郑州市男男性接触人群HIV/AIDS相关知识和行为的调查分析

目的 了解郑州市男男性接触人群的艾滋病相关知识和行为,为开展艾滋病防治工作提供依据. 方法 以郑州市男男性接触人群为调查对象,随机抽取194人进行横断面现场调查. 结果 郑州市男男性接触人群对艾滋病的传播途径问题回答的正确率较高,超过85％,对非传播途径问题回答的正确率较低.文化程度高的男男性接触人群艾滋病相关知识的回答正确率高于文化程度低的研究对象,差异有统计学意义（P＜0.05）.该人群普遍存在高危性行为及双性性行为.84.4％研究对象最近六个月与同性发生过性行为,33.5％与同性发生性行为时从未使用过安全套,36.7％偶尔使用.33.5％研究对象最近六个月与异性发生过性行为,与异性有过性经历的研究对象中,坚持使用安全套的人占23.9％,绝大多数人从未使用或偶尔使用.94.5％的研究对象接受安全套宣传和发放,但接受艾滋病检测水平较低（45.4％）. 结论 郑州市男男性接触人群的艾滋病相关知识掌握较好,但仍存在高危性行为,需要进一步加强艾滋病健康教育,尤其是行为干预须进一步加强.     

Knowledge,Attitudes, and Sexual Behaviors in HIV/AIDS and Predictors Affecting Condom Use among Men Who Have Sex with Men in South Korea

ObjectivesIn South Korea, men who have sex with men (MSM) are rather understudied, but are known to be at high risk for human immunodeficiency virus infection (HIV)/acquired immunodeficiency syndrome (AIDS). This study was to access HIV/AIDS knowledge, attitudes, and risk behaviors, and to identify the factors of condom use in HIV prevention.MethodsWe recruited 1070 MSM in Korea, using the Internet to maximize the confidentiality of the MSM.ResultsThe prevalence of self-reported and sexually transmitted infections and HIV in the total sample was 10.7% and 2.7%, respectively. Factual knowledge and phobias regarding HIV/AIDS and self-efficacy were relatively high among the MSM. After controlling for age, education, marital status, and sexual identity, predictors of condom use at most recent anal sex included knowledge (OR = 1.25; p < 0.0001); self-efficacy (OR = 1.33; p = 0.02), additionally, having HIV testing (OR = 1.45; p = 0.02); and having a regular partner (OR = 0.53; p < 0.0001) were also positively associated with condom use.ConclusionThe intervention programs for MSM in Korea may need to take the idiosyncratic societal and cultural pressures of the region into consideration in order to reduce infection risk.     

以家庭和社区为基础的农村艾滋病病毒感染者/病人及其家属关怀模式

[目的]探索和建立对农村艾滋病病毒感染者和病人关怀和支持的工作模式,提高目标人群的生活质量,减少艾滋病病毒在感染者家庭夫妻间经性传播及非婚性传播,促进艾滋病的预防控制。[方法]社区(乡村)医生参与干预和关怀的服务;开展自愿咨询检测;培训同伴教育者(志愿者);提供感染者家庭生产支持与救助,孤儿关怀与救助,加强部门间的合作。[结果]项目覆盖24个乡,完成了大量干预、关怀、培训工作,达到了预期的要求。[结论]初步探索出了在农村地区对艾滋病病毒感染者和病人进行关怀和支持的工作模式。     

盈江县HIV/AIDS高流行区感染者关怀和吸毒行为社区综合干预

[目的]解决农村家庭如何应对艾滋病预防、治疗和护理问题。[方法]为感染者及家属提供关怀服务,发放艾滋病宣传册、安全套,为感染者提供体检及抗机会性感染治疗;利用同伴的影响进行针具交换。[结果]许多家庭有了接受过培训的护理员,从而提高了HIV感染者/病人及其家属的艾滋病防护知识,使他们的生活质量得到了一定改善;吸毒者的相关知识增长,危险行为降低。[结论]干预促进了吸毒者的行为改变。     

携手共享七彩天空--昆明男男性行为者性病艾滋病综合防治

[目的]提高男男性行为者的性病艾滋病预防意识,促进安全性行为的实施,控制艾滋病在此类人群中传播。[方法]建立适应项目工作的环境,开展多种形式的服务。[结果]建立了稳定的志愿者队伍,提高了男男性行为者的性病艾滋病预防知识,促进了安全套的使用率。[结论]在昆明男男性行为者人群中开展性病艾滋病防治工作取得预期的效果,其成功的经验为下一步的工作奠定了基础。     

艾滋病病毒感染者生活质量与相关耻辱的关系

目的探讨艾滋病病毒感染者和病人的生活质量与耻辱的关系。方法对215名艾滋病病毒感染者和病人进行匿名问卷调查,采用WHO生活质量简表中文版和BergerHIV耻辱量表测定调查对象的生活质量和感受到的耻辱,对其生活质量和艾滋病相关耻辱感进行典则相关分析。结果艾滋病病毒感染者和病人生活质量各个维度的平均得分为50.74(生理领域)、46.01(心理领域)、53.78(社会关系领域)和43.94(环境领域);耻辱4个维度的得分为49.89(个人耻辱)、29.77(担心公开)、35.18(负面自我印象)和57.80(关注公众态度)。典则相关分析结果显示,自我负面印象和心理领域分别是耻辱和生活质量中起主要作用的因素,两者呈负相关,相关系数为0.4938(P<0.05)。结论艾滋病病毒感染者和病人的负面自我印象越小,生活质量心理方面越好。     

A social-ecological perspective on power and HIV/AIDS with a sample of men who have sex with men of colour

This paper applies a social-ecological theory of power to posit that individual HIV-related vulnerability stems from how power is leveraged across situations over time. The current study identified six power domains and explored how the interchangeability of power shapes HIV-related vulnerability among men who have sex with men of colour. Data were collected as part of a mixed-methods study on the social networks and experiences of racial/ethnic and sexual minority status. A total of 35 Asian/Pacific Islander, Black and Latino men who have sex with men were recruited and individual in-depth interviews were conducted. Results showed that men who have sex with men of colour actively traded upon various domains to alter their relative power within a given situation. Results suggest that power interchangeability, or the degree to which power from one domain can be leveraged to gain power in another, may shape HIV-related vulnerability. Findings offer a dynamic understanding of the nature of HIV risk as derived from everyday power exchanges and provide theoretical foundation for future work on individual resilience against HIV-related risks over time.     

1 126例艾滋病病毒感染者和病人相关知识行为调查

目的了解安徽省艾滋病综合防治示范区/全球基金艾滋病项目地区艾滋病病毒感染者/病人的艾滋病知识和行为状况,为评估项目前期执行效果和制订后期计划提供依据。方法采取整群抽样方法,对8个县(市、区)1 126名艾滋病病毒感染者/病人进行问卷调查。结果艾滋病知识知晓率为92.01%,传播途径和非传播途径知晓率分别为82.42%和86.59%;与配偶最近1次安全套使用率和最近3次安全套坚持使用率分别达91.42%和81.83%,明显高于基线调查结果;在婚外性行为中,最近1次安全套使用率和最近3次安全套坚持使用率分别为77.78%和55.56%;VCT服务的利用率达到94.05%,无偿献血知识知晓率为57.02%。结论我省项目地区艾滋病病毒感染者/病人艾滋病知识知晓率和配偶间安全套使用率有所上升,但无偿献血知识知晓率和婚外性行为安全套使用率较低。因此今后应大力开展艾滋病防治知识和无偿献血知识宣传,增强安全套使用的干预力度,提高感染者和病人的安全套使用率和知识知晓率。     

2008年济南市部分男男性行为人群艾滋病相关知识、性行为特征及HIV和梅毒感染状况调查

[目的]了解济南市男男性行为人群(MSM)的性行为特征、艾滋病及梅毒感染状况。[方法]2008年10~12月,对在济南市疾病预防控制中心自愿接受艾滋病咨询的男男性行为人群进行匿名问卷调查和艾滋病病毒抗体、梅毒抗体检测。[结果]调查542人,艾滋病相关知识知晓率为84.51%。最近1年接受过有关预防艾滋病服务的占55.97%;相关知识信息的主要来源为网络(占64.66%)、电视(占43.46%)、免费宣传材料(占42.93%)、报刊(占41.62%);65.93%的人通过网络寻找性伴;24.56%的人同时与女性有性行为,最近半年内平均性伴数为4.23±8.08人;68.35%的人最近6个月与男性性伴发生肛交性行为时未能每次都使用安全套。HIV抗体阳性检出率为1.55%,梅毒抗体抗体阳性检出率为5.31%。[结论]MSM人群艾滋病相关知识知晓率较高,但普遍存在高危性行为。     

The Role of Cultural Practices and the Family in the Care for People Living With HIV/AIDS Among the Igbo of Anambra State,Nigeria

The HIV/AIDS pandemic is one of the worst epidemics that have been experienced by humankind. It is indeed a major event of our time. The pandemic has killed so many people around the world and Sub-Saharan Africa is the worst hit. The nature of the pandemic lent it to stigma and discrimination, which have made caring for people living with HIV/AIDS (PLWHA) a big problem. It has also brought so much suffering on PLWHA around the world. This article examines the role of culture and the family in the care for PLWHA in Anambra State. Quantitative and Qualitative data collection methods (questionnaire and in-depth interviews) are used to elicit information from respondents. A total of 1000 copies of a questionnaire were administered on adult males and females and 914 were completed and analyzed. Furthermore, in-depth interviews were conducted on 10 opinion leaders using an interview guide. Data were analyzed in themes based on the objectives and the data from in-depth interviews were used to support data from the questionnaire. The results showed that certain cultural practices such as cultural obligations to sick, blood relations, collective ownership of children, affinity to blood relations, and strong marital bond enhance care and support for PLWHA. Also, the burden of care for PLWHA was found to be on the family in the study area. In conclusion, cultural practices and the family play major roles in the care for PLWHA in the area and should be harnessed in order to make life more comfortable for PLWHA.     

深圳市男男同性恋人群艾滋病疾病进程及影响因素

目的了解深圳市男男同性恋(MSM)人群感染HIV的AIDS病程进展及其影响因素。方法调查236个MSM的HIV/AIDS疾病进程,分析影响因素。结果 236例HIV/AIDS中快速进展组(RP)70人(29.66%),非快速进展组(NRP)组166人(70.34%)。中位潜伏期为5.63年,其中RP组和NRP组中位潜伏期分别是3.68年和6.51年。多因素Logistic回归分析结果显示影响潜伏期的主要因素是年龄(P0.05)、文化程度(P0.01)和基线CD4+T水平(P0.01)。结论年龄、文化程度、基线CD4+T水平是影响MSM HIV/AIDS病程进展重要因素。应加强随访和CD4+T检测,掌握患者病情进展,及时进行抗病毒治疗。     

男男性行为者艾滋病风险认识与知识和高危性行为关联性

目的 了解男男性行为者(MSM)艾滋病风险认识现状,分析其与知识及高危性行为的关联性。方法 在四川省绵阳市采用滚雪球抽样法抽取MSM,对MSM进行艾滋同风险认识、艾滋病知识及性行为等调查并抽取静脉血进行HIV-抗体和TP-抗体检测,采用描述流行病学分析方法对结果进行分析,并采用多因素非条件logistic回归模型进行风险认识与知识、高危性行为关联性分析。结果 回收有效问卷1 226份,MSM平均年龄 (27.5 ± 9.0)岁,高中及以上占87.9%(1 078/1 226),未婚占81.1%(994/1 226)。艾滋病知识知晓率为97.4%(1 194/1 226),近6个月肛交有保护占71.4%(802/1 123),有风险认识占94.6%(1 160/1 226)。多因素分析结果显示,相对于无风险认识者,知晓艾滋病知识 (OR_a=18.951,95%CI:6.813~52.720)、近6个月肛交有保护(OR_a=1.821,95%CI:1.074~3.262)者有风险认识概率更高。结论 MSM具一定风险认识,风险认识与知识及高危性行为相关,知识对风险认识、风险认识对行为的促进作用明显。     

安徽省重点地区HIV感染者和AIDS病人艾滋病知识行为调查分析

目的了解安徽省全球基金艾滋病项目重点地区HIV感染者/AIDS病人知识、行为的现状,客观评价2010年度艾滋病防治工作效果及五年行动规划(2006-2010年)目标实现情况。方法采取整群抽样方法,对安徽省9个全球基金项目重点县1 226名HIV感染者/AIDS病人进行面对面问卷调查,以项目中期(2008年)调查结果进行对比。结果艾滋病相关知识8题全答对者1 005人,占81.97%,对艾滋病相关知识获得途径和希望知识获得途径均为"医生"、"电视"、"免费宣传材料"。与2008年项目评估比较,"无偿献血不会传染艾滋病的知识点"正确回答率由84.30%上升到94.78%(χ2=60.435,P0.001),"每六个月以上献血对身体无害"由84.46%上升到93.20%,(χ2=41.011,P0.001);"最近一次使用安全套的比例"由93.58%上升到98.00%,(χ2=38.163,P0.001);"最近三个月坚持使用安全套的比例"由80.90%上升到92.00%,(χ2=14.765,P0.001)。结论重点地区HIV感染者/AIDS病人艾滋病和无偿献血知识知晓率较2008年评估结果有所提高,安全套坚持使用率较2008年大幅度提高;获得艾滋病知识的途径较单一,个人及家庭歧视现象依然存在,消除歧视、向"零"艾滋迈进将是今后一段时间的工作重点。     

HIV/AIDS病人生活质量及社会支持调查

目的 了解皖北农村地区人类免疫缺陷病毒（HIV）感染者／艾滋病（AIDS）病人的生活质量和社会支持现状，分析其相关的影响因素。方法 通过典型抽样法采用一般情况问卷、感染史本底资料调查表、生活质量综合评定问卷（GQOLI-74）和社会支持评定量表（SSS）对85名HIV感染者／AIDS病人进行调查。采用单因素方差和多元线性回归方法对调查结果进行分析。结果 单因素分析显示，不同性别、不同文化程度的HIV感染者／AIDS病人GQOLI-74总分差异有统计学意义（P〈0．05）；不同乡镇的HIV感染者／AIDS病人SSS总分差异有统计学意义（P〈0．05）。多元线性回归分析结果表明，负性生活事件是影响HIV感染者／AIDS病人社会支持的不利因素。而好的邻里关系、烦恼诉说是影响HIV感染者／AIDS病人生活质量的有利因素。结论 诸多因素影响皖北农村地区HIV感染者／AIDS病人的生活质量和社会支持，农村应加强艾滋病社区关爱、社会支持工作，建立以家庭、邻里为依托的社区关爱模式。     

Attitudes towards and perceptions of reproductive health needs of persons living with HIV/AIDS in rural Kilimanjaro,Tanzania

The introduction of antiretroviral treatment has resulted in the resumption of socially productive and sexually active lives of people living with HIV/AIDS, together with the desire for children. However, factors affecting the reproductive health needs of people living with HIV/AIDS are not well understood. With this in mind, the aim of this paper was to investigate factors associated with these health needs using a qualitative approach. Findings indicate that attitudes and perceptions about reproductive health needs are influenced by fertility beliefs, the central role of family, procreation and the perceived social and clinical consequences of pregnancies among people living with HIV/AIDS. While there was mixed opinion about acceptability of people living with HIV/AIDS, having children, marriage and family were institutions important for partnerships maintenance and procreation. These findings suggest that living with HIV in a community with strong pro-life attitudes is challenging for people living with HIV/AIDS who do not have children. Apart from having to grapple with potential stigma of not having children, people living with HIV/AIDS also face social challenges in realising their reproductive choices. Interventions to address stigma, societal changes and the integration of reproductive-health education into HIV care and treatment are needed.     

‘Othering’ tactics and treatments of patients with HIV/AIDS: a study of the construct of professional ethics by Thai nurses and nursing trainees

Despite efforts to tighten the code of professional ethics amongst health workers by the Thai authorities, recent studies have shown that discrimination towards HIV-positive patients persists amongst nurses, thus compromising the quality of patient care. Using a framework of ‘Othering’, this paper examines the constructions of professional ethics and duties by a group of Thai nurses, with the aim of identifying problems with the existing approach to discrimination reduction. Twenty semi-structured interviews were conducted with qualified and trainee nurses from a Bangkok nursing college. Following a standard attitudinal measure of HIV-related stigma, participants were asked to explain the reasons behind their responses, and reflect on how these might have shaped their personal and professional encounters with HIV-positive patients. The findings showed that despite heightened awareness about the code of non-discrimination, biases towards HIV-positive patients were evident. Various strategies were employed to maintain a perception of the Self as being in line with the prescribed professional ethical guidelines while leaving personal biases towards HIV-positive patients unchanged. These included the dismissal of discrimination as conducts of ‘Other’ people (i.e. the lay public or unethical colleagues), redefining the nature of nursing duties to avoid providing certain services to HIV-positive patients (e.g. taking blood), and stigmatising patients on the basis of presumed/actual high-risk behaviours (e.g. injecting drug use) instead of HIV status. Broadening nurses’ understanding of the distal factors relating to HIV transmission was discussed as an alternative approach for reducing nurses’ biases towards patients with HIV/AIDS.     

云南省HIV/AIDS病人抑郁和焦虑现状及影响因素分析

目的分析云南省HIV/AIDS病人的抑郁和焦虑情况,并分析影响因素。方法于2016年1—2月采用方便抽样法抽取云南省昆明市和陇川县的HIV/AIDS病人作为调查对象,采用病人健康问卷抑郁量表(PHQ–9)和广泛性焦虑量表(GAD–7)测定其抑郁和焦虑情况,采用社会支持评定量表测定其社会支持程度;采用多因素logistic回归法分析其抑郁和焦虑的影响因素。结果本次共调查HIV/AIDS病人410例,其社会支持总得分为(28.05±7.23)分;HIV/AIDS病人的抑郁率为81.5%,其中男性为79.7%,女性为85.7%;焦虑率为68.1%,其中男性为68.0%,女性为77.3%;35~44岁的HIV/AIDS病人的抑郁率和焦虑率最高(P<0.05);未接受过治疗和感染期间症状或体征数越多的HIV/AIDS病人出现抑郁和焦虑的可能性越大;主观支持得分越低的HIV/AIDS病人出现焦虑的可能性也越大。结论云南省HIV/AIDS病人的抑郁和焦虑情况较严重,加强对HIV/AIDS病人的早期抗病毒治疗和社会支持与关怀,有助于改善其心理状况。     

艾滋病医护人员工作压力源、应对方式与工作倦怠的关系

目的 了解艾滋病医护人员工作倦怠与工作压力源和应对方式的关系.方法 采用中式工作倦怠量表(CMBI),简易应对方武问卷(SCSQ)以及自编工作压力源问卷对342名艾滋病医护人员进行调查.结果 ①工作倦怠3个维度与工作压力源和应对方式的多个因素有显著相关关系(P＜ 0.05和0.01).②管理问题和职业风险的压力对情感耗竭以及职业风险对人格解体的预测作用均极其显著(P＜0.01);消极应对对于情感耗竭和人格解体具有显著正向预测作用(P＜ 0.01和0.05),而积极应对对成就感降低具有显著反向预测作用(P＜0.01).③Amos路径分析表明,职业风险的压力和消极应对方式直接影响情感耗竭和人格解体,人际排斥的压力直接影响成就感降低,而积极应对反向作用于成就感降低;消极应对在压力源和工作倦怠中起着部分的中介作用.结论 应当重视艾滋病医护人员的工作压力问题,指导他们使用积极的应对方式,以降低其工作倦怠水平,提高工作生活质量.     

安徽省艾滋病病毒感染者和病人卫生服务利用及其对生存质量的影响

目的 了解艾滋病病毒感染者和病人(PLWHAS)的卫生服务利用(HSU)现状及其对生存质量(QOL)的影响,为合理分配卫生服务资源,提高其QOL提供依据。方法 采用整群分层抽样方法抽取10个县(市、区)的PLWHAS,使用简明健康调查量表(MOS-HIV)对选定人群的HSU和QOL状况进行问卷调查,通过描述性统计和多重线性回归分析评价PLWHAS的HSU及其对QOL的影响。结果 PLWHAS的CD4免费检测的利用率最高(96.39%),其次为医疗保险(95.36%),而生活保障的利用率最低(71.14%)。PLWHAS的生理健康总分(PHS)为48.29±8.73分,心理健康总分(MHS)为46.67±8.45分,GH、PF、RF、SF、PN、MH、VT、HD共8个维度的得分均低于一般人群(P<0.000 1)。接受免费病毒载量(VL)检测、获得持续固定补贴的PHS差异有统计学意义(P<0.05);享受低保、医保、关爱活动、CD4检测的MHS差异有统计学意义(P<0.05);除GH外,HSU对各维度均产生不同程度的影响(P<0.05)。享有低保和医保的QOL优于无医保的,有低保、新农合、持续固定补贴和每年2次的CD4检测对PHS、MHS及PF、RF、CF、MH、VT、HD、QL的影响均有统计学意义(P<0.05)。结论 安徽省PLWHAS的QOL低于一般人群,HSU较好,医保、低保、固定补贴均能提高其QOL,建议扩大PLWHAS机会性感染、药物副作用报销比例,将新农合、医疗保险、医疗救助有机结合,并逐步开展心理支持、中医调理性治疗以提高其QOL。