娱乐场所女服务员性病艾滋病知识和高危行为调查

目的 调查龙岩市娱乐场所女服务员性病艾滋病知识掌握情况及与HIV感染相关危险行为发生状况，探讨HIV／AIDS流行趋势，为制定适合本地情况的HIV／AIDS干预措施提供科学依据。方法 分层随机抽取娱乐场所女服务员456人为调查对象，采用问卷调查进行AIDS有关知识、避孕套使用及高危行为的调查。结果 89．7％的女性服务员曾提供过商业性服务，女性服务员对经血、性接触传播途径认识率较高，分别为56．8％和55．9％，但仅有34．2％的人认为母婴传播能感染艾滋病；在过去的一个月中与朋友发生性关系每次都使用避孕套的占12．9％，最近一次性生活使用的占32．7％。结论 龙岩市娱乐场所女服务员提供性服务的比率较高，且AIDS知识知晓率低，应在娱乐场所女服务员开展STD／AIDS防治知识和安全性行为的宣传教育活动，并实施干预，以减少HIV的性传播。     

HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis.

BACKGROUND AND PURPOSE. Peer norms influence the adoption of behavior changes to reduce risk for HIV (human immunodeficiency virus) infection. By experimentally intervening at a community level to modify risk behavior norms, it may be possible to promote generalized reductions in HIV risk practices within a population. METHODS. We trained persons reliably identified as popular opinion leaders among gay men in a small city to serve as behavior change endorsers to their peers. The opinion leaders acquired social skills for making these endorsements and complied in talking frequently with friends and acquaintances. Before and after intervention, we conducted surveys of men patronizing gay clubs in the intervention city and in two matched comparison cities. RESULTS. In the intervention city, the proportion of men who engaged in any unprotected anal intercourse in a two-month period decreased from 36.9 percent to 27.5 percent (-25 percent from baseline), with a reduction from 27.1 percent to 19.0 percent (-30 percent from baseline) for unprotected receptive anal intercourse. Relative to baseline levels, there was a 16 percent increase in condom use during anal intercourse and an 18 percent decrease in the proportion of men with more than one sexual partner. Little or no change was observed among men in the comparison cities over the same period of time. CONCLUSIONS. Interventions that employ peer leaders to endorse change may produce or accelerate population behavior changes to lessen risk for HIV infection.     

The use of the female condom by women in Brazil participating in HIV prevention education sessions.

OBJECTIVES: To study HIV-positive women and women at risk of becoming infected with HIV who attended HIV prevention education group sessions at a university hospital in Brazil and to compare the use of the female condom and the male condom by these two groups of women. METHODS: The study subjects were 165 women participating in HIV prevention education group sessions at the Medical School Hospital of Ribeir?o Preto of the University of S?o Paulo, in the city of Ribeir?o Preto, S?o Paulo, Brazil. Women could be enrolled in the study from August 2000 to June 2001, and the follow-up observation time period was from August 2000 to July 2001. Male condoms and female condoms were freely distributed to all the participants at the end of each educational session and also at the end of each follow-up visit that the participants made. Each woman took part in an initial interview and was asked to return monthly. At each follow-up visit an additional short interview was carried out in order to investigate use of the male condom and of the female condom. Variables that were examined for the study included age, education, ethnic group, marital or relationship status, number of children, the women's use of male condoms and female condoms, commercial sex (whether the women had ever had sex in exchange for money, gifts, or favors), and previous knowledge of the female condom. RESULTS: The 165 women studied fell into the following three categories: 132 of them (80.0%) were HIV-positive, 26 of them (15.8%) had a sexually transmitted disease (STD) other than HIV and did not have an HIV-positive partner, and 7 of them (4.2%) had an HIV-positive partner but did not have HIV or any other STD. The women ranged in age from 15 to 64 years, with a mean of 30.3 years. Of the women in the study, 69.7% of them were married or were cohabitating, and 90.9% of them had a sexual partner. Just over two-thirds of the women had seven years of formal schooling or less. Out of 163 women, a total of 31 of them (19.0%) had never used the male condom with a partner, and 49 of the 163 (30.1%) had not used a male condom at the time of the last sexual intercourse. Out of the 165 women, 74 of them (44.8%) returned for at least one follow-up visit. Of these 74 women, 58 of them (78.3%) reported using the female condom between the initial interview and the first follow-up visit. The majority of the 74 women who returned for a visit liked using the female condom, and the women reported that their partners also generally accepted the female condom. In comparison to women at risk of HIV, HIV-positive women were more likely to have used the male condom with a partner before the initial interview. Women who continued returning over a longer follow-up period were more likely to have used the female condom at the time of the last sexual intercourse. No association was found between female condom use at the time of last sexual intercourse and the woman's HIV infection status. CONCLUSIONS: In comparison to the women at risk of HIV, the HIV-positive women in our study were more likely to use male condoms with their partners, to return for follow-up visits, and to have a longer follow-up period. The acceptance of the female condom among the HIV-positive women in this study, as reported at their first follow-up visit, appears to be similar to the acceptance of the female condom among women in general in Brazil.     

AIDS education in Tanzania: promoting risk reduction among primary school children.

OBJECTIVES: The purpose of this study was to test the effects of an education program in Tanzania designed to reduce children's risk of human immunodeficiency virus (HIV) infection and to improve their tolerance of and care for people with acquired immunodeficiency syndrome (AIDS). METHODS: A randomized controlled community trial including baseline and 12-month follow-up surveys was employed. Public primary schools in the Arusha and Kilimanjaro regions of Tanzania were stratified according to location and randomly assigned to intervention (n = 6) or comparison (n = 12) conditions. Of the 1063 sixth-grade students (average age: 13.6 years) who participated at baseline, 814 participated in the follow-up survey. RESULTS: At follow-up, statistically significant effects favoring the intervention group were observed for exposure to AIDS information and communication, AIDS knowledge, attitudes toward people with AIDS, and subjective norms and behavioral intentions toward having sexual intercourse. A consistent positive but nonsignificant trend was seen for attitudes toward having sexual intercourse and for initiation of sexual intercourse during the previous year (7% vs 17%). CONCLUSIONS: It is feasible and effective to train local teachers and health workers to provide HIV/AIDS education to Tanzanian primary school children.     

The relationship between women''s attitudes about condoms and their use: implications for condom promotion programs.

A survey of 759 women attending contraceptive care clinics revealed that a majority of women endorsed condom use as an important way to reduce the spread of AIDS (acquired immunodeficiency syndrome); 82 per cent reported past use of condoms, but only 14 per cent reported using condoms in addition to another form of contraception to prevent infection with sexually transmitted pathogens, including HIV (human immunodeficiency virus). Acceptance of condom advertisement, perceived male and peer acceptance of condoms, and the effect of condom use on the enjoyment of sexual intercourse predicted condom use.     

云南省2015年新报告988例非婚异性传播HIV/AIDS病例性行为及影响因素分析

目的 了解人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者/获得性免疫缺陷综合征（acquired immunodeficiency syndrome,AIDS）患者经非婚异性性接触感染的高危性行为特点及其影响因素,为控制艾滋病经性传播策略制定提供科学数据。方法 连续抽取云南省2015年新报告非婚异性传播HIV/AIDS病例,进行问卷调查,了解调查对象获知感染HIV前后危险行为等情况。结果 调查男性498人、女性490人。获知感染HIV前一年内有商业性行为的比例为39.88%（男性占68.67%,女性占10.61%）,性别差异有统计学意义（χ²=352.797,P<0.001）,地点集中在路边店/街头,坚持使用安全套比例仅为8.38%;71.36%有临时性伴间性行为（男性占64.46%,女性占78.37%）,且性别差异有统计学意义（χ²=23.379,P<0.001）,临时性伴主要是朋友/熟人（占82.52%）;存在多种性行为交叉和叠加。获知感染HIV后仍有12.96%发生高危性行为,仅31.86%愿意告知性伴自身的感染状况。结论 异性传播影响人群扩大,控制异性传播的策略应转为在强化高危人群干预工作基础上,倡导全民推广使用安全套的普遍防护,宣传教育时增加风险行为识别和安全性行为警示性教育,艾滋病感染者随访管理工作中应评估其传播风险并采取相应措施。     

15-month followup of women methadone patients taught skills to reduce heterosexual HIV transmission.

Heterosexual contact with intravenous drug users accounts for a growing proportion of cases of acquired immunodeficiency syndrome (AIDS) among women. In an earlier study designed to reduce sexual risk behavior, the authors randomly assigned 91 methadone maintained women to information-only or skills-building conditions. Modest outcomes favored participants in the skills-building group. In this 15-month followup of 62 remaining study participants, skills-training group members were more likely than controls to use condoms. In comparison with controls, members in the skills-building group felt more comfortable talking about safe sex, perceived themselves as more able to reduce their exposure to AIDS, but were more likely to attribute AIDS risk to luck. No associations were found between group condition and number of sexual partners or frequency of buying and carrying condoms. Some gains associated with a group intervention tended to be maintained over time, indicating that preventive interventions composed of multiple sessions and conducted in treatment settings may have promise as useful strategies to prevent human immunodeficiency virus (HIV) infection. Nevertheless, decay was evident in other domains, suggesting that prevention specialists should consider booster sessions or other means of maintaining changes in risk behavior.     

沈阳市性病患者艾滋病／性病的知信行调查

目的了解沈阳市性病患者艾滋病／性病知识、态度和行为等情况，为在本市性病患者中采取有针对性的预防艾滋病干预措施提供参考。方法对沈阳一所医院性病门诊就诊患者进行自愿匿名的问卷调查，由专业人员进行现场督导，并现场收回问卷。结果性病患者对艾滋病知识有一定的了解，有91．4％的被调查者对艾滋病存有恐惧心理，与妻子／丈夫或女／男朋友以外的人发生性关系时，每次都能用安全套的占17．2％，与妻子／丈夫和女／男朋友发生性关系时使用安全套的仅占8．6％。结论性病患者是感染艾滋病病毒的高危人群，多渠道提高该人群的艾滋病相关知识水平，并开展行为干预工作十分必要。     

Efficacy of an HIV prevention program among female adolescents experiencing gender-based violence

OBJECTIVES: We examined the efficacy of an HIV prevention intervention among African American female adolescents reporting a history of gender-based violence. METHODS: In this analysis of a subgroup of participants involved in a randomized controlled trial, consistent condom use, psychosocial mediators associated with HIV-preventive behaviors, and presence of sexually transmitted diseases were assessed at 6- and 12-month follow-ups. The intervention emphasized ethnic and gender pride, HIV knowledge, condom attitudes, healthy relationships, communication, and condom use skills. RESULTS: Relative to the comparison condition, participants randomized to the intervention reported using condoms more consistently, had fewer episodes of unprotected vaginal sex, engaged in a greater proportion of protected intercourse acts, were more likely to have used a condom during their most recent intercourse, were less likely to have a new sexual partner, were less likely to have a sexually transmitted disease, and demonstrated more proficient condom skills. CONCLUSIONS: Given the substantial prevalence of gender-based violence among female adolescents and the associations observed between gender-based violence, HIV risk, and HIV infection, it is essential that HIV interventions involving young women address partner violence.     

外展服务对性服务小姐艾滋病行为干预效果评价

[目的]评价外展服务对城乡结合部的性服务小姐的艾滋病认知水平和行为改变的效果。[方法]通过外展服务，工作人员主动深入现场，与目标人群建立信任关系，开展健康咨询和健康教育，提供性病诊疗建议。实施发放宣传资材、发放安全套、增加安全套的可获得性、一对一访谈、观看录像等干预措施。[结果]提高了性服务小姐的艾滋病知识的正确知晓率，坚持每次使用安全套的率和最近一次性生活中安全套使用率分别从干预前的20.00%、27.34%提高到于预后的51.28%和60.02%。[结论]外展服务干预是预防艾滋病的有效措施，可以提升性服务小姐对艾滋病的正确知晓率，纠正错误观念，改变高危行为，提高安全套的使用率。     

Sexual behavior and condom use among urban women attending a family planning clinic in the United States

In this paper I present data on risky sexual behavior and condom use among a sample of 100 adult women who attended a family planning clinic in an urban area of the United States. Although the women in this study protected themselves from pregnancy by using contraception, they engaged in sexual behaviors that put them at risk for sexually transmitted human immunodeficiency virus (HIV), including unprotected oral, anal, and vaginal intercourse, and sex with risky partners. Alcohol and drug use were also common among the women in this sample. Almost half of the participants reported a history of sexually transmitted infections. Health assessment for women using contraception should include assessment of risk factors for sexually transmitted HIV infection. All women should be counseled regarding methods of reducing their risk for HIV.     

Reductions in HIV risk-associated sexual behaviors among black male adolescents: effects of an AIDS prevention intervention.

BACKGROUND. The number of reported cases of acquired immune deficiency syndrome (AIDS) is increasing disproportionately among Blacks in the United States. The relatively high incidence of sexually transmitted diseases among Black adolescents suggest the need for AIDS prevention programs to reduce their risk of sexually transmitted human immunodeficiency virus (HIV) infection. METHODS. Black male adolescents (n = 157) were randomly assigned to receive an AIDS risk reduction intervention aimed at increasing AIDS-related knowledge and weakening problematic attitudes toward risky sexual behavior, or to receive a control intervention on career opportunities. RESULTS. The adolescents who received the AIDS intervention subsequently had greater AIDS knowledge, less favorable attitudes toward risky sexual behavior, and lower intentions to engage in such behavior than did those in the control condition. Follow-up data collected 3 months later revealed that the adolescents who had received the AIDS intervention reported fewer occasions of coitus, fewer coital partners, greater use of condoms, and a lower incidence of heterosexual anal intercourse than did the other adolescents. CONCLUSIONS. These results suggest that interventions that increase knowledge about AIDS and change attitudes toward risky sexual behavior may have salutary effects on Black adolescents' risk of HIV infection.     

Effectiveness of an intervention to reduce HIV transmission risks in HIV-positive people.

BACKGROUND: As many as one in three HIV-positive people continue unprotected sexual practices after learning that they are HIV infected. This article reports the outcomes of a theory-based intervention to reduce risk of HIV transmission for people living with HIV infection. METHODS: Men (n=233) and women (n=99) living with HIV-AIDS were randomly assigned to receive either (1) a five-session group intervention focused on strategies for practicing safer sexual behavior, or (2) a five-session, contact-matched, health-maintenance support group (standard-of-care comparison). Participants were followed for 6 months post-intervention. RESULTS: The intervention to reduce risk of HIV transmission resulted in significantly less unprotected intercourse and greater condom use at follow-up. Transmission-risk behaviors with non-HIV-positive sexual partners and estimated HIV transmission rates over a 1-year horizon were also significantly lower for the behavioral risk-reduction intervention group. CONCLUSIONS: This study is among the first to demonstrate successful HIV-transmission risk reduction resulting from a behavioral intervention tailored for HIV-positive men and women.     

Psychosocial Correlates of HIV Sexual Protective Behavior Among Puerto Rican Women Residing in the Bronx,New York

In this study, correlates of HIV sexual protective behavior, in the form of condom use, were examined within a population of urban women identified as at increased heterosexual risk for HIV infection. Hierarchical regression analyses were used to analyze data collected via structured interviews for 187 Puerto Rican women recruited from the waiting areas of a comprehensive health clinic in the Bronx, New York. Increased condom use with primary partners was associated with higher levels of mastery, more non-Hispanic acculturation, and greater adherence to traditional female gender roles. Increased condom use with nonprimary partners was associated with higher HIV/AIDS prevention self-efficacy. Thus, primary versus nonprimary relationships appeared to represent distinct contexts for HIV sexual risk behavior, with implications for different intervention strategies based upon relationship contexts for Latina women.     

Life optimism, substance use, and AIDS-specific attitudes associated with HIV risk behavior among disadvantaged innercity women

The development of more effective human immunodeficiency virus (HIV) prevention programs for disadvantaged women requires identification of factors associated with risk. In the present study, 158 women - all of whom met criteria indicative of HIV risk - were recruited in innercity primary healthcare clinics and administered measurements that assessed variables in three domains believed pertinent to HIV sexual risk behavior: (1) substance use in the past 3 months, (2) acquired immunodeficiency syndrome (AIDS)-specific cognitive and attitudinal factors, including AIDS risk knowledge, condom attitudes, perceived risk for AIDS, behavior change intentions, and perceived self-efficacy, and (3) life context variables, including self-esteem, fatalism, personal optimism toward the future, and current life satisfaction. When women were categorized into highest and lower groups based on their recent risk behavior, AIDS-specific cognitive and attitudinal factors, as expected, differentiated the groups. However, women at highest risk for HIV also most often used a variety of substances and scored lower in self-esteem, held views more characterized by personal fatalism and low optimism concerning the future, and had greater life dissatisfaction than women at lower risk. HIV prevention programs for disadvantaged women require attention not only to AIDS-specific knowledge, attitudes, and skills development but also to broader issues of life context that, if unaddressed, may limit women's ability and motivation to reduce risk for HIV/AIDS.     

深圳口岸交通员工艾滋病相关知识、态度、行为调查

[目的]了解深圳口岸交通员工艾滋病相关知识、态度和行为现状，为对其进行健康教育和行为干预提供科学依据。[方法]采用匿名自填问卷的方式，于2007年3-6月对深圳1：3岸皇岗、罗湖、沙头角3个体检点的交通员工进行艾滋病相关知识、态度和行为的问卷调查。[结果]约80．0％的交通员工知道艾滋病经性接触、血液和母婴传播。但仍有相当一部分交通员工对艾滋病有不正确的认识，如“蚊虫叮咬不会传染艾滋病”这个问题的回答正确率只有41．2％。交通员工的自我保护意识不强，例如“不与他人共用剃须刀、牙刷”这个问题的回答正确率只有41．7％。不同年龄段、文化程度、HIV知识及格与否的交通员工对HIV相关行为的态度不同。约有50％左右的交通员工表示出对艾滋病感染者的宽容。54．0％的交通员工承认自己有过婚前性行为，26.4％的交通员工承认有过婚外性行为。743（13．0％）人自报告曾经与性服务小姐（暗娼）有过性关系。交通员工在商业性性行为中安全套使用率很低，在自报告与性服务小姐（暗娼）发生性行为的743人中，经常使用的占6．2％；每次都用的仅占3．5％。[结论]深圳口岸交通员工对艾滋病有所了解，但仍然缺乏全面的认识，安全性行为的比例也不高。建议进一步加强对交通员工的健康教育和行为干预，提高他们的自我防病能力。     

A school-based AIDS education programme for secondary school students in Nigeria: a review of effectiveness.

Nigerian secondary school students are becoming sexually active at an increasing earlier age. Sexually active students are at risk of contacting STDs, including HIV infection. As a result, health education initiatives to increase level of knowledge, influence attitudes and encourage safe sexual practices are being implemented in schools, but the effectiveness of these programmes have not been evaluated. In this study, the knowledge, attitude and sexual risk behaviors of 223 students who received a comprehensive health education intervention were compared with 217 controls. At post-test, intervention students exhibited greater knowledge about HIV/AIDS transmission and prevention (P < 0.05). Intervention students were less likely to feel AIDS is a white man's disease and were more likely to be tolerant of people living with the disease (P < 0.05). After the intervention, the mean number of reported sexual partners among the experimental students significantly decreased from 1.51 to 1.06, while it increased from 1.3 to 1.39 among the controls. Among the intervention students there was also an increase in consistent use of the condom and the use of the condom at last sexual intercourse. We conclude that students can benefit from specific education programmes that transmit important information necessary to prevent risky behavior, and improve knowledge and attitudes on HIV/AIDS.     

南昌市娱乐场所服务小姐艾滋病的KAP干预研究

目的调查南昌市娱乐场所服务小姐的艾滋病相关知识、态度和性行为的变化情况,为制定和评估AIDS预防控制策略提供依据。方法运用统一调查问卷,于干预前对娱乐场所内的145名服务小姐进行基线调查,并对她们进行以健康教育、安全套推广、改善求医行为为主要内容的综合干预,干预结束后再次对106名服务小姐进行调查以评价干预效果。结果干预后服务小姐艾滋病预防知识知晓率有显著提高。性行为中安全套的使用率明显上升,在与非固定性伴性行为中,最近1次安全套的使用率由干预前的86.90%上升到干预后的97.17%(P<0.05);最近1 w和最近1个月每次都用安全套的使用率分别由86.21%、84.83%上升为94.34%(P<0.05)、92.45%(P<0.05)。在个人求医态度方面,自己购药比例和去私人诊所就诊比例下降,去公立医院就诊比例上升。结论通过对娱乐场所内服务小姐开展预防艾滋病的综合干预,能有效地降低这些高危人群的艾滋病感染率,取得良好的防制效果。     

Preventing the high-risk sexual behavior of adolescents: focus on HIV/AIDS transmission, unintended pregnancy, or both?

Adolescents are at high risk for negative health outcomes associated with unprotected sexual intercourse including infection with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and unintended pregnancy. That unprotected sexual intercourse is the risk behavior common to both problems has not been fully capitalized on in prevention programs. Limited knowledge about the effects of type-of-outcome expectancy (i.e., disease vs. pregnancy) on the association between risk perceptions and precautionary or health-protective sexual behavior makes it difficult to determine what preventive approach would be most effective with adolescents. The literature suggests that pregnancy prevention is a greater concern for adolescents than disease prevention. This review focuses on the implications of these differential risk perceptions for HIV/AIDS prevention programs targeting adolescents.     

Misunderstanding of 'safer sex' by heterosexually active adults.

To assess the understanding of safer sex among heterosexual adults, people enrolled in human immunodeficiency virus (HIV) education trials at a sexually transmitted disease (STD) clinic and a university student health service were surveyed concerning sexual behavior with their latest reported partner. Of 646 sexually active persons enrolled in the trials, 233 (36 percent) reported having had safer sex with their latest partner; 124 of them (53 percent) also reported having vaginal or anal intercourse without a condom during that sexual encounter. Among the 124 who reported safer sex despite having intercourse without a condom, only 23 percent reported asking partners about their HIV status, 46 percent had asked about intravenous drug use, and 47 percent had asked about the number of prior sexual partners. For 34 percent of those surveyed, the length of the sexual relationship with their latest partner was 1 month or less, and 18 percent estimated that this partner had had 11 or more prior sexual partners. STD clinic participants characterized intercourse without a condom as safer sex more often than student health service enrollees (76 percent versus 39 percent, P < 0.001). The concept of safer sex is often misunderstood by persons engaging in behavior at risk for HIV transmission, and the level of misunderstanding differs among samples. Interventions to reduce transmission of HIV must confront misconceptions about the risk of sexual intercourse without condoms and include specific instructions understood by the targeted group.