社区卫生服务机构对男男性行为人群开展艾滋病梅毒干预检测的效果分析

目的：探索社区卫生服务机构对男男性行为（men who have sex with men，MSM）人群开展艾滋病梅毒干预检测的效果分析。方法：广州市荔湾区逢源街社区卫生服务中心与社会组织（community-based organization，CBO）合作，通过艾滋病自愿咨询检测（HIV voluntary counseling ＆ tesing，VCT）门诊对169名男男同性恋者进行艾滋病健康教育、问卷调查，动员HIV快速检查、梅毒初筛，以及阳性病例告知等干预服务。结果：与干预前比较，干预后MSM人群的艾滋病知识知晓率提高80％（χ^2=137．80，P〈0．01），安全性行为知识知晓率提高81．8％（χ^2=144．07，P〈0．01），多性伴的男同比率降低15．5％（χ^2=4．65，P〈0．05），安全套的使用率提高30％（χ^2=18．97，P〈0．01）；169人接受了HIV快速检测，阳性率为7．1％，梅毒初筛阳性率为1．8％。结论：通过社区卫生服务机构与CBO合作对MSM人群开展艾滋病梅毒的预防干预、快速检测等服务模式是可行的，并能取得较好效果。建议重视对社区VCT门诊的建设，利用网络开展对MSM人群的特色服务和健康宣教。

Analysis on the Effect of AIDS and Syphilis Prevention and Intervention Among MSM by Community Health Service

Objective：To analyze the effect of AIDS and syphilis intervention among MSM by community health service. Methods： Community Health Center of Fengyuan Street cooperated with CBO to provide intervention program for 169 MSM through VCT clinic. The main activities includ- ed health education, questionnaire survey, mobilizing rapid HIV testing, syphilis screening and positive cases counseling services. Results：After the intervention service, the awareness of AIDS among MSM increased by 80% （Z2 = 137.80,P 〈0. 01 ）, the awareness of safe sex increased by 81.8% （ χ^2 = 144. 07, P 〈0.01 ）, the ratio of muhiple sex partners reduced by 15.5% （χ^2 = 4. 65 ,P 〈0. 05）, condom use increased by 30% （χ^2= 18.97 ,P 〈0. 01 ）. 169 persons accepted HIV on-site testing, the positive rate was 7.1%, and syphilis screening positive rate was 1.8%. Conclusion ：The results showed that it is feasible for the community health service and CBO to provide AIDS and syphilis prevention interventions among MSM. It is important to establish com- munity based VCT clinics and should use internet to promote health education among MSM.