中国18城市男男性接触者艾滋病社区干预效果评价

目的 评价针对男男性接触人群的艾滋病社区干预项目开展2年后的效果.方法 在7个省18个城市中开展男男性接触人群的综合干预,基线调查于2006年9月进行,通过滚雪球法共抽取5178名调查对象,终末调查于2008年5月进行,通过滚雪球法或同伴推动抽样(RDS)法在18个城市抽取5460名调查对象.对每个调查对象进行问卷调查,调查内容包括调查对象的一般人口学资料、艾滋病相关知识、行为状况和接受干预状况;同时抽取5 ml静脉血,检测人类免疫缺陷病毒(HIV)感染状况.评价干预效果.结果 经过2年的项目实施,2008年与2006年相比,调查对象艾滋病知晓率从76.0%(3933/5178)上升到90.5%(4943/5460)(X~2=451.786,P<0.01);与男性发生肛交性行为时最近1次安全套使用率从58.0%(2382/4105)上升到76.7%(3643/4750)(X~2=215.491,P<0.01);最近6个月安全套坚持使用率从28.2%(1163/4118)上升到44.5%(2114/4753)(X~2=264.606,P<0.01);做过HIV抗体检测的比率从18.8%(973/5170)提高到39.1%(2136/5454)(X~2=530.181,P<0.01);HIV感染率从2.3%(118/5178)上升到5.0%(271/5427)(X~2=47.613,P<0.01).结论 针对男男性接触者的社区干预项目促进了人群对艾滋病防治知识的掌握和安全性行为的采用.

Evaluation of effect of community-based HIV/AIDS interventions among men who have sex with men in eighteen cities, China

Objective To evaluate the effect of a community-based intervention project among men who have sex with men (MSM) after two-year implementation. Methods Comprehensive interventions among MSM in 18 cities of seven provinces were conducted. The pre-intervention questionnaire was conducted in September 2006 and 5178 subjects were investigated through snowball method. In May 2007, post-questionnaire was conducted and 5460 subjects were investigated through snowball or accompanier recommendation method. For each subject, a questionnaire was completed, including basic information, HIV/ AIDS knowledge,behaviours and intervention status. At the same time,5 ml intravenous blood sample was collected to detect HIV infection and evaluated the intervention effect. Results After two-year implementation,the awareness rate of HIV/AIDS knowledge increased from 76.0% (3933/5178) in 2006 to 90. 5% (4943/5460) in 2008(X~2 =451. 786,P<0.001) ; the rate of condom use in the last anal sex with males increased from 58.0% (2382/4105) to 76.7% (3643/4750) (X~2=215.491 ,P<0.01) ; the rate of consistent condom use in the last six months increased from 28. 2% (1163/4118) to 44.5% (2114/4753) (X~2=264.606 ,P<0.01 ) ; the proportion of MSM receiving HIV antibody test increased from 18.8% (973/ 5170) to 39. 1% (2136/5454) (X~2=530. 181 ,P<0.01) ; and the HIV infection rate increased from 2.3% (118/5178) to 5.0% (271/5427) (X~2=47.613, P<0.01). Conclusion The MSM community-based intervention project achieved some good results after two-year implementation and contributed to an increase in HIV/AIDS knowledge and safe sex.