干预后调查，使用相同问卷对艾滋病相关知识和安全套使用情况进行调查。基线调查和干预后调查分别收回有效问卷418份和461份，采用EpiData3.1建立数据库，使用SPSS13.0统计软件对数据进行统计分析。结果 1.临海市女性性工作者年龄在25岁及以下的占了55.50%；文化程度初中及以下的占69.38%；未婚者占51.67%；81.82%的人来自于22个不同的外省（直辖市、自治区）；44.74%的人在本地工作不足6个月。 2.基线调查结果显示女性性工作者艾滋病相关知识知晓率为77.51%，不同档次娱乐场所间知晓率差异有统计学意义（χ~2=14.480，P=0.001），其中低档娱乐场所女性性工作者的知晓率最高。以调查对象的各项一般人口学资料、所在场所类型、接受预防艾滋病服务情况等作为自变量，艾滋病相关知识知晓情况作为应变量，引入logistic回归模型，结果预防艾滋病宣传、年龄和场所类型等3个因素进入回归方程。调查对象安全套使用自我效能平均的得分为84.83±10.89分，不同档次娱乐场所间的得分不全相同（F=19.722，P＜0.001），以低档娱乐场所女性性工作者得分为最高，经多元逐步回归分析探讨安全套使用自我效能的影响因素，最终进入方程的因素有场所类型、艾滋病相关知识得分和同伴教育。女性性工作者最近一次性行为安全套使用率为41.6%，在未使用安全套的调查对象中，未使用的首要原因为性伴不愿意使用。有16.7%的人最近一个月每次发生性行为时均使用安全套，不同档次娱乐场所间安全套使用情况差异有统计学意义（χ~2=78.482，P＜0.001），使用率最高的是低档娱乐场所女性性工作者。使用logistic回归分析探讨安全套使用情况的影响因素，结果安全套使用自我效能、预防艾滋病宣传、在本地工作时间和场所类型等因素进入回归方程。低档娱乐场所接受同伴教育的比例要高于中高档娱乐场所（χ~2=3.854，P=0.050）。实验室检测结果显示，不同档次娱乐场所感染过梅毒（ELISA阳性）的女性性工作者比例不全相同（χ~2=19.621，P＜0.001），但新近感染的人（RPR阳性）所占比例在不同档次娱乐场所间无显著性差异（χ~2=4.413，P=0.110）。 3.干预后，女性性工作者的艾滋病相关知识知晓率提高到89.15%，干预前后差异有统计学意义（χ~2=21.691，P㩳0.001），干预后不同档次娱乐场所间知晓率差异无统计学意义（χ~2=5.600，P=0.061）。最近一个月发生性行为时每次均使用安全套的比例为29.07%，干预前后差异有统计学意义（χ~2=18.637，，P＜0.001）。干预后，不同档次娱乐场所间安全套使用情况差异有统计学意义（χ~2=38.724，P＜0.001），高档娱乐场所和中档娱乐场所的安全套使用情况较干预前差异均有统计学意义（Z=-3.260，P=0.001；Z=-5.164，P＜0.001），而低档娱乐场所干预前后的差异无统计学意义（Z=-0.123，P=0.902）。结论 1.临海市女性性工作者艾滋病相关知识认知水平参差不齐，安全套使用率低，是感染和传播性病、艾滋病的高危人群。 2.女性性工作者最近一次发生性行为时未使用安全套的首要原因为性伴不愿意使用；安全套使用自我效能水平、预防艾滋病宣传、在本地工作时间和场所类型是最近一个月安全套使用情况的影响因素。 3.连续的综合性干预措施能有效提高女性性工作者的艾滋病相关知识认知水平和安全套使用情况。
[Abstract]:objective
Knowledge about AIDS among female sex workers in the city, condom use self-efficacy and condom use situation, and to explore its influencing factors, carry out comprehensive intervention measures, to evaluate the effect of intervention, to provide scientific basis for further adjustment of effective intervention mode in this population.
Method
The urban waterfront entertainment by high, low level of stratification, using stratified sampling in proportional sampling method to determine the location of research, drawn in the entertainment by convenient sampling from the object of study, 2012 June selection of female sex workers in the entertainment places in the largest number of places within the time period, all the post and not in the working state of female sex workers was conducted, including investigation of AIDS related knowledge, condom use self-efficacy, condom use and comprehensive intervention; baseline survey after the completion of all places in 4 months, and at the end of the intervention for the patients after a month of investigation. Using the same questionnaire survey on AIDS related knowledge and condom use. The baseline survey and intervention survey. 418 valid questionnaires and 461 copies, built using EpiData3.1 SPSS13.0 statistics software is used to make statistical analysis of the data.
Result
1., the number of female sex workers aged 25 years old and below accounted for 55.50% of the total sex workers in Linghai City, 69.38% of the educational level and below, 51.67% of the unmarried persons, 81.82% of the 22 different provinces (municipalities and autonomous regions), and 44.74% of the local people working for less than 6 months.
2. baseline survey results show that the AIDS related knowledge awareness rate of female sex workers was 77.51%, various places between the awareness rate difference was statistically significant (~2=14.480, P=0.001), low grade entertainment female sex workers in the highest known rate. The general demographic data of the subjects and the location type, accept AIDS prevention service as the independent variables, AIDS related knowledge as the dependent variables, logistic regression model is introduced, the prevention of AIDS, 3 factors of age and place types in the regression equation. The survey of condom use self-efficacy score an average of 84.83 + 10.89, various places between the scores are not all the same (F=19.722, P < 0.001), with low female sex workers in entertainment places for the highest score, by stepwise regression analysis on condom use self Factors affecting the efficiency, there is a place type eventually entered into the equation, AIDS knowledge score and peer education. Female sex workers recently disposable condom use rate was 41.6%, in the survey did not use condoms in the primary cause of unused for sexual partners were reluctant to use condoms. There are 16.7% people recently a month of each sex, the condom use was statistically significant difference between different grades of entertainment (x ~2=78.482, P < 0.001), the highest utilization rate is low entertainment female sex workers. Logistic regression analysis was used to explore the influence factors of condom use, the condom use self-efficacy, the prevention of AIDS. Enter the regression equation in the local time and place type and other factors. Entertainment venues accept peer education ratio is higher than that in high grade entertainment Entertainment places (x ~2=3.854, P=0.050). The laboratory test results showed that different places syphilis infection (ELISA positive) the proportion of female sex workers are not all the same (x ~2=19.621, P < 0.001), but the newly infected people (RPR positive) the proportion of no significant difference in different grades of entertainment room the difference (~2=4.413, P=0.110).
3. after the intervention, the rate increased to 89.15% of AIDS knowledge among female sex workers, there was a significant difference between before and after intervention (x ~2=21.691, P? 0.001), after the intervention of different places between the awareness rate of the difference was not statistically significant (~2=5.600, P=0.061). Sexual behavior in last month when using condom each time the proportion is 29.07%, there was significant difference between before and after intervention (~2=18.637, P < 0.001). After the intervention, significant differences in the use of condoms at various places between (x ~2=38.724, P < 0.001), high-end entertainment and mid-range entertainment condom use compared with before intervention, there were statistically significant differences (Z=-3.260 P=0.001; Z=-5.164, P < 0.001), while there was no significant difference before and after the intervention of the entertainment venues (Z=-0.123, P=0.902).
conclusion
1. the cognition level of AIDS related knowledge of female sex workers in Linghai city is uneven, and the use rate of condom is low. It is the high risk population of infection and transmission of STD and AIDS.
The primary reason for not using condoms in 2. female sex workers last sexual partners is not willing to use condom use; the level of self-efficacy, the prevention of AIDS, in the local working time and place types are the influence factors of condom use in recent months.
3. continuous comprehensive interventions can effectively improve the cognitive level of AIDS related knowledge and condom use in female sex workers.

【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.91

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