医学生性行为的现状调查与分析

目的：了解高年级医学生性行为的现状,探讨性健康教育对策.方法：对某医科大学2000级348名大学生进行整群调查.结果：调查对象中87.62%的医学生知道避孕方法,74.54%赞同在学校内销售避孕套,仅有7.27%不同意在学校内销售避孕套.65.23%的医学生曾有过性生活史,28.80%的从未采用过避孕措施,46.90%的采用避孕套;其中有30名学生有妊娠史,41人次怀孕学生选择了人工流产、药物流产、引产等方式终止妊娠.结论：医学生的性观念发生了变化,无防护性行为增多.这种现状对高校性健康教育提出了更新更高的要求.     

4 769名女大学生性行为调查

目的:了解中国女大学生性行为状况. 方法:在中国武汉地区,按学校类型、专业类型(文、理、医、艺术等)、年级等特征进行随机整群抽样.共发放5 076份问卷,回收有效问卷4 769份,有效问卷回收率为93.95%.对调查对象以无记名的自填式问卷调查表进行问卷调查.调查数据录入计算机,以SPSS 13.0进行分析. 结果:女大学生中有接吻拥抱行为者2 535人(占53.16%),性行为(性交)863人(占18.10%);不同专业和不同年级的女大学生性行为率有统计学差异,以艺术类(性行为率为35.10%)和高年级(性行为率27.56%)的发生率为高.女大学生初次性行为的原因以一时感情冲动、好奇、为了加强与男友的关系为主,还有迫于暴力等原因;而近一年内性行为的原因以为了加强与男友的关系和生理需要为主.无论是初次性行为还是近一年内的性行为,其性伴侣以自己的男朋友为主(分别占93.28%和95.28%),但也有一般熟人、一夜情对象和性交易对象;另有多性伴现象存在,最多的有11个以上的性伴.结论:女大学生中的性行为率较高,她们中存在性暴力和性滥等问题.     

Determinants of consistent condom use among adolescents and young adults attending a tertiary educational institution in Ile-Ife, Nigeria

OBJECTIVES: This study evaluated the determinants of consistent condom use among adolescents and young adults aged 15 - 29 years. METHODS: This was a cross-sectional survey to which 600 (300 of each gender) adolescents/young adults who had never married were recruited. Information was collected from respondents by means of a purpose-designed, self-administered questionnaire. Information sought includes the respondents' social and demographic characteristics, sexual practices and issues relating to condom use. RESULTS: Five hundred and thirty-six (89.3%) of the 600 questionnaires were suitable for analysis; 372 (69.4%) had had sexual intercourse. A third reported that they were having sex frequently or fairly frequently; 145 (41.7%) had more than one partner while 74 (19.9%) were aware that their partners had other sexual partners. Two-thirds of currently sexually active respondents reported that condoms were readily available and cheap although only 90 (24.2%) reported using condoms consistently. The factors that were statistically significant predictors of consistent condom use among the males were age; younger respondents were more likely to be consistent users (p = 0.015), having more than one sexual partner (p = 0.030) and ability to refuse sex with a partner who would not want to use condom (p = 0.008). Among the females, statistically significant predictors were frequency of sexual intercourse; respondent who had sex frequently were more likely to use condoms consistently (p = 0.018) and having more than one partner (p=0.018). CONCLUSION: Inconsistent condom use is rampant and females were probably disadvantaged as far as condom negotiation is concerned.     

中国未婚大学生性行为和避孕节育现状与需求现况调查

目的 了解中国未婚大学生避孕节育教育与服务的现状及需求,为高校开展避孕节育服务和教育提供参考.方法 采用定量研究方法,根据知情同意原则选择80 000名大学生进行匿名问卷调查.结果 共回收74 258份有效问卷,避孕相关知识知晓率总体水平偏低,女生高于男生,医学类学生高于其他专业学生,差异有统计学意义(P<0.01).70%以上的学生对婚前性行为及未婚同居持宽容态度,但认为有必要学习更多避孕知识的达87.2%;未婚性交发生率为14.4%;性交中每次都采取避孕措施的只有28.7%;未婚性交中导致意外妊娠的比例达25.2%,男生高于女生,本科生高于博士生,差异有统计学意义(P<0.01).科普读物或报刊杂志(70.1%)、网络(54.6%)及同学朋友(41.6%)是大学生获取避孕节育知识的3种最主要途径,大学生最推崇的3种避孕节育知识获取方式是科普读物或报刊杂志(69.2%)、课程教育或专题讲座(61.4%)及网络(48.5%);有性行为史的大学生中57.3%从超市、药店购买避孕药具,只有5.9%通过校医院、保健科获得,而其中51.7%最希望通过超市或药店购买避孕药具,只有9.9%最希望通过学校医院/保健科免费提供而获得;90.1%的大学生认为大学有必要开展避孕节育相关知识教育,39.7%的学生希望以课程教育的形式开展避孕节育教育,64.5%的学生认为大学避孕节育教育应该从大一即开展,越早越好.结论 大学生性观念开放,避孕节育相关知识知晓率低,性行为中意外妊娠发生比例高;大学生对避孕节育知识和方法有迫切的需求,希望通过课程教育等多种形式获得,但如何保障大学生隐秘,使其方便地获取避孕节育服务需进一步探讨.     

Urgent need for contraceptive education and services in Chinese unmarried undergraduates: A multi-campus survey

In order to ascertain prevalence rate of premarital sexual intercourse,unintended pregnancy and abortion,and evaluate associated factors of unintended pregnancy among undergraduates from all over China,the representative sample of unmarried undergraduates was obtained by using a multi-stage,stratified,probability cluster design,and data were collected by using a survey questionnaire.62 326 available responders were gained.11.6% of them acknowledged having experiences of premarital sexual intercourse(standardized prevalence rate of sexual intercourse was 13.8%).31.5% of students active in premarital sex acknowledged undergoing unintended pregnancy.76.2% of pregnant students selected abortion to end it.Of students active in premarital sex,46.2% used contraception at the first sexual intercourse,28.2% replied "always" using contraception in sexual intercourse.The rate of using condoms,oral contraceptives(OCs),and withdrawal among students who had used contraception was 52.0%,31.0%,and 27.2% respectively."No preparation for sex"(40.3%),"pleasure decrement"(32.1%),"won’t-be-pregnancy in occasional sexual intercourse"(30.2%) were their common excuses for using no contraception.The identified risk factors for unintended pregnancy among students active in premarital sex by multivariate analysis were as follows:having no steady lover [having no steady lover vs having a steady lover:odds ratio(OR),1.875;95% confidence interval(CI),1.629-2.158],unaware of the course of conception(unaware vs aware:OR,2.023;95% CI,1.811-2.260),considering abortion not endanger women’s physical and mental health(no endangerment vs endangerment:OR,2.659;95% CI,2.265-3.121),nonuse of contraception(never use vs always use:OR,1.682;95% CI,1.295-2.185).Medical students were not less likely to experience an unintended pregnancy than nonmedical students(OR,1.111;95% CI,0.906-1.287).The substantial proportion of unintended pregnancy among undergraduates indicates a need for convenient and targeted contraceptive education and services.     

What do Malawi Polytechnic first year students know and do about HIV and AIDS?

Background

The Polytechnic introduced a “WHY WAIT?” course to equip first year students with skills to help reduce transmission of Human Immune-deficiency Virus (HIV). Training is conducted during the first week of arrival at college. The study aimed to explore existing knowledge, beliefs and attitudes in order to tailor the training programme to students'' needs.

Methods

This was a cross sectional study. During first day of arrival, first year students available on campus were given a structured self-administered questionnaire which was filled and submitted before the course. Out of 320 questionnaires distributed, 295 were returned representing 92% response rate.

Results

Ten percent (30) had more than one girlfriend or boyfriend. Ninety-seven percent (286) indicated that condoms are not 100% effective towards prevention of HIV while 72% (169) reported that they had never had sexual intercourse before. Of 66 students who had had sexual intercourse before, 30% indicated that they used condoms always during sexual intercourse, 40% used it occasionally while 30% never used condoms. Thirty-two percent (94) reported having an HIV test before and 19% (56) would feel uncomfortable to share a room with an HIV infected person.

Conclusion

The Polytechnic first year students have varying knowledge and practices about HIV and AIDS. There is need to intensify “WHY WAIT?” course to first years during first week at College to help equip them with necessary knowledge and skills to protect themselves against HIV and AIDS.     

流出地校外青少年艾滋病相关危险行为及其影响因素

目的：了解流出地15~24岁未婚校外青少年艾滋病相关危险行为发生情况及影响因素,为对此人群开展相关健康教育提供参考。方法：采用整群抽样方法,抽取某县某所劳务培训和输出机构所有15~24岁未婚校外青少年进行问卷调查。以理性行为理论为基础设计结构式问卷,匿名,在调查员的指导下填写后当场装入信封回收。共收回问卷1 800份,有效问卷1 712份。利用Epidata 3.0建立数据库用SPSS 13.0软件进行统计分析。结果： (1)流出地校外青少年艾滋病危险行为发生率较高,婚前性行为的发生率为18.0%,其中过去3个月中性行为从未使用过安全套的占27.3%,有多性伴者占30.8%,有过商业性行为者占31.0%,有过使用毒品经历占9.7%;艾滋病知识知晓率仅为25.1%;同伴环境较差;(2)性行为中使用安全套与艾滋病知识得分、性关系中能谈论安全套相关;发生多性伴行为与年龄、朋友中有多性伴者、对多性伴的态度、主观规范相关;发生商业性行为与艾滋病知识得分、家庭住址、朋友中有发生商业性行为、主观规范、商业性行为意向相关;静脉吸毒与年龄、艾滋病知识得分、朋友吸毒、主观规范、吸毒意向相关;(3)理性行为理论框架中主观规范和行为意向对校外青少年艾滋病危险行为的发生影响较大。结论：流出地校外青少年感染艾滋病的危险性主要表现为缺乏相关知识和应对不良的伙伴压力的能力,应帮助他们树立良好的行为规范,外出打工前期是对校外青少年进行相关健康教育的“关键期”。     

High-risk STD/HIV behavior among college students

The current sexually transmitted disease (STD) epidemic in adolescents has led to concern about the potential for spread of the human immunodeficiency virus (HIV). In 1988, a total of 5514 students in first-year community college and university classrooms across Canada were surveyed to assess STD/HIV-related knowledge, attitudes, and risk behavior. The students' mean age was 19.7 years; the male-to-female ratio was 1:1.4. Students knew more about HIV/acquired immunodeficiency syndrome than other STDs. Of the 74.3% of the men and 68.9% of the women who were coitally active, 14.3% of the men and 18.6% of the women had participated in anal intercourse and 5.5% reported a previous STD. Only 24.8% of the men and 15.6% of the women always used a condom during sexual intercourse. Among the 21.3% of the men and 8.6% of the women with 10 or more partners, regular condom use was reported in only 21% and 7.5%, respectively. In this subgroup, anal intercourse was practiced by 26.9% of the men and 34.8% of the women, and previous STD was reported by 10.6% and 24.2%, respectively. Factors associated with not using a condom included number of sexual partners, embarrassment about condom purchase, difficulty discussing condom use with a partner, use of oral contraceptives, insufficient knowledge of HIV/STDs, and the belief that condoms interfere with sexual pleasure. These factors are potentially amenable to change. Effective, behaviorally focused educational programs are needed to improve condom use and reduce STD/HIV risk.     

三门峡市社区美沙酮维持治疗基线调查分析

目的:了解进入社区美沙酮维持治疗(Methadone maintenance Treatment,MMT)门诊吸毒人群的吸毒行为、性行为等特征,为艾滋病防制措施的制定提供依据。方法:对进入三门峡市社区MMT门诊的220名戒毒人员进行人口学特征、吸毒行为和性行为规律等问卷调查。结果:男性占82.71%,女性占17.2%,平均年龄为33.86±5.39岁,HIV阳性率0.90%,HCV阳性率为10.9%。吸毒方式以口吸为主,注射吸毒和其他方式混用27人(12.27%)。在静脉注射吸毒者中过去1个月有共用注射器者39人,占17.73%。最近一次发生性行为时使用安全套的64人,占29.09%。104人从未使用过安全套,占47.27%。结论:MMT吸毒者中存在HIV和HCV传播的高危性,在美沙酮维持治疗的同时进行预防艾滋病及其他经血液传播疾病的健康教育和行为干预很有必要。     

合肥市青年男男性行为者梅毒和HIV感染状况分析

目的了解合肥市青年男男性行为者(MSM)梅毒和HIV感染状况以及相关的因素,为对该人群进行梅毒与HIV预防干预提供依据。方法采用应答者驱动招募、关键知情人介绍及在MSM网站上发布广告三种方法招募年轻的男男性行为者,进行匿名问卷调查与HIV和梅毒血清学检测。结果202名调查对象平均年龄为20.7岁,大学及以上学历占66.9%,在校学生为62.4%,63.4%的人自认为是同性性取向,26.7%的人自认为是双性性取向。HIV感染率为1.0%,RPR阳性率为7.0%,TPPA阳性率为13.1%。单因素2检验表明,曾进行过HIV检测、一生中肛交同性性伴4个以上与梅毒感染相关,2值分别为10.944与7.696(均P<0.01)。结论年轻的男男性行为者中梅毒感染情况严重,HIV在该人群中流行条件已经具备,急需在该人群中开展性病艾滋病的高危行为干预,尤其要加强大、中学校学生性病艾滋病知识宣传和健康教育。     

高档娱乐场所服务小姐艾滋病相关因素研究

目的了解广州市番禺区高档娱乐场所服务小姐与艾滋病相关行为特征及艾滋病知识知晓率,为向该人群干预提供依据。方法基于健康信息模型理论,采用整群抽样,匿名自填问卷方法,对355名服务小姐进行调查。结果婚前有性行为的占90.42%,确定曾患过性病者占7.32%,最近5次性关系中5次均使用了安全套的占12.39%;与固定性伴使用安全套者占23.10%;有口交行为的占27.32%,有肛交行为的占3.66%,既有口交又有肛交行为的占2.25%;初中文化程度占52.39%,对艾滋病可以通过3种途径传播传染知晓率为43%,存在婚前多性伴现象。结论高档娱乐场所女性性工作者属艾滋病感染高危人群,应加强高档娱乐场所服务小姐预防艾滋病的宣传教育工作,在此类人群中推广艾滋病自愿咨询检测服务非常必要。     

上海市婚检妇女婚前妊娠情况及其影响因素分析

为了解上海市婚检妇女婚前妊娠情况及其婚前妊娠的因素，作用利用上海３个市区和２个郊县２５８０名婚前体检的未婚妇女的问卷调查资料进行了分析。结果表明，有性经历的对象中，３９．８％曾有过妊娠史；郊县对象曾妊娠的比例明显高于市区对象；农村户口、婚检时年龄较小、文化程度和经济收入较低的对象婚前妊娠的比例较高；妊娠的原因：７７．４％为未用避孕措施，２０．７％为避孕失败，１．９％为准备结婚等其他原因；多元分析影     

Relationship between Contraceptive Knowledge, Cognition and Behaviors among Vocational High School Students

Rise in prevalence rate of sexual activity among middle/high school students have gone with decline in age of sex initiation in recent years. Due to special training purposes and characteristics of student resources, most vocational high school students s…     

门诊性病患者相关知识、态度和行为特征分析

目的分析门诊性病患者的性病相关知识、态度和行为特征,为探索预防性病/艾滋病的干预方法提供基线资料。方法采用横断面研究设计,随机抽取确诊的门诊性病患者156例,进行匿名访谈式问卷调查;获有效问卷151份（有效率为96.79%）。自行设计问卷,问卷内容涉及患者一般情况、性病防治常识、相关态度、高危行为等。结果 20~40岁的患者占71.5%。男性患者与女性患者的性病知识平均得分比较,差异无统计学意义（P〉0.05）。患者认知率较低的性病传播途径有共用马桶或浴缸（66.9%）、共用床单或被褥（49.7%）;认知率较低的非性病传播途径有蚊虫叮咬（68.9%）、接吻（62.3%）。反对婚前性行为和婚外性行为的男性患者比例明显低于女性患者（P〈0.05）。性伴数2人及以上的患者占67.5%;性伴数在10人以上的占11.9%。37.8%的患者在怀疑感染后仍发生性行为;41.1%的患者最近一次性行为未使用安全套;仅74.3%的患者将自己的患病情况告之性伴。结论针对门诊性病患者的防治干预,应充分结合这类艾滋病高危人群的特点,在知识宣传、高危态度和行为引导、诊疗行为指导等方面采取及时、有效的干预策略。     

Attitudes and behaviours of young Indigenous people in Townsville concerning relationships, sex and contraception: the "U Mob Yarn Up" project

OBJECTIVE: To gain some understanding of the attitudes and behaviours of Indigenous young people in Townsville concerning relationships, contraception and safe sex. DESIGN: Cross-sectional study using a computer-assisted self-administered survey and single-sex focus group discussions designed by a Young Mums' Group operating on participatory action principles and acting as peer interviewers. PARTICIPANTS AND SETTING: 171 Indigenous students in Years 9-11 at three high schools and 15 residents of a homeless youth shelter in Townsville, Queensland, 27 April - 8 December 2004. MAIN OUTCOME MEASURES: Self-reported attitudes and behaviour about relationships, sexual intercourse and contraception. RESULTS: 84/183 participants (45.9%) reported past sexual intercourse, with 56.1% commencing intercourse at age 13-14 years. The likelihood of having had sex increased with being male (P=0.001), increasing age, increased perceived sexual activity of peer group (both P=0.000), and drinking alcohol at least weekly (P=0.015). Young women were more likely to report unwanted sexual touching (P=0.031), and less likely to report enjoying sexual intercourse (P=0.001). The main qualitative themes concerned females' reputations, coercion, and denial of female desire. Only 49/80 participants (61.3%) reported always using condoms. The main reasons for not using contraception were "just not thinking about it", shame, and problems with access. Despite having reasonable knowledge about contraception, most lacked the confidence and negotiation skills to communicate with partners about condom use. CONCLUSIONS: Like teenagers elsewhere, Indigenous teenagers in Townsville are becoming sexually active at a young age, and not practising safe sex reliably. The need to protect their reputations puts young women at risk by not being prepared for safe sex by carrying condoms.     

Sexual activity and condom use in high school students.

OBJECTIVE: To determine the level of sexual experience and condom use among Year 9 high school students. DESIGN: Self-administered questionnaire to all Year 9 students attending a personal development workshop. SETTING: The study was carried out in two regional high schools in New South Wales, one in an urban area and the other in a rural area. PARTICIPANTS: A total of 253 students in Year 9 at the two high schools; only two students declined to participate. RESULTS: Seventy-one students (28.1%) had had intercourse at least once. There was no statistically significant difference between the percentage of male and female students or rural and urban students who had had intercourse. Thirty students (42.3%) always used condoms, 35.2% used them sometimes and the other sexually active students had never used them. The commonest reasons for non-use were unplanned sex, unavailability or no time. CONCLUSIONS: The unpredictability of teenage sexual activity may mean that condoms are not available at the crucial time. Girls appear to have more difficulty in asking for condoms to be used, but the numbers are two small in this survey to draw definite conclusions. If both pregnancy and sexually transmissible diseases are to be prevented among adolescents, sex education must encourage condom use as the first method of contraception for this group and emphasise the need for consistent availability and use.     

Improving Sexual and Contraceptive Behaviours of Unmarried Female Youth with First Trimester Induced Abortion in Sichuan, China

Along with concerns about the spread of HIV/STDs in China comes increasing evidence of risky sexual behaviours among Chinese youth. Proportion engaging in premarital sex have reportedly increased, and is usually unprotected. Unwanted pregnancies, abortion…     

Sexual, reproductive and contraceptive risk factors for carcinoma-in-situ of the uterine cervix in Sydney

Sexual, reproductive and contraceptive risk factors were investigated in a matched community-based case-control study of carcinoma-in-situ of the uterine cervix in Sydney. The risk was related strongly to the number of sexual partners: women who had had seven or more sexual partners in a lifetime had a six-fold increased risk compared with those with one or no partner. Early age at first sexual intercourse was also a risk factor, but this effect was reduced substantially after adjustment for the number of partners, with only a two-fold excess risk persisting for those with first intercourse before the age of 16 years as compared with those whose first sexual intercourse was at the age of 25 years or later. The long-term use of oral contraceptive agents was associated with an elevated risk (relative risk, 2.3 for more than six years of use); this effect was maintained for both oestrogen and progestogen doses. The risk increased with the number of induced abortions that had been undergone (relative risk, 2.2 for two or more abortions), but this effect was not statistically significant. A protective effect was found for women who had had a tubal ligation, for those who practised the rhythm method of birth control, and for women who breastfed. It is possible that these reduced risks may relate to unmeasured variables of life-style.     

南宁市暗娼HIV感染调查及高危行为分析

目的了解暗娼艾滋病危险行为和感染状况。方法采取整群随机抽样方法抽取379名暗娼，进行面对面无关联匿名问卷调查并采血作HIV和梅毒抗体的检测。结果艾滋病基本知识总答对率为84．14％，与2005年相比有了明显的提高。第一次发生性行为年龄小于或等于20岁占70．14％，第一次发生商业性行为年龄小于或等于20岁占55．88％。性伴侣数多，平均每天性伴侣2．2个，最近一次发生商业性行为安全套使用率73．1％，不用的主要原因有客人／本人不愿用占47．94％。HIV抗体阳性率0．53％。梅毒抗体阳性率3．68％。结论暗娼人群呈现低龄化趋势，应加强对青少年性病艾滋病的宣传教育工作。     

The relationship of tubal infertility to barrier method and oral contraceptive use

We studied past contraceptive use in 283 nulliparous infertile women who had a diagnosis of tubal adhesions or occlusion and in 3833 women admitted for delivery at seven collaborating hospitals from 1981 to 1983. The relative risk of tubal infertility associated with barrier contraceptive use or oral contraceptive use was calculated using multivariate logistic regression to control for confounding by region, age, religion, education, smoking, number of sexual partners, time since menarche, and use of other contraceptive methods. Women who had ever used barrier methods of contraception were at a significantly decreased risk of tubal infertility (relative risk = 0.6; 95% confidence limits, 0.5 and 0.8). When type of barrier method used for the longest time was evaluated, those who used the diaphragm or condoms plus spermicides were at lower risk than those who used condoms or spermicides alone. Overall, past use of oral contraceptives neither increased nor decreased a woman's risk of tubal infertility, but there was evidence that the association between oral contraceptives and tubal infertility may vary by the amount of estrogen and type of progestogen in the oral contraceptive used. We conclude that contraceptive users who use barrier methods that combine both a mechanical and chemical barrier, such as diaphragms, cervical caps, and condoms plus spermicides, have the clearest protection against tubal damage.