昆明地区医护人员实施普遍性防护原则及相关问题的调查

我国目前已出现大批艾滋病病人，医院等医疗机构应加速做好应对准备。其中，有效实施世界卫生组织推荐的普遍性防护原则是关键。为了解昆明地区各级医院面临艾滋病流行趋势的应对能力，该研究对16所医院的557名医护人员进行了定量、定性(包括个人深入访谈和非参与性观察)的研究。研究发现，医护人员中已有33．6％的人在工作中接触过HIV感染者和AIDS病人，但却没有有意识的实施普遍性防护原则。医院要求的操作程序中还存在危险环节(如针头毁形)。50．8％的医护人员报告在过去3个月中被针头或锐器扎伤。研究表明，医院内医护人员实施普遍性防护原则的能力急待加强。     

医务人员预防HIV职业暴露与减少歧视的调查报告

近年来我国HIV职业暴露的情况时有发生，并呈逐年上升趋势。暴露方式主要为针头刺伤。暴露发生人员由实验室工作人员为主逐渐扩大到基层综合医院临床医护人员。虽然目前在我国医务人员中尚未发现因职业暴露而感染艾滋病的病例，但是随着接触艾滋病人的医护人员增多，不排除将来经由“职业暴露”感染艾滋病的可能。为提高医务人员防范意识，提高职业暴露防护技能，减少医务人员经血感染艾滋病的风险，减少医院对艾滋病人的歧视，中国控烟协会开展了《推广普遍性防护减少医院对艾滋病人歧视》项目，该课题在北京、上海、苏州市各选择一所医院作为研究现场，苏州项目点工作已于2006年1月开始，3月份完成基线调查，现将本次调查情况报告如下。     

某医院医务人员艾滋病职业暴露防护干预的研究

目的了解医院医务人员对艾滋病防护知识掌握和职业暴露情况，探索在医院中开展预防因职业暴露感染艾滋病的有效干预模式。方法建立健全医院安全防护制度，对医务人员进行普遍性防护原则培训。干预前后分两次进行问卷调查，评价干预效果。结果通过干预后，该院医务人员对艾滋病职业暴露处理和预防用药的知晓率有明显提高，对诊疗活动中的防护知识和技能掌握有明显提高，对艾滋病人的态度有明显改善，干预前后差异有统计学意义。结论对医务人员进行普遍性防护原则培训，建立并实施医院安全防护制度和管理办法是提高医务人员防范意识，减少职业暴露感染艾滋病的有效干预模式。     

广西医护人员对艾滋病认识程度和接受态度的初步研究

目的 了解医护人员关于艾滋病的知识和态度，为制定培训计划和采取干预措施提供依据。方法 选择省、市、县级医院各一家，对149名医护人员进行艾滋病知识、态度的问卷调查。结果 临床医护人员对艾滋病基本知识有一定了解，但对艾滋病非传播途径存在很多误解，21．5％的人不知道艾滋病不会通过共用坐厕染上；32．2％的人不知道蚊虫叮咬不会传播艾滋病；91．9％调查对象对在医疗工作中可能感染艾滋病表示担心；23．5％的调查对象存在不同程度的不愿意照料艾滋病病人的想法。结论 应加强对临床医务人员艾滋病防治专业知识的培训，端正对艾滋病病毒感染者和病人的态度。     

新医护人员锐器伤调查及预防措施

目的了解新医护人员诊疗工作中发生锐器伤情况及其防护意识和处理措施。方法自行设计问卷，对某校3所附属医院工作3年以内的668名新医护人员进行回顾性调查。结果被调查的新医护人员中发生锐器伤人数为639人(95．66％)，共发生4476次，受伤2次以上者占90．87％。锐器伤种类以注射器针头刺伤为主，占63．43％，其次为手术时缝针刺伤和刀片划伤(32．77％)。发生锐器伤后上报者仅占7．67％。结论临床新医护人员锐器伤发生率高，受伤后汇报率低；加强全面性防护意识教育，建立并执行全面性防护措施，减少医护人员职业性、血源性疾病的传播是当前职业防护的重要课题。     

女性医务人员艾滋病职业防护意识及应对能力影响因素分析

目的了解综合医院女性医务人员艾滋病职业防护意识及应对能力,探索影响因素。方法自制调查问卷,对543名女性医务人员的艾滋病职业防护意识及应对能力进行调查和评估。采用多元线性逐步回归分析其影响因素。结果调查对象防护意识及应对能力得分(77.1±10.3)分;外科和医技科室、技师专业、工龄长和参加过系统职业防护培训,是女性医务人员艾滋病职业防护意识及应对能力的保护因素。结论女性医务人员艾滋病职业防护意识及应对能力不高,职业暴露危险评估及应急处置能力欠缺。应加强医护人员职业防护教育与培训,增强其自我防护意识,提高防护能力。     

某院应届毕业护士AIDS防护意识及应对能力评估

目的了解应届毕业护士AIDS职业防护意识及应对能力。方法通过自制问卷评估某三甲医院89名应届毕业护士AIDS职业防护认知水平、职业暴露应对处理及防护行为。结果护士艾滋病职业防护认知总分为52.8分,其中职业防护基本知识得分76.4分,职业暴露应对认知得分33.1分;本科护士得分均高于大专。职业防护行为得分,手卫生3题,以接触病人血液、体液、标本时带手套正确率最低(71.6%);防护用品使用3题正确率总体不高(53.3%~63.2%);锐器物处置3题,以禁止将使用后的一次性针头重新套上针头套正确率最低(78.5%),禁止用手直接接触使用后的针头、刀片等锐器者次之(85.7%)。结论应届毕业护士职业危害认知较低,防护意识不高,日常操作中存在不安全行为。应积极研究合适的职业防护课程和实践培训,同时医院应完善相关规章制度,建立安全的工作场所,减少职业危害的发生。     

安徽省县级妇产科业务骨干对普遍性防护原则的知-信-行调查

目的　了解县级妇产科业务骨干对普遍性防护原则的知识、态度和行为以及职业暴露和防护情况。方法　采用半结构式问卷方法 ,对参加安徽省降低孕产妇死亡专题县级师资培训班的学员进行自填式问卷调查。结果　有 1 5 %的人听说过普遍性防护原则 ,有 2 5 4%的人能正确地写出普遍性防护原则的内容 ;没有人能正确回答出污染针头刺伤传播艾滋病病毒的概率 ,3 3 6%的人知道针头刺伤传播乙型肝炎病毒的概率 ;1 68%的人在工作中遇到过感染了艾滋病病毒的患者 ,96 61 %人在工作中遇到过感染了乙型肝炎的患者 ;妇检、产检和全身检查时戴手套的频率分别是 95 76%、 1 1 0 2 %和 6 78% ,妇检比其他两类检查高 (P <0 0 1 ) ;妇检、产检和全身检查前后洗手的频率分别是 84 75 %、 77 3 9%和 73 0 4% ,妇检洗手率比其他两类检查高 (均P <0 0 5 ) ;其中妇检同全身检查的洗手率比较 (P <0 0 5 ) ,产检同全身检查的洗手率比较没有显著性差异。结论　安徽省县级妇产科工作人员对普遍性防护原则的了解程度有限、对职业暴露的危险性认识不足、存在明显的职业暴露现象 ,且县级医院和妇幼保健机构在妇产科职业防护方面措施不到位。     

聊城市各级医护人员艾滋病防治与HIV职业暴露防护知识调查研究

目的 了解聊城市各级医护人员有关艾滋病的防治以及艾滋病病毒职业暴露防护知识的掌握情况，为今后开展医护人员培训提供依据。方法 采用分层随机抽样的方法，抽取31家单位的部分医护人员以及部分乡村医生和个体开业医生共计1295人进行问卷调查。结果 聊城市医护人员艾滋病防治与HIV职业暴露防护知识总的得分率为65.4％。H1V职业暴露防护知识掌握情况比较差，其平均得分率仅为56．1％。不同级别单位和医院不同科室之间得分差异有统计学意义（P＜0．001），妇幼保健机构和基层医务人员得分明显低于其他医疗机构医务人员（P＜0．05），妇产科人员得分明显低于其他科室的人员（P＜0．05）。结论 聊城市各级医务人员普遍缺乏HIV职业暴露防护知识。妇幼保健机构和基层医护人员艾滋病相关知识的掌握情况较差，应尽快加强这方面相关知识的培训。     

医院患者HIV监测结果分析及医护人员职业防护

目的 了解深圳市医院患者HIV感染状况和及早发现病人，预防医护人员职业感染。方法 对2002年10月至2004年10月在深圳市第二人民医院门、急诊就诊的性病患者、体检人员、孕产妇、住院手术病人、内科需要穿刺的病人、疑似艾滋病患者等进行HIV血清学检测。结果 检测人数共21476例，HIV抗体阳性数19例，检出率为0.09％。其中住院病人检出率为0.12％。性病患者为0．16％，孕产妇为0．04％，体检人员为0．00％，其他为0．03％，在住院病人中，手术、穿刺病人检出率为0.05％。结论 由于潜在HIV感染者增多，应加强医院住院病人、性病患者、孕产妇、体检人员的HIV血清学检测，及时发现病人．预防医护人员职业感染，控制艾滋病的蔓延。     

医务人员对艾滋病职业暴露相关知识和态度的分析

目的分析和总结医疗机构医务人员对艾滋病职业暴露相关的知识与态度。万诸对经济水平和叉滋炳发惰个同地区的两所综合医院的医务人员进行问卷调查。结果医务人员中,77．5％发生过职业暴露,49．1％不知道职业暴露后如何处理．50．3％不知道艾滋病职业暴露后预防服药时间,70．4％没有参加过标准防护培训,27．5％认为对艾滋病病人进行常规检查有风险：如果知道病人是艾滋病感染者,43．8％会避免与其接触;如果在手术前知道病人感染艾滋病,41．0％认为会放弃手术。结论医务人员发生职业暴露的比例较高,暴露后处理的知识和技能欠缺;艾滋病预防知识存在缺陷：标准防护培训不到位：面对艾滋病病人时。医务人员会通过不接触或拒绝为其手术等方式过度保护自己。     

Interviews with senegalese commercial sex trade workers and implications for social programming

The purpose of the study was to assess the efficacy of the Senegalese pubic policy toward registered sex workers through an interview process examining their backgrounds and evaluating their knowledge of sexual health. Sixty registered sex workers in Dakar, Senegal, were interviews at the Institute d'Hygiene Social (IHS) to investigate patient knowledge of contraceptives and sexually transmitted infections (STIs). Ninety-eight percent of the women reported that, as a result of their visits to the clinic, they had increased precaution in their trade by demanding their clients use condoms and refusing clients who did not comply. Nearly 96% of the women were able to define the three main ways by which HIV is contracted, while 100% of the women reported that they used male condoms with their clients and would refuse clients who rejected the use of condoms. Senegal's proactive policy toward the safeguarding of women's health and the containment of HIV/AIDS through the legalization and monitoring of sex workers can serve as an example for successful strategies in the fight against the global spread of HIV/AIDS.     

南京市医务人员性病／艾滋病专业知识调查

目的 了解南京市医疗机构开展性病/艾滋病培训的情况及医务人员掌握性病/艾滋病知识的现状，方法 对南京市57家区县级以上医疗机构的医务处负责人进行问卷调查。了解他们开展性病/艾滋病培训的情况；对南京市区、郊区43所医疗机构的562名医务人进行问卷调查。了解他们的性病/艾滋病知识，结果 1996-1999年间，被调查的57家医疗机构中，13家（22.6%)开展过性病/艾滋病教育；14.9%(84/562)的被调查医务人员接受过培训；被调查医务人员的性病/艾滋病知识平均分数为59.8分。医务人员知识水平的高低与所在医疗机构的级别及他们的职称、专业、是否诊治过性病/艾滋病患，是否接受过培训有关。结论 南京的医疗机构中仅一小部分开展过性病/艾滋病教育，医务人员的性病/艾滋病知识水平仍较低，对他们的教育必须加强。。     

'We are also dying like any other people, we are also people': perceptions of the impact of HIV/AIDS on health workers in two districts in Zambia

In countries with a high AIDS prevalence, the health workforce is affected by AIDS in several ways. In Zambia, which has a prevalence rate of 16.5%, a study was carried out in 2004 with the aim to: explore the impact of HIV/AIDS on health workers, describe their coping mechanisms and recommend supportive measures. The qualitative study was complemented by a survey using self-administered questionnaires in four selected health facilities in two rural districts in Zambia, Mpika and Mazabuka. It is one of the few studies to have explored the impact of HIV/AIDS from the perspective of health workers and managers in the region. Thirty-four in-depth interviews and five group discussions were conducted with health workers, managers and volunteers, and 82 self-administered questionnaires were filled out by health workers. In addition, burnout among 42 health workers was measured using the Maslach Burnout Inventory (MBI). The MBI measures three components that contribute to burnout: emotional exhaustion, depersonalization and personal accomplishment. The results show that in both districts, HIV/AIDS has had a negative impact on workload and has considerably changed or added tasks to already overburdened health workers. In Mpika, 76% of respondents (29/38), and in Mazabuka, 79% (34/44) of respondents, expressed fear of infection at the workplace. HIV-positive health workers remained 'in hiding', did not talk about their illness and suffered in silence. Despite the fact that health workers were still relatively motivated, emotional exhaustion occurred among 62% of the respondents (26/42). The interviews revealed that counsellors and nurses were especially at risk for emotional exhaustion. In each of the selected facilities, organizational support for health workers to deal with HIV/AIDS was either haphazardly in place or not in place at all. AIDS complicates the already difficult work environment. In addition to health workers, management also needs support in dealing with AIDS at the workplace.     

Interviews with Senegalese Commercial Sex Trade Workers and Implications for Social Programming

Abstract

The purpose of the study was to assess the efficacy of the Senegalese public policy toward registered sex workers through an interview process examining their backgrounds and evaluating their knowledge of sexual health. Sixty registered sex workers in Dakar, Senegal, were interviewed at the Institut d'Hygiene Social (IHS) to investigate patient knowledge of contraceptives and sexually transmitted infections (STIs). Ninety-eight percent of the women reported that, as a result of their visits to the clinic, they had increased precaution in their trade by demanding their clients use condoms and refusing clients who did not comply. Nearly 96% of the women were able to define the three main ways by which HIV is contracted, while 100% of the women reported that they used male condoms with their clients and would refuse clients who rejected the use of condoms. Senegal's proactive policy toward the safeguarding of women's health and the containment of HIV/AIDS through the legalization and monitoring of sex workers can serve as an example for success-ful strategies in the fight against the global spread of HIV/AIDS.     

东莞市农民工艾滋病知识、态度、行为调查

目的：了解东莞市农民工艾滋病知识、态度和行为，为制定针对这一人群的艾滋病防制措施提供依据。方法：采取整群抽样和方便抽样的方法，对东莞市厚街镇和常平镇两闯工厂的615名农民工进行调查，内容包括社会人口学、对艾滋病防治知识的掌握情况、对HIV／AIDS及非婚性行为的态度及个人行为。结果：东莞市的农民工多为来自农村、15～39岁的未婚人群；对艾滋病防治知识的知晓率为44．39％，已婚及文化程度高的农民工艾滋病防治知识的知晓率显著高于未婚和文化程度低者；农民工的艾滋病防治知识主要来源渠道为电视和报刊；对婚前性行为、婚外情、一夜情、卖淫和嫖娼行为的赞同率分别为11．71％、2．28％、2．76％、0．49％和0．81％，且男性和文化程度高者对上述5种非婚性行为的赞同率均显著高于女性和文化程度低者；22．16％的未婚农民工有过性行为、6．02％的农民工有临时性行为，2．93％的农民工曾经有一夜情；农民工在近6个月与固定性伴和临时性伴发生性关系时每次都使用安全套的比例分别为儿．47％和21．62％；农民工中性病的患病率为1．79％，患病后90％以上的人均能去正规医疗机构就诊。结论：东莞市农民工艾滋病防治知识知晓率偏低、对非婚性行为普遍不赞同，但该人群中依然存在非婚性行为、安全套使用率低等感染HIV的高危行为。建议通过电视和报刊等农民工喜闻乐见的媒体加大宣传教育力度，同时开展推广使用安全套等干预措施，遏制艾滋病在这一人群传播。     

海宁市外来务工人员艾滋病相关知识现况调查

目的了解海宁市不同场所的外来务工人员艾滋病防治知识水平、获取知识的途径、方式等,为实施有针对性的健康教育策略提供依据。方法通过随机抽样方式,对海宁市城郊结合部、建筑工地、工业企业等地的外来务工人员进行随机抽样调查,在征得被访者知情同意的前提下由医务人员进行面对面访谈。结果本次共调查了1527人,被调查者对艾滋病传播途径知识答对率为56.71%,艾滋病防治知识答对率为57.4%,获得艾滋病信息的途径主要是通过电视媒介了解,占50.56%,在建筑工地中的务工人员中,通过亲戚朋友同事间获得艾滋病信息者占35.45%,被调查对象中以企业外来艾滋病知识掌握相对较好,达到了67.21%。结论必须进一步强化对外来务工人员的艾滋病健康教育宣传,采取针对性的防治措施进行行为干预,以提高其艾滋病知识水平,促使其建立良好健康行为。     

攀枝花市城区女性商业性性工作者艾滋病行为监测结果分析

目的 为评估干预活动效果、制定和调整艾滋病防治策略提供参考依据。方法 在干预活动开展之前和进程中，按照艾滋病综合监测方案对女性商业性性工作者（CSW）进行定期的、连续的行为调查。结果 通过2年的干预活动，CSW艾滋病相关知识知晓率从干预前的64．31％提高到82．08％、81．54％，商业性行为时最近1个月使用安全套坚持率持续提高，3年分别为28．2％、40．4％、56．5％，选择公立医院就诊的比例也逐渐增加；但CSW认知自身感染艾滋病的危险和对自身健康关注程度方面仍不足。结论 干预项目应根据当地实际情况和目标人群需求制定全面的、有针对性的计划，并及时地根据实践经验和监测结果调整干预策略，持续的干预活动能取得良好的效果。     

Risk of infections by the human immunodeficiency virus (HIV) among health professionals]

To investigate the occupational risk of infection by HIV among health professionals, 36 cases of occupational accidents involving exposure to material potentially infected with HIV, reported at a Brazilian General Hospital (HCFMRP), were studied. Of the injured workers 75% were female and 25% male (ranging from 23 to 49 years old) and just one of them had high-risk behavior of HIV infection. Of these health professionals, 52.8% were nursing auxiliaries, 19.4%, nurses, 13.9%, nursing attendants, 5.5%, laboratory technicians, 2.8% surgery instrumentalist, 2.8% accountants and 2.8% nursing technicians. In 47.2% of cases the workers had a parenteral exposure to blood (needlestick injuries). The right hand and fingers were the body areas most effected. The serologic test to detect HIV antibodies by the ELISA method was required of all the workers. The results were negative and no seroconversion was registered during the one year follow-up period. The professionals were retested one month, 2 months, 6 months and one year after the exposure. In conclusion, the risk of infection by HIV among health professionals of HCFMRP seems to be very low. Continuing education should be provided for health care workers with a view to reinforcing the use of universal precaution, especially those to prevent injuries caused by needles or other sharp instruments.