2010-2012年昆明市某高校大学生艾滋病相关危险行为及影响因素研究
发布时间：2018-09-12 20:14
【摘要】：目的 (1)分析2010-2012年昆明市某高校大学生人群的艾滋病动态流行趋势及影响因素,艾滋病知识知晓及相关行为特征,找出高校预防与控制艾滋病的教育的关键问题,强化高校预防艾滋病健康教育工作,改进高校健康教育的策略与措施。 (2)分析2010-2012年昆明市某高校大学生人群艾滋病相关危险行为及其影响因素,探究并提出预防措施,便于提升大学生预防艾滋病的自我保护意识,为高校艾滋病健康教育探索新模式、提供新思路。 (3)通过哨点监测,为下一步制定艾滋病防治策略、干预措施、效果评价、改善监测体系等工作提供依据,为大学生艾滋病疫情估计和预测提供参考信息。 方法 (1)定量研究与血样实验研究：采用中国卫生部艾滋病哨点监测项目统一方案进行。采用中国疾病预防与控制中心(以下简称中国CDC)统一制定的流行病学问卷进行问卷调查,收集人口学、行为学、社会学、艾滋病知识知晓、艾滋病防治等情况特征,并采用连续的横断面血清学调查采集血液标本,采集的血液标本均由云南省CDC统一利用酶联免疫吸附试剂进行HIV、梅毒、HCV抗体的检测。 (2)数据录入及统计软件：采用国家哨点监测系统要求录入数据,采用SPSS17.0软件进行统计分析。 结果 三年共监测2400人。发放调查问卷和抽取血样2400份,剔除无效问卷56份,血样与问卷保持一致,样本有效完成率为97.7%。2344名毕业班大学生中,2010年共调查797人,2011年共调查755人,2012年共调查792人。2010-2011年血清学监测结果显示：HIV、HCV、梅毒抗体均为阴性,无阳性发现；2012年发现HCV抗体阳性1(0.1%)名、梅毒抗体抗体阳性1(0.1%)名,其余HIV、 HCV、梅毒抗体均为阴性。性行为发生率2010-2012年依次为3.3%(26/783)、13.1%(96/735)、16.1%(125/775),经线性趋势检验呈增长趋势(X2=26.13；P0.01),多因素Logistic回归模型结果提示：男性、年龄越大最近一年性行为发生率更高。第一次性行为年龄方面,最小为12岁,最大为26岁,平均20.53±2.26岁；2010年平均为18.45±1.99岁,2011年平均为20.65±2.22岁,2012年平均为20.90±2.11岁,经单因素方差分析可知,三年第一次性行为年龄有显著统计学差异(F=11.921,P0.01),三年第一次性行为年龄逐年递增趋势。本次研究危险性行为定义为非保护性临时性行为、商业性行为或男男性行为。最近1年危险性行为发生率2010-2012年依次为0.3%(2/783)、1.0%(7/735)、1.4%(11/775),经线性趋势检验呈增长趋势(z2=18.35；P0.01),多因素Logistic回归模型结果提示：男性、少数民族、艾滋病知晓率低、第一次性行为年龄越早,最近一年危险性行为发生率越高。艾滋病知识知晓方面,2010-2012年,大学生艾滋病知晓率为98.8%(2315/2344),三年依次为97.2%(775/797)、99.3%(750/775)和99.7%(790/792),呈现增长趋势,三年艾滋病知识知晓率的差异有显著统计学意义(X2=22.460,P0.01)。可见该高校对青年学生艾滋病知识教育的重视导致该工作已见成效,也反映出学生对艾滋病知识掌握的程度比较令人满意。最近一年是否接受预防AIDS宣传方面,2010-2012年,大学生接受过预防AIDS宣传为61.6%(1443/2344),三年依次为51.9%(414/797)65.0%(484/775)和69.5%(545/792)；最近一年是否参与预防AIDS宣传方面,总体参与过预防AIDS宣传为25.6%(601/2344),三年依次为17.1%(136/797)、29.4%(219/775)和31.4%(246/792)；经卡方检验,大学生三年的行为干预方面差异均有有显著统计学意义(X2=55.800、44.496,P0.01),可见在在最近一年行为干预方面,大学生三年的接受率、参与率均成增长趋势。最近一年接受艾滋病检测方面,2010-2012年大学生接受检测率为5.3%(125/2344),三年依次为1.9%(15/797)、6.8%(51/775)和7.5%(59/792)；经卡方检验,大学生三年的艾滋病检测方面差异均有显著统计学意义(X2=29.417,P0.01),可见在在最近一年艾滋病检测方面,大学生三年的检测率均成增长趋势。在艾滋病检测知晓方面,在参与回答的人群中,2010-2012年大学生的艾滋病检测结果知晓率为15.7%(19/121),三年依次为26.7%(4/15)、12.2%(6/49)和15.8%(9/57)；经卡方检验,大学生三年的艾滋病检测结果知晓率差异无统计学意义(X2=1.805,P=0.406). 结论 虽然该高校大学生三年监测未发现艾滋病感染,大学生对艾滋病认知尚可,可见该高校对大学生艾滋病知识教育的重视导致该工作己见成效,也反映出学生对艾滋病知识掌握的程度比较令人满意。但是掌握足够的知识并不能完全避免危险行为的出现。通过三年哨点监测发现,虽然高校青年学生文化层次较高,艾滋病预防知识知晓情况较乐观,对防艾宣传有一定的认识和了解,但是自觉防范艾滋病,改变或纠正不健康行为习惯等方面的参与程度还不理想,仅少部分学生既往参与HIV检测,其中还有部分大学生甚至不愿意知道自己检测结果,该高校大学生发生性行为、危险性行为时安全套使用率也不够理想。该高校大学生性行为、危险性行为发生率依旧呈增长趋势,艾滋病在该人群中传播蔓延的危险因素仍然存在；处于中国西部地区的大理学院大学生性行为发生率为17.6%,本次研究发现昆明市某高校男性大学生性行为发生比例为19.2%,高于广州地区大学生(13.5%),意味着我国西部地区也是大学生性行为发生的高发地区,对性行为、危险性行为问题在性健康教育中需要引起足够重视,要控制大学生性行为、危险性行为发生率,并提倡推迟第一次性行为时间,帮助他们建立正确的性行为方式与观念,大学生容易感染艾滋病的脆弱性也是伴随其自身肆意行为过程而造就的,应该引起全社会足够的关注与及时健康宣教干预。建议高校在艾滋病健康教育体系中,需要进一步加强大学生性安全知识教育,强调“防艾教育”与学校学科知识教育齐头并进,强化“防艾教育”与公民道德教育相结合,要求家庭教育与同伴教育共开展,更好的落实安全套策略,通过干预重点提高性伴侣间安全套的使用意识,更广泛的健康宣教与干预,鼓励更多的社会力量进入高校开展有效的防艾健康宣教,在同伴间以点带面的起到宣传影响及正确引导效果。防控艾滋病健康教育的可持续发展问题比它的开展和普及更为严峻、更为重要,建议务必做好高校性教育的模式创新与工作落实。卫生机构也可以更大强度的细化哨点监测工作,政府需要鼓励并监督社会减少艾滋病歧视心态及行为,青年学生HIV潜在感染者自愿进行免费咨询检测,建议扩大大学生人群艾滋病咨询检测覆盖范围,可提供方便可及的VCT服务或定期为大学生人群免费进行体检,检验结果及时告知目标人群。阳性结果告知应做到及时与保密,并需要及时引导他们正确求医行为。总之,青年学生人群是国家的未来,大学生更是青年学生中的精英与栋梁,希望全社会共同努力参与到艾滋病预防与干预的队伍中,奉献自己的力所能及,携手帮助他们,从而全面彻底、积极高效的一起做好预防大学生感染艾滋病工作。
[Abstract]:objective
(1) To analyze the dynamic epidemic trend and influencing factors of AIDS among college students in Kunming from 2010 to 2012, to find out the key issues of AIDS prevention and control education in Colleges and universities, to strengthen the work of AIDS prevention and health education in Colleges and universities, and to improve the strategies and measures of health education in Colleges and universities.
(2) To analyze the AIDS-related risk behaviors and their influencing factors among college students in Kunming from 2010 to 2012, and to explore and propose preventive measures, so as to enhance college students'awareness of self-protection against AIDS, and to explore a new model for AIDS health education in Colleges and universities.
(3) Through sentinel surveillance, we can provide the basis for further formulation of AIDS prevention and control strategies, intervention measures, effect evaluation, and improvement of surveillance system, and provide reference information for estimating and predicting AIDS epidemic among college students.
Method
(1) Quantitative study and blood sample experiment: The unified program of the AIDS sentinel surveillance project of the Ministry of Health of China was adopted. The epidemiological questionnaire was used to collect demographic, behavioral, sociological, AIDS knowledge, AIDS prevention and control information. The blood samples were collected by continuous cross-sectional serological investigation. All the blood samples were detected by enzyme-linked immunosorbent assay (ELISA) in Yunnan CDC.
(2) Data entry and statistical software: using the national sentinel monitoring system requirements for data entry, using SPSS17.0 software for statistical analysis.
Result
A total of 2 400 people were monitored over the past three years. A total of 2 400 questionnaires and 2 400 blood samples were sent out and 56 invalid questionnaires were rejected. The valid sample completion rate was 97.7%. Among 2 344 graduates, 797 were surveyed in 2010, 755 in 2011 and 792 in 2012. The incidence of sexual intercourse was 3.3% (26/783), 13.1% (96/735), 16.1% (125/775) in 2010-2012, and showed an increasing trend by linear trend test (X2 = 26.13; P 0.01). The results of logistic regression model showed that the incidence of sexual intercourse was higher in the last year when men were older. The age of first sexual intercourse was significantly different in three years (F = 11.921, P 0.01). The age of first sexual intercourse was increasing year by year in three years. 4% (11/775), the linear trend test showed an increasing trend (z2 = 18.35; P 0.01), the results of multivariate logistic regression model showed that: men, ethnic minorities, low awareness of AIDS, the earlier the first sexual age, the higher the incidence of dangerous sexual behavior in the last year. AIDS knowledge awareness, 2010-2012, the AIDS awareness rate of college students was 98. 9.8% (2315/2344), 97.2% (775/797), 99.3% (750/775) and 99.7% (790/792) in three years, showing an increasing trend. There was a significant difference in the three-year AIDS knowledge awareness rate (X2 = 22.460, P 0.01). It can be seen that the emphasis on AIDS knowledge education among young students in this university has led to the success of this work, and also reflects the students'knowledge of AIDS. In 2010-2012, 61.6% (1443/2344) of college students received propaganda on AIDS prevention, 51.9% (414/797) 65.0% (484/775) and 69.5% (545/792) of them took part in propaganda on AIDS prevention in three years, and 25.6% of them took part in propaganda on AIDS prevention in the last year. (601/2344), followed by 17.1% (136/797), 29.4% (219/775) and 31.4% (246/792) in three years; Chi-square test showed that there were significant differences in the three-year behavior intervention among college students (X2 = 55.800, 44.496, P 0.01). It can be seen that in the last year, the acceptance rate and participation rate of college students in three years were increasing. In 2010-2012, 5.3% (125/2344) of college students were tested for AIDS, followed by 1.9% (15/797), 6.8% (51/775) and 7.5% (59/792) in three years; by Chi-square test, there were significant differences in three years of AIDS testing (X2 = 29.417, P Among the respondents, the awareness rate of AIDS test results was 15.7% (19/121), 26.7% (4/15), 12.2% (6/49) and 15.8% (9/57) respectively in 2010-2012, and the difference was found by Chi-square test. There was no statistical significance (X2=1.805, P=0.406).
conclusion
Although the three-year surveillance of college students did not find AIDS infection, college students'awareness of AIDS is still acceptable, it can be seen that the university's emphasis on AIDS knowledge education has led to the success of the work, but also reflects the degree of students' knowledge of AIDS is relatively satisfactory. However, adequate knowledge can not be completely avoided. Through three-year sentinel surveillance, we found that although young college students have a higher level of education, an optimistic awareness of AIDS prevention knowledge and a certain understanding of AIDS prevention propaganda, their involvement in self-awareness of AIDS prevention, changing or correcting unhealthy behavior habits and other aspects is not ideal, only a small number of students learn Students have participated in HIV testing in the past, and some of them do not even want to know their test results. College students have sexual behavior, condom use rate is not ideal when dangerous sexual behavior. The incidence of sexual behavior among college students in Western China was 17.6%. This study found that the proportion of male college students in Kunming was 19.2%, higher than that of college students in Guangzhou (13.5%). The problem of risky sexual behavior needs to be paid enough attention in sexual health education. It is necessary to control the sexual behavior and the incidence of risky sexual behavior among college students, and to advocate postponing the first sexual behavior time to help them establish correct sexual behavior patterns and concepts. It is suggested that in the AIDS health education system, colleges and universities should further strengthen the education of sexual safety knowledge of College students, emphasize that "AIDS prevention education" should go hand in hand with school subject knowledge education, strengthen the combination of "AIDS prevention education" and civic moral education, and require the family. Home education and peer education should be carried out together to better implement condom strategies. Through intervention, condom use awareness among sexual partners should be enhanced. Wider health education and intervention should be conducted. More social forces should be encouraged to enter colleges and universities to carry out effective health education on AIDS prevention. Sustainable development of health education for AIDS prevention and control is more serious and important than its development and popularization. It is suggested that the mode innovation and implementation of sex education in Colleges and universities should be done well. It is suggested that the coverage of HIV counseling and testing among college students should be expanded, VCT services can be provided conveniently and accessibly, and free physical examination for college students can be carried out regularly. The test results should be informed to the target population in time. Positive results should be informed in a timely and confidential manner and should be quoted promptly. In a word, young students are the future of our country, and college students are the elite and pillar of young students. We hope that the whole society will make joint efforts to participate in the team of AIDS prevention and intervention, contribute their own strength and help them hand in hand, so that we can do a good job in preventing the University thoroughly, actively and efficiently. HIV infection.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.91
本文编号：2240106
[Abstract]:objective
(1) To analyze the dynamic epidemic trend and influencing factors of AIDS among college students in Kunming from 2010 to 2012, to find out the key issues of AIDS prevention and control education in Colleges and universities, to strengthen the work of AIDS prevention and health education in Colleges and universities, and to improve the strategies and measures of health education in Colleges and universities.
(2) To analyze the AIDS-related risk behaviors and their influencing factors among college students in Kunming from 2010 to 2012, and to explore and propose preventive measures, so as to enhance college students'awareness of self-protection against AIDS, and to explore a new model for AIDS health education in Colleges and universities.
(3) Through sentinel surveillance, we can provide the basis for further formulation of AIDS prevention and control strategies, intervention measures, effect evaluation, and improvement of surveillance system, and provide reference information for estimating and predicting AIDS epidemic among college students.
Method
(1) Quantitative study and blood sample experiment: The unified program of the AIDS sentinel surveillance project of the Ministry of Health of China was adopted. The epidemiological questionnaire was used to collect demographic, behavioral, sociological, AIDS knowledge, AIDS prevention and control information. The blood samples were collected by continuous cross-sectional serological investigation. All the blood samples were detected by enzyme-linked immunosorbent assay (ELISA) in Yunnan CDC.
(2) Data entry and statistical software: using the national sentinel monitoring system requirements for data entry, using SPSS17.0 software for statistical analysis.
Result
A total of 2 400 people were monitored over the past three years. A total of 2 400 questionnaires and 2 400 blood samples were sent out and 56 invalid questionnaires were rejected. The valid sample completion rate was 97.7%. Among 2 344 graduates, 797 were surveyed in 2010, 755 in 2011 and 792 in 2012. The incidence of sexual intercourse was 3.3% (26/783), 13.1% (96/735), 16.1% (125/775) in 2010-2012, and showed an increasing trend by linear trend test (X2 = 26.13; P 0.01). The results of logistic regression model showed that the incidence of sexual intercourse was higher in the last year when men were older. The age of first sexual intercourse was significantly different in three years (F = 11.921, P 0.01). The age of first sexual intercourse was increasing year by year in three years. 4% (11/775), the linear trend test showed an increasing trend (z2 = 18.35; P 0.01), the results of multivariate logistic regression model showed that: men, ethnic minorities, low awareness of AIDS, the earlier the first sexual age, the higher the incidence of dangerous sexual behavior in the last year. AIDS knowledge awareness, 2010-2012, the AIDS awareness rate of college students was 98. 9.8% (2315/2344), 97.2% (775/797), 99.3% (750/775) and 99.7% (790/792) in three years, showing an increasing trend. There was a significant difference in the three-year AIDS knowledge awareness rate (X2 = 22.460, P 0.01). It can be seen that the emphasis on AIDS knowledge education among young students in this university has led to the success of this work, and also reflects the students'knowledge of AIDS. In 2010-2012, 61.6% (1443/2344) of college students received propaganda on AIDS prevention, 51.9% (414/797) 65.0% (484/775) and 69.5% (545/792) of them took part in propaganda on AIDS prevention in three years, and 25.6% of them took part in propaganda on AIDS prevention in the last year. (601/2344), followed by 17.1% (136/797), 29.4% (219/775) and 31.4% (246/792) in three years; Chi-square test showed that there were significant differences in the three-year behavior intervention among college students (X2 = 55.800, 44.496, P 0.01). It can be seen that in the last year, the acceptance rate and participation rate of college students in three years were increasing. In 2010-2012, 5.3% (125/2344) of college students were tested for AIDS, followed by 1.9% (15/797), 6.8% (51/775) and 7.5% (59/792) in three years; by Chi-square test, there were significant differences in three years of AIDS testing (X2 = 29.417, P Among the respondents, the awareness rate of AIDS test results was 15.7% (19/121), 26.7% (4/15), 12.2% (6/49) and 15.8% (9/57) respectively in 2010-2012, and the difference was found by Chi-square test. There was no statistical significance (X2=1.805, P=0.406).
conclusion
Although the three-year surveillance of college students did not find AIDS infection, college students'awareness of AIDS is still acceptable, it can be seen that the university's emphasis on AIDS knowledge education has led to the success of the work, but also reflects the degree of students' knowledge of AIDS is relatively satisfactory. However, adequate knowledge can not be completely avoided. Through three-year sentinel surveillance, we found that although young college students have a higher level of education, an optimistic awareness of AIDS prevention knowledge and a certain understanding of AIDS prevention propaganda, their involvement in self-awareness of AIDS prevention, changing or correcting unhealthy behavior habits and other aspects is not ideal, only a small number of students learn Students have participated in HIV testing in the past, and some of them do not even want to know their test results. College students have sexual behavior, condom use rate is not ideal when dangerous sexual behavior. The incidence of sexual behavior among college students in Western China was 17.6%. This study found that the proportion of male college students in Kunming was 19.2%, higher than that of college students in Guangzhou (13.5%). The problem of risky sexual behavior needs to be paid enough attention in sexual health education. It is necessary to control the sexual behavior and the incidence of risky sexual behavior among college students, and to advocate postponing the first sexual behavior time to help them establish correct sexual behavior patterns and concepts. It is suggested that in the AIDS health education system, colleges and universities should further strengthen the education of sexual safety knowledge of College students, emphasize that "AIDS prevention education" should go hand in hand with school subject knowledge education, strengthen the combination of "AIDS prevention education" and civic moral education, and require the family. Home education and peer education should be carried out together to better implement condom strategies. Through intervention, condom use awareness among sexual partners should be enhanced. Wider health education and intervention should be conducted. More social forces should be encouraged to enter colleges and universities to carry out effective health education on AIDS prevention. Sustainable development of health education for AIDS prevention and control is more serious and important than its development and popularization. It is suggested that the mode innovation and implementation of sex education in Colleges and universities should be done well. It is suggested that the coverage of HIV counseling and testing among college students should be expanded, VCT services can be provided conveniently and accessibly, and free physical examination for college students can be carried out regularly. The test results should be informed to the target population in time. Positive results should be informed in a timely and confidential manner and should be quoted promptly. In a word, young students are the future of our country, and college students are the elite and pillar of young students. We hope that the whole society will make joint efforts to participate in the team of AIDS prevention and intervention, contribute their own strength and help them hand in hand, so that we can do a good job in preventing the University thoroughly, actively and efficiently. HIV infection.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.91
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