广西男性医学大学生包皮环切接受意愿影响因素研究

[目的]调查男性医学生对包皮环切术的接受意愿,分析影响其接受意愿的关键因素,为建立促进包皮环切预防艾滋病的宣传模武奠定基础. [方法]通过整群抽样的方法抽取广西男性医学大学生作为研究对象,对其包皮环切术接受意愿及影响因素进行问卷调查. [结果]490名男性医学生中有包皮环切意愿的占53.5%(262/490).单因素分析结果显示,愿意接受包度环切手术组和不愿意接受手术组医学生对"包茎或包皮过长易形成包皮垢"的认知存在统计学差异(x2=4.706,P=0.030);两组医学生中患包茎或包皮过长的比例差异也有统计学意义(x2=117.5,P=0.000).Logistic回归分析结果发现,是否有包皮疾患(OR=22.940,95%CI=11.241～46.812)和是否知道包皮过长易引起尿道感染(OR=1.632,95%CI=1.064～2.503)与手术接受意愿相关.[结论]男性医学生包皮环切接受意愿较高,可利用医学生接受包皮环切术的示范效应开发我国推广包皮环切术预防艾滋病的宣传模式.     

非穆斯林男性吸毒者包皮环切术接受意愿调查

目的 了解非穆斯林男性吸毒者对包皮环切术的接受意愿及其影响因素.方法 采用横断面调查研究,于2010年1-11月对新疆乌鲁木齐市350名非穆斯林男性吸毒者进行问卷调查.结果 350名非穆斯林男性吸毒人员中,55.1％ (193/350)有意愿接受包皮环切术,其中74.6％ (144/193)完全是出于个人意愿,其次是医生的建议、周围朋友的影响、配偶或女友的支持和父母的安排,分别占15.5％ (30/193)、13.0％ (25/193)、11.9％ (23/193)和8.8％(17/193);有44.8％(157/350)不愿意接受,其中,87.9％(138/157)认为没有必要、不影响健康;不愿意选择该手术的人有93.0％(146/157)完全是出于个人意愿;多因素logistic回归分析结果显示,身边有亲戚朋友或者同学做过该手术(OR=2.071,95％ CI=1.043 ～4.110)和感觉自己包茎或包皮过长(OR=9.355,95％CI=4.607 ～ 18.993)与包皮环切术的接受意愿相关.结论 该人群中大部分人有意愿接受包皮环切术,但其预防艾滋病的相关知识了解不够.     

广西吸毒者包皮环切接受意愿调查及影响因素研究

[目的]调查吸毒者包皮环切手术接受意愿,探讨其影响因素。[方法]采用滚雪球抽样方法招募吸毒者446名,以面对面访谈形式对其包皮环切术知识、手术意愿及影响因素进行问卷调查。[结果]446名吸毒者中,321人了解包皮环切手术相关知识,占71.5%;217人有包皮环切意愿,占48.7%。多因素Logistic回归分析显示,包皮过长(P=0.000,OR=5.58,95%CI=3.09～10.07)以及知道"包皮过长易患生殖器炎症"(P=0.026,OR=1.66,95%CI=1.06～2.60)会显著提高手术意愿;小于40岁年龄组的手术意愿比40岁以上年龄组高47%(P=0.063,OR=1.47,95%CI=0.98～2.21)。无手术意愿组,在免费手术情况下,29.9%的人会选择手术。[结论]吸毒者包皮环切手术意愿较高,但应针对影响因素进行干预,以提高该人群包皮环切率。     

男男性行为人群包皮环切术预防HIV意愿调查

目的 了解男男性行为人群进行包皮环切手术以预防艾滋病感染的意愿情况及其影响因素.方法 于2009年2月-3月,在北京市招募男男性行为者进行问卷调查,了解其对艾滋病及包皮环切术预防艾滋病感染的认知情况.结果 在参加调查的200名男男性行为者中,13人已经接受了包皮环切,3人不清楚是否做过包皮环切;在参加者184人未做过包皮环切的中,36.4%表示愿意参加今后的包皮环切预防男男性行为感染艾滋病的科学研究.多因素Logistic回归分析显示,其影响因素包括包皮过长(OR=2.82,95%CI=1.45～5.49)和认为包皮环切能增加自己/同伴性伴的同性性乐趣或性快感(OR=4.50,95%CI=1.77～11.49).结论 应在该人群中加大包皮环切及艾滋病知识的普及力度,消除人们对包皮环切手术及相关预防艾滋病感染研究的担心和歧视.     

广西男性居民包皮环切接受意愿影响因素

目的 了解广西男性居民对包皮环切术(male circumcision,MC)的接受意愿,分析影响其接受意愿的影响因素.方法 于2009年10-12月通过多阶段整群抽样方式对广西钦州市和贺州市男性居民进行访谈式问卷调查.结果 668名调查对象中,选择“愿意”、“可能愿意”、“可能不愿意”和“不愿意”接受MC者分别占15.1% (101/668)、8.1%(54/668)、4.2% (28/668)和2.6% (485/668);将“愿意”及“可能愿意”接受MC者作为有接受手术倾向者,则有包皮环切意愿的占23.2%(155/668);“可能不愿意”或“不愿意”接受MC者中89.8%(459/513)认为是“没有必要,不影响健康”;Logistic回归分析结果表明,存在包茎或包皮过长现象及知道包皮过长会引起包皮垢,影响生殖健康与接受MC意愿相关(P＜0.05).结论 广西男性居民接受MC意愿较低,提高MC基本知识将有助于在该人群中推广包皮环切术.     

医学生包皮环切术接受意愿影响因素分析

目的 了解重庆医科大学男性医学生对包皮环切术的认知状况及影响因素,为进一步提高艾滋病重点人群包皮环切术接受意愿宣传提供科学依据.方法 采用自制问卷对整群随机抽样法抽取的580名1～4年级大学生进行横断面调查.结果 男生对包皮过长或包茎的危害、手术常见原因有一定了解,但完全知晓率分别为39.65％(224/565)、7.69％(35/455);认为手术可以预防艾滋病及其他性传播疾病的占38.9％(177/455);不选择手术的原因:76.31％(190/249)觉得不影响健康、没必要,38.96％ (97/249)担心手术风险,26.51％ (66/249)不知道手术的医学益处,22.89％ (57/249)担心影响性功能,15.66％(39/249)担心费用过高;当男生了解手术并发症发生率很低,而且可预防艾滋病及其他性传播疾病,保护生殖健康后,33.06％(81/245)愿意手术,40.82％( 100/245)不确定.结论 相关知识的掌握情况、手术的安全性和费用影响医学生对包皮环切术的接受意愿.     

广州市男性工人包皮环切术接受意愿及影响因素分析

目的 调查男性工人包皮环切手术接受意愿现状,分析手术接受意愿的影响因素。方法 以广州市南沙区建筑工地和工厂为基地采用方便整群抽样方法选取4家建筑工地和2家制造业工厂,对男性工人进行现场问卷调查;应用Logistic回归模型分析数据。结果 实际有效调查836名男性工人,其中建筑工地工人391人（46.8%）,制造业工人445人（53.2%）,手术接受意愿率为85.4%。不同文化程度间的接受意愿差异有统计学意义（χ2=12.67,P=0.002）,且手术接受意愿具有随着文化程度的提高而升高的趋势;艾滋病知识高分组的手术接受意愿比低分组高,差异有统计学意义（χ2=16.19,P<0.001）;手术知识高分组与低分组比较差异有统计学意义（χ2=19.90,P<0.001）;调整相关混杂因素后,对手术医学益处认知得分越高（OR=1.84,95% CI:1.44～2.34,P<0.001）,身边有人做过包皮环切术（OR=1.83,95% CI:1.06～3.15,P=0.029）是愿意接受手术的促进因素。结论 男性工人的手术接受意愿较高,提示该人群适合手术的推广和普及。     

男男性接触者包皮环切术接受意愿调查

目的 了解男男性接触者(MSM)对进行包皮环切术(Male Circumcision,MC)的接受意愿.方法 2008年8-9月,通过"滚雪球"和方便抽样招募方式对辽宁省沈阳市123名MSM进行访谈式问卷调查.结果 123名调查对象中,61.8%的MSM存在异性性伴,其中57.9%在最近1个月与女性性伴的性行为中未使用安全套.4.9%的MSM曾接受过包皮环切手术.未进行过包皮环切术的MSM中47.O%愿意接受MC.而对于免费提供的MC,接受比例为60.0%.Logistic回归分析显示,存在包茎现象及认为包皮环切可预防性病感染与MSM愿意接受MC存在显著的关联性(P＜0.05).结论 MSM存在向其异性性伴传播人类免疫缺陷病毒(HIV)的危险性.MC干预可降低MSM的HIV感染率及向普通人群传播的风险.     

我国西部地区外来务工者对包皮环切预防HIV认知和行为的定性研究

目的了解我国西部外来务工者对包皮环切术作为HIV预防措施的认知和行为情况,为相关宣传材料开发及模式推广研究提供理论数据。方法选择广西壮族自治区、重庆市和新疆维吾尔族自治区18岁及以上未做过包皮环切的男性外来务工者各30人,进行个人深入访谈。结果 3个地区中,仅有8人知道包皮环切术可以预防HIV感染。广西壮族自治区和重庆大多数被访者(21/30)认为包茎或包皮过长者才有必要行包皮环切术;新疆维吾尔族自治区有部分被访者(12/30)能说出一些包皮环切相关知识。当知道包皮环切可以预防HIV,并可免费之后,近半数人表示愿意接受手术。存在包茎或包皮过长、认为包皮环切能够保持生殖卫生健康、改善性生活和当地人群包皮环切相关知识是影响包皮环切术可接受性的主要因素。被访者缺乏正确的艾滋病知识、态度,普遍存在无保护性行为。结论包皮环切及艾滋病预防相关知识的匮乏,是在该类人群推行包皮环切术的一大障碍。     

吸毒人群包皮环切预防艾滋病推广效果评价

目的 评价包皮环切(MC)预防艾滋病在广西吸毒人群中的推广效果.方法 采用整群抽样的方法抽取广西南宁市、柳州市4个美沙酮门诊共490名艾滋病病毒(HIV)阴性的男性吸毒者为研究对象,基线调查后1个月进行MC预防艾滋病宣传和干预,愿意手术且无手术禁忌症者则实施MC,干预后第9个月随访,了解研究对象对MC预防艾滋病知、信、行的变化情况.结果 干预后,与基线比较,吸毒人群中MC接受意愿从56.1％上升到66.1％(x2 =9.769,P=0.002),手术率从0上升到22.8％(x2=125.662,P =0.000);知晓MC可以预防艾滋病及其他性传播疾病从29.2％上升到70.5％(x2=160.499,P=0.000),知晓MC可以保护性伴生殖卫生与健康从33.7％上升到随访的68.1％(x2=111.148,P=0.000),知晓MC可以预防生殖器炎症或肿瘤从33.1％上升到63.2％(x2 =85.502,P =0.000).结论 MC预防AIDS的推广可提高吸毒人群对MC的知晓情况、手术意愿和手术率.     

Female genital mutilation and domestic violence among Egyptian women

The purpose of this study was to determine if there is a relationship between female circumcision and domestic violence. Results showed that women who suffered from domestic violence and women who experienced genital circumcision shared many low socioeconomic and educational characteristics. Circumcised women were more likely to support continuation of female circumcision, to circumcise their daughters, and to accept the right of husbands to beat their wives.     

Christians’ cut: popular religion and the global health campaign for medical male circumcision in Swaziland

Abstract

Swaziland faces one of the worst HIV epidemics in the world and is a site for the current global health campaign in sub-Saharan Africa to medically circumcise the majority of the male population. Given that Swaziland is also majority Christian, how does the most popular religion influence acceptance, rejection or understandings of medical male circumcision? This article considers interpretive differences by Christians across the Kingdom’s three ecumenical organisations, showing how a diverse group people singly glossed as ‘Christian’ in most public health acceptability studies critically rejected the procedure in unity, but not uniformly. Participants saw medical male circumcision’s promotion and messaging as offensive and circumspect, and medical male circumcision as confounding gendered expectations and sexualised ideas of the body in Swazi Culture. Pentecostal-charismatic churches were seen as more likely to accept medical male circumcision, while traditionalist African Independent Churches rejected the operation. The procedure was widely understood to be a personal choice, in line with New Testament-inspired commitments to metaphorical circumcision as a way of receiving God’s grace.     

广西地区650 名男男性行为者对暴露前预防HIV感染接受意愿及其影响因素研究

目的 了解广西地区男男性行为者(MSM)对暴露前预防(PrEP)HIV感染的接受意愿及其影响因素.方法 采用滚雪球法招募650名MSM,利用自行设计的调查问卷一对一面访,了解MSM与艾滋病相关的高危行为、对PrEP的知晓情况及接受意愿.结果 假设PrEP使用的药物安全、有效且免费提供,有91.9%的MSM表示愿意服用药物.自述愿意服药的原因主要为可降低HⅣ感染的风险,不愿意服用药物的原因主要为担心药物的副作用和怀疑药物的效果.logistic回归分析显示,与接受PrEP意愿有关的因素为"是否通过朋友介绍性伴"(OR=6.21,P=0.020)、"是否有能力预防HIV感染"(OR=O.32,P=0.010)、"是否拒绝与不使用安全套的人发生性行为"(OR=0.34,P=0.010)、"是否建议朋友接受PrEP"(OR=39.32,P=0.000).结论 药物的安全性、有效性及费用可能是影响广西地区MSM接受PrEP的主要因素,免费提供安全、有效且副作用小的药物可能是推广PrEP的较好方式;以同伴教育的方式宣传PrEP可能会提高其接受意愿.

Abstract：

Objective To study the acceptability of pre-exposure prophylaxis (PrEP) to prevent the transmission of HIV among men who have sex with men (MSM) in Guangxi, China.Methods Snow-balling methods were used to recruit 650 MSM in Guangxi. Questionnaires and interview were administrated to these 650 men, using a self-designed questionnaire and face to face interviews to collect information on HIV-related risk behaviors, knowledge and acceptability of PrEP.effective, safe and free of charge', 597 (91.9%) of the 650 MSM claimed that they would accept it,who refused to use it, most of them said that were afraid of the side-effect and doubted on the effectiveness of PrEP. Data from logistic regression analysis showed that those who had found partners through friends (OR=6.21, P=0.020) and those who would advise his friend to use PrEP (OR=39.32, P=0.000) were more likely to accept PrEP. Those who thought they could protect themselves from HIV infection (OR=0.32, P=0.010) or not having sex with the ones who refused to use a condom (OR=0.34, P=0.010) were less likely to accept PrEP. Conclusion Effectiveness, safety and cost seemed to be the main influential factors related to the acceptability of PrEP. Peer education might improve the acceptability of PrEP.     

Condom avoidance and determinants of demand for male circumcision in Johannesburg, South Africa

BACKGROUND Circumcision is efficacious in reducing HIV acquisition in heterosexual males. The South Africa government has been reluctant to adopt a national circumcision programme, possibly due to concerns that circumcision may result in decreased condom use. OBJECTIVE To identify the determinants of demand for male circumcision, to examine variations by ethnicity, and to determine whether it is demanded to avoid condom use. METHODS 403 parents and 237 sons in Johannesburg, South Africa, were recruited through a randomized household survey, with oversampling to balance between blacks (n = 220), 'coloured' (mixed ethnicity) (n = 202) and whites (n = 218). The demand for male circumcision was estimated using a conjoint analysis, with each respondent randomly receiving four tasks comparing seven possible benefits-six identified through key informant interviews and one for condom avoidance. Respondents' choices were analysed using logistic regression, including stratified analyses to test for homogeneity. RESULTS Overall, circumcision's beneficial effects on HIV transmission (P < 0.001), sexually transmitted infection (STI) transmission (P?< 0.001), hygiene (P < 0.05) and sex (P < 0.05) were identified as determinants of demand, but the condom avoidance hypothesis was rejected as it was 'repulsive' to respondents (P < 0.001). Consistent results were found for blacks (P < 0.001) and coloured (P < 0.001), but not for whites who found condom avoidance attractive (P < 0.04), a result not explained by variations in wealth, age or paternal circumcision status. CONCLUSIONS Male circumcision programmes should be tailored to accommodate variations in the determinants of demand across the target population. We find that circumcision's protective effect against HIV acquisition in men is the only determinant to be found consistently across all ethnic groups in Johannesburg. We also find that concerns over condom avoidance may have been overstated. This said, male circumcision strategies should reinforce a range of HIV prevention strategies, including condom use, as we find evidence that whites may view circumcision as a means to avoid condom use.     

男童包皮发育及父母对环切术接受情况的调查

目的：对鲁西南地区男童包皮发育情况及父母对包皮环切接受情况进行调查研究。方法选取山东省枣庄、济宁以及菏泽等鲁西南地区的婴幼儿和中小学在校学生作为研究对象,将年龄介于0～3岁,4～6岁,7～10岁,11～14岁以及15～18岁研究对象分为5组,分别为第一到第五组,每组选取200名儿童调查其包皮发育情况,并分别对5组研究对象的家长做包皮环切术接受度的调查;其中包皮上翻程度分为Ⅰ度至Ⅶ度,家长接受情况分为接受、不接受和不清楚3种,并对结果进行分析。结果在5组研究对象中,随着年龄的增长其平均包皮长度逐渐增长（ t＝16．729,P＝0．000＜0．05）。在1000例研究对象中,有534例（53．4％）存在包茎,随着年龄的增长包茎发病逐渐减少（χ2＝119．963,P＝0．000＜0．05）;有182例（18．2％）存在包皮过长,随着年龄增长包皮过长发病也逐渐减少（χ2＝44．054,P＝0．000＜0．05）;有70例（7．0％）人存在包皮口狭窄,但发病与年龄无关（χ2＝1．382,P＝0．847＞0．05）。家长对包皮环切接受率由低年龄儿童到高年龄逐渐增加（χ2＝0．000,P＝1．000＞0．05）,但接受率均少于30％。结论研究表明调查对象包皮过长以及包茎现象较为严重,但随着年龄的增长逐渐好转,包茎率逐渐降低,并且随着年龄的增长,家长对儿子进行包皮环切的接受度也逐渐增高,但总体而言对男童进行包皮环切术接受率较低。     

Circumcision and neonatal tetanus: disclosure of risk and its reduction by topical antibiotics.

BACKGROUND: Previous case-control studies have paradoxically suggested that circumcisions protect against neonatal tetanus (NNT), but these observations have not been adjusted for differences in the length of survival of cases and controls. METHODS: Boy cases (n = 133) and their sex-matched controls (n = 399) were extracted from a population-based study of NNT undertaken in Punjab Province, Pakistan. In the resulting file, circumcisions were censored such that analysis was restricted to only those that occurred before onset in cases or before age of onset in the matched case for controls. The effect of topical antibiotics in circumcision wounds was then evaluated. RESULTS: After adjusting for confounders, circumcision before onset posed a significant risk for NNT (matched odds ratio [OR] = 3.1, 95% CI: 1.2-8.0). The risk of NNT in those circumcised before onset and treated with topical antibiotics did not differ significantly from the referent group who had not been circumcised before onset (matched OR = 1.1, 95% CI: 0.2-6.8), whereas the lack of topical use was associated with significant risk (matched OR = 4.2, 95% CI: 1.4-12.6). This suggests that topical antibiotics are likely to be highly effective in preventing NNT from circumcision wounds. We estimated an overall risk of about 16 fatal NNT cases per 1000 live boy births with circumcision wounds that were not protected by topical antibiotics, and that circumcision and umbilical wounds each accounted for about half of this overall risk in these boys. CONCLUSIONS: Topical antibiotics should be routinely applied to all wounds created by traditional circumcisions, to prevent NNT and sepsis from these frequently unsterile procedures.     

Circumcision in Australia: further evidence on its effects on sexual health and wellbeing

Objective: To report on the prevalence and demographic variation in circumcision in Australia and examine sexual health outcomes in comparison with earlier research. Methods: A representative household sample of 4,290 Australian men aged 16–64 years completed a computer‐assisted telephone interview including questions on circumcision status, demographic variables, reported lifetime experience of selected sexually transmissible infections (STIs), experience of sexual difficulties in the previous 12 months, masturbation, and sexual practices at last heterosexual encounter. Results: More than half the men (58%) were circumcised. Circumcision was less common (33%) among men under 30 and more common (66%) among those born in Australia. After adjustment for age and number of partners, circumcision was unrelated to STI history except for non‐specific urethritis (higher among circumcised men, OR=2.11, p<0.001) and penile candidiasis (lower among circumcised men, OR=0.49, p<0.001). Circumcision was unrelated to any of the sexual difficulties we asked about (after adjusting for age) except that circumcised men were somewhat less likely to have worried during sex about whether their bodies looked unattractive (OR=0.77, p=0.04). No association between lack of circumcision and erection difficulties was detected. After correction for age, circumcised men were somewhat more likely to have masturbated alone in the previous 12 months (OR=1.20, p=0.02). Conclusions: Circumcision appears to have minimal protective effects on sexual health in Australia.     

Controlling varicella in the healthcare setting: barriers to varicella vaccination among healthcare workers.

We surveyed healthcare workers to determine factors that may influence acceptance of varicella-zoster virus vaccine. Of 2,801 workers tested, 90 were susceptible to varicella; of workers offered vaccination, 68% accepted. Workers providing direct patient care were 3.7-fold more likely than other workers to accept VZV vaccination (P=.04).     

辽宁省2006-2015年流动人口结核病流行病学特征分析

目的 分析辽宁省2006-2015年流动人口结核病患者相关资料,为掌握本省流动人口结核病流行病学特征,探索更合理的防控措施。方法 收集整理2006-2015年全省各市的结核病患者病案信息,对流动人口结核病患者的相关特征资料进行分析。结果 2006-2015年辽宁省共登记流动人口患者8 369例,各年流动人口患者占总登记患者比例整体呈上升趋势（χ_趋势2=112.90,P<0.001）;省间流动患者占流动人口患者总数的74.53%;发病年龄集中在15~44岁青、中年人群;68.07%流动人口患者集中在大连,但沈阳（χ_趋势2=122.55,P<0.001）、鞍山（χ_趋势2=11.51,P=0.001）所占比例呈逐年上升趋势;职业以家政家务及待业为主且呈上升趋势（χ_趋势2=498.41,P<0.001）;患者来源方面中因症就诊患者所占比例上升较为明显（χ_趋势2=141.85,P<0.001）。结论 流动人口患者流行病学特征更加分散,可通过扩展宣教范围、健全跨区域管理制度,加强健康筛查,增加参保率、给予激励政策等措施来加强结核病防控。