暗娼及嫖客双向干预模式研究

目的评价暗娼单纯干预及暗娼和嫖客的双向干预效果,探索干预模式。方法通过当地三轮车协会及娱乐场所业主动员研究对象参与,开展为期1年的健康教育和干预。对双向干预的暗娼和嫖客以及单纯干预的暗娼艾滋病相关知识知晓情况及相关行为进行干预前后调查。结果干预前单纯干预点与双向干预点地区暗娼艾滋病3种传播途径知晓率分别为38．38％和58．04％,全部问题回答正确率分别为21．21％和27．68％,主动检测HIV分别为7．78％和4．46％;嫖客最近1次与暗娼性交安全套使用率仅56．58％,自备安全套仅有6．97％。干预后,双向干预点暗娼及嫖客在“3种传播途径”正确回答率、最近1次安全套使用率、HIV检测率均有提高;双向点的暗娼问题全部回答正确、正确回答3种传播途径、HIV检测、最近1次安全套使用率分别为37．25％、91．50％、16．00％和83％,均高于单纯干预点。结论开展双向干预,同时将暗娼和嫖客作为重点人群干预,可以提高干预效果。     

294名性服务人员的艾滋病知识、行为、HIV感染调查

[目的]了解性服务小姐的艾滋病知识、行为、HIV感染状况，更好地开展健康教育、行为干预。[方法]由专业人员制订调查方案并设计调查表，现场问巷同时采集5ml静脉血样。[结果]共查294人，她们对所调查的艾滋病传播途径、预防措施回答正确率均高于75．85％、非传播途径勾45．58％～84．35％、进行商业性行为时每次都使用安全套的人均少于51，30％。最近1次未用主要原因为感观认定客人无病（占33．33％）、客人增加报酬（占29．55％）。HIV抗体均为阴性。[结论]性服务人员大多数已掌握了预防艾滋病的理论知识，在行动中安全套使用率却很低。在开展健康教育、行为干预时，重点应及时纠正其进行商业性行为时错误观念，同时加强对男方艾滋病健康教育、来改变其高危行为。     

256名性服务人员性病艾滋病知识、行为、感染情况调查

[目的]了解性服务小姐的艾滋病性病知识、行为、感染状况,更好地开展键康教育、行为干预.[方法]事先制订调查方案并设计调查表,现场问卷同时采集5 ml静脉血样和宫颈表面分泌物检测抗-HIV及衣原体.[结果]共查256人,她们对所调查的艾滋病传播途径、预防措施回答正确率为39.45%～98.1%;最近1次与客人在一起时使用安全套的占51.95%,高档娱乐场所（62.24%）显著高于低档娱乐场所（18.33%）,没有用安全套的原因,主要是客人不愿意用占83.74%;过去曾患过性病占10.94%;HIV抗体均阴性,衣原体检测阳性率24.37%.[结论]性服务人员对艾滋病有关知识回答正确率较低、安全套使用率低.应加大行为干预力度,低档娱乐场所应作为干预工作的重中之重.     

Social and behavioral factors associated with condom use among female commercial sex workers (CSWs) in tarlac, the Philippines

This study examines social and behavioral factors associated with condom use among female commercial sex workers (CSWs) in Tarlac, the Philippines. One hundred and twenty-one CSWs who visited a social hygiene clinic for regular check-ups were asked to fill out a self-administered questionnaire with thirty-one items. More than 80% of the respondents had experience of using condoms with clients. However, only 48% of them used consistently. Six factors, level of education, knowledge of condom application, knowledge of condom effectiveness for preventing AIDS, knowledge of AIDS, use of other contraceptives, and sex premise managers’ advice about using condoms, were significantly associated with their condom use by bivariate analyses. Following a logistic regression analysis, three variables, education, knowledge of condom effectiveness, and sex premise managers’ advice, were revealed to be independently associated with consistent condom use. We recommend that managers of sex premises take an active role in advocating condom use, and that the effectiveness of condoms as an AIDS preventative be emphasized in future educational and interventional programs.     

某乡镇暗娼艾滋病知识、态度、安全套使用与STD感染调查分析

目的了解乡镇地区暗娼艾滋病知识、态度、安全套使用及性传播疾病（STD）感染状况,为乡镇地区开展健康教育与行为干预提供依据。方法暗娼知情同意后,采取一对一的方式进行问卷调查、STD按要求进行采样检测。结果暗娼文化程度低,艾滋病3条传播途径正确回答率为62.5%～71.3%,所调查暗娼中没有人认为自已可能会感染艾滋病。商业性性行为中能坚持使用安全套的只占7.5%,不使用安全套的原因主要为客人拒绝使用,对方看起来没有性病,从来没有想过要使用安全套。性病总检出率为50.0%,淋病、沙眼衣原体、梅毒、滴虫检出率分别为21.3%、8.8%、13.8%、6.3%。结论乡镇地区暗娼艾滋病知识知晓率低,在商业性性行为中安全套使用频率非常低,性病检出率高,在乡镇娱乐服务场所推广安全套预防艾滋病性病刻不容缓。     

四川省艾滋病行为监测

目的　通过对目标人群进行行为学调查 ,为艾滋病防治规划提供依据。方法　按照艾滋病行为监测方案的操作程序及调查方法对不同的目标人群进行行为监测。结果　高危人群艾滋病传播与预防知识普遍缺乏 ;2 4 84 %的暗娼在上次与客人发生性关系时没有使用安全套 ,只有 2 9 6 4%的吸毒者在最近一次与商业性伴发生关系时使用了安全套 ,只有 30 86 %的长卡司机在与商业性伴发生关系时每次都使用安全套 ;有 2 8 70 %的吸毒者最近 1次与别人共用注射器。结论　根据监测结果调整健康教育的策略 ;干预的重点应放在推广安全套、针具交换等行为干预方面 ;应进一步提高医务人员的认识 ,加强对医务人员的培训 ;在社区大力推行自愿检测咨询工作 ,引导目标人群正确求医行为。     

Interviews with senegalese commercial sex trade workers and implications for social programming

The purpose of the study was to assess the efficacy of the Senegalese pubic policy toward registered sex workers through an interview process examining their backgrounds and evaluating their knowledge of sexual health. Sixty registered sex workers in Dakar, Senegal, were interviews at the Institute d'Hygiene Social (IHS) to investigate patient knowledge of contraceptives and sexually transmitted infections (STIs). Ninety-eight percent of the women reported that, as a result of their visits to the clinic, they had increased precaution in their trade by demanding their clients use condoms and refusing clients who did not comply. Nearly 96% of the women were able to define the three main ways by which HIV is contracted, while 100% of the women reported that they used male condoms with their clients and would refuse clients who rejected the use of condoms. Senegal's proactive policy toward the safeguarding of women's health and the containment of HIV/AIDS through the legalization and monitoring of sex workers can serve as an example for successful strategies in the fight against the global spread of HIV/AIDS.     

暗娼安全套使用及其影响因素的研究

目的 了解四川和云南两省暗娼安全套使用情况及其影响因素。方法 通过社会学小组座谈、个人深入访谈和流行病学横断面问卷调查，收集暗娼的社会背景、性病艾滋病知识、性行为特点和安全套使用情况等资料。结果 商业性性行为中大多数暗娼不能坚持每次使用安全套；影响安全套使用的因素主要是：嫖客不愿使用、经济原因和安全套不易获得；流行病学调查发现避孕措施也是影响安全套使用的因素(OP=7.623，95％CI3.832～15.165)。结论 四川和云南两省暗娼安全套使用频率较低，嫖客不愿意使用是最主要的原因。     

蒙城县暗娼人群艾滋病防治知识、行为变化趋势分析

目的了解蒙城县2006-2008年娱乐场所暗娼艾滋病防治知识知晓情况及性行为改变情况,为项目的评估提供依据。方法由经过培训的调查员用统一的艾滋病专项调查问卷对娱乐场所的暗娼进行艾滋病知识和行为状况调查。结果蒙城县娱乐场所暗娼的艾滋病防治知识总知晓率从项目开展初期的12.8%（2007年1月）,现已达到77.8%（2008年12月）;暗娼最近一个月在商业性性行为中或与固定性伴使用安全套（每次都用）的比例在3年中均呈上升趋势,但与固定性伴发生性行为时使用率较低。暗娼愿意接受干预的比例也在逐年增加。结论暗娼的艾滋病知识水平的提高和全球基金艾滋病项目的开展促进了其行为改变,应充分利用当前优越的艾滋病防治政策环境,确保各项干预措施落到实处。     

娱乐场所预防艾滋病行为干预的试点研究

目的 探讨在娱乐场所服务小姐中开展预防艾滋病的健康教育和行为干预的方法、效果及可行性。方法 调查员深人现场，采用面对面的深人访谈与咨询，免费分发宣传材料和避孕套，演示避孕套正确使用方法等，运用封闭式调查问卷和定性访谈方法，评价干预效果。结果 干预前后分别调查385人和399人。通过干预，服务小姐艾滋病预防知识水平有显提高，对避孕套预防艾滋病经性传播的态度和信念有明显转变。在与固定和非固定性伴性行为中，最近一次避孕套的使用率分别为63．9％和89．0％；最近三次性行为中，每次都使用避孕套的分别达到39．1％和64．2％，较干预前均有显提高。结论 在娱乐场所服务小姐中开展预防艾滋病的健康教育和行为干预是可行的而且是有效的。     

Interviews with Senegalese Commercial Sex Trade Workers and Implications for Social Programming

Abstract

The purpose of the study was to assess the efficacy of the Senegalese public policy toward registered sex workers through an interview process examining their backgrounds and evaluating their knowledge of sexual health. Sixty registered sex workers in Dakar, Senegal, were interviewed at the Institut d'Hygiene Social (IHS) to investigate patient knowledge of contraceptives and sexually transmitted infections (STIs). Ninety-eight percent of the women reported that, as a result of their visits to the clinic, they had increased precaution in their trade by demanding their clients use condoms and refusing clients who did not comply. Nearly 96% of the women were able to define the three main ways by which HIV is contracted, while 100% of the women reported that they used male condoms with their clients and would refuse clients who rejected the use of condoms. Senegal's proactive policy toward the safeguarding of women's health and the containment of HIV/AIDS through the legalization and monitoring of sex workers can serve as an example for success-ful strategies in the fight against the global spread of HIV/AIDS.     

Beliefs, sexual behaviours and preventive practices with respect to HIV/AIDS among commercial sex workers in Daulatdia, Bangladesh

OBJECTIVES: Despite the rising prevalence of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) since 1994 in Bangladesh, the World Bank found the epidemic to be preventable provided vigorous and prompt action is taken. High-risk heterosexual contact, especially among commercial sex workers (CSWs), is a major mode of transmission. Formulation of relevant and effective prevention programmes for HIV/AIDS requires better understanding of the knowledge, attitudes, behaviours and practices in the high-risk groups. STUDY DESIGN AND METHODS: A cross-sectional survey comprising face-to-face interviews using a structured questionnaire with items on knowledge, beliefs, condom use and other sexually transmitted diseases (STDs). SETTINGS: In total, 300 CSWs were interviewed between July and October 2000 in Daulatdia brothel. Daulatdia is one of the largest river ports in Bangladesh. RESULTS: Although most CSWs had heard of AIDS, correct knowledge of transmission and symptoms was lacking. HIV/AIDS was viewed as a remote threat, over-ridden by immediate economic and survival concerns. Although the majority of CSWs knew that condoms afforded protection against STDs/AIDS, only one-third of sex acts on the last day of work were protected through condom use. CSWs who were married, had been a CSW for less than 5 years, were with a new client, or had two or more clients in last working day reported significantly higher condom use. Client dissatisfaction was the major reason for not using condoms. Many did not obtain treatment for STDs in a timely fashion, if at all. CONCLUSIONS: Bangladesh needs a comprehensive HIV programme that combines clinical and screening measures with behaviour change and communication interventions, along with change in social norms and attention to the rights of CSWs in order to avert a widespread epidemic.     

安徽省项目地区居民艾滋病知识和行为调查分析

目的了解安徽省项目地区全球基金项目两年执行情况，为后3年项目计划提供依据。方法中期评估采用普查和分层整群抽样的方法，在我省8个示范区／全球基金艾滋病项目县分别对性工作者（普查）和感染者／病人、流动人口、居民、学生（分层整群抽样）等人群进行问卷调查。利用项目基线资料评价项目中期效果。结果7336名调查对象的艾滋病知识平均知晓率是83．78％，其中暗娼90．17％、感染者／病人86．90％、流动人口82．61％、居民（重点乡镇）87．38％、居民（非重点乡镇）73．09％、居民（城镇）86．26％、中学生（83．24％）、吸毒人群84．00％（x^2=904．32，P〈0．001）。8个项目县平均知晓率分别为96．95％、92．26％、89．84％、88．32％、85．26％、81．70％、77．60％和77．11％（x^2=392．42，P〈0．001）。暗娼最近1次与客人发生性关系时使用安全套的有303人（84．4％），最近3次每次使用安全套的有264人（73．5％）。感染者／病人最近1次与配偶过性生活时使用安全套有639人（56．7％），最近3次每次都使用安全套的有572人（50．8％）。与基线相比，除了吸毒人群外，所有人群的艾滋病知识知晓率均有不同程度的提高；所有人群对10个艾滋病知识点的答对率都有所提高；暗娼和感染者／病人的安全套使用率有所提高。结论我省项目地区居民的艾滋病相关知识知晓率和安全性行为形成率较项目启动时明显提高，但不同地区和不同人群的知识和行为不平衡，仍需要加大力度全面开展艾滋病健康教育和行为干预工作。     

湖北省三县市暗娼艾滋病知识宣传效果评价

目的了解湖北省大冶、随州、襄城3县市暗娼2007年和2008年艾滋病知识知晓情况和其希望获得相关知识的途径,评价暗娼艾滋病知识干预效果,为以后进一步完善艾滋病健康教育提供依据。方法采用二阶段按比例抽样方法,用暗娼健康调查问卷对3县市暗娼艾滋病知识知晓情况进行调查。结果3县市共调查暗娼1778人,2007年和2008年分别为817人和961人。在艾滋病知识方面,除“正确使用安全套能降低艾滋病传播的危险吗”等3个问题外,3县市暗娼知识回答正确率2008年都比2007年高,其中,“仅与一个忠实的、未感染艾滋病的性伴发生性行为能否降低艾滋病传播的风险”等4个问题两年间的差异有统计学意义。在获得艾滋病知识信息主要来源方面,除“朋友”这项外,其余问题的回答两年间差异均有统计学意义,艾滋病知识主要来源和其最希望获得相关知识的途径均为电视和免费宣传材料。结论暗娼主要来源于洗脚、洗头屋和发廊,说明艾滋病知识健康教育取得了一定效果。     

Cost-effectiveness of the female condom in preventing HIV and STDs in commercial sex workers in rural South Africa

We assessed the cost-effectiveness of the female condom (FC) in preventing HIV infection and other STDs among commercial sex workers (CSWs) and their clients in the Mpumulanga Province of South Africa. The health and economic outcomes of current levels of male condom (MC) use in 1000 CSWs who average 25 partners per year and have an HIV prevalence of 50.3% was compared with the expected outcomes resulting from the additional provision of FCs to these CSWs. A simulation model calculated health and public sector cost outcomes assuming 5 years of HIV infectivity, 1 month of syphilis and gonorrhea infectivity, and FC use in 12% of episodes of vaginal intercourse. Delayed infections and interactions between STDs and HIV were modeled. The simulation was extended to non-CSWs with as few as one casual partner per year. We conducted multiple sensitivity analyses. The program would distribute 6000 FCs annually at a cost of $4002 and would avert 5.9 HIV, 38 syphilis, and 33 gonorrhea cases. This would save the public sector health payer $12,090 in averted HIV/AIDS treatment costs, and $1,074 in averted syphilis and gonorrhea treatment costs for a net saving of $9163. Sensitivity analyses indicate that the economic findings are robust across a wide range of values for key inputs. The program generates net savings of $5421 if HIV prevalence in CSWs is 25% rather than 50.3% and savings of S3591 if each CSW has an average of 10 clients per year rather than 25. A program focusing on non-CSWs with only one casual partner would save $199. We conclude that a well-designed FC program oriented to CSWs and other women with casual partners is likely to be highly cost-effective and can save public sector health funds in rural South Africa.     

女性商业性工作者STD／AIDS检测及安全套使用现状的调查与分析

目的了解安徽省某市女性商业性工作者人群性传播疾病／艾滋病（STD／AIDS）感染及安全套使用情况,为干预和控制性病、艾滋病的蔓延提供依据。方法采用分层方便抽样方法对市区75家中低档娱乐场500名女性商业性工作者进行STD／AIDS检测及安全套使用情况进行调查。结果共调查女性商业性工作者500人,梅毒检出率为2．75％,丙型肝炎检出率为1．00％,未检出HIV阳性者;不同档次场所的女性商业性工作者基本上了解安全套使用相关知识,知晓率为77.80％;女性商业性工作者最近一次安全套使用率为82．20％,不愿意使用的主要原因是客人不愿使用,最近一个月每次均使用率为5300％（但中档场所明显高于低档场所）。结论不同档次娱乐场所的女性商业性工作者虽基本上了解安全套使用相关知识,但每次性行为均使用安全套比率较低,加强商业性工作者尤其是嫖客人群安全套使用知识的宣传教育,提高其安全套的全程正确使用率,应作为今后干预工作的重点。     

Preventive behaviors against HIV transmission adopted by Japanese commercial sex workers (CSWs)

To assess self-protective behaviors of commercial sex workers (CSWs) against HIV transmission, a consecutive study was conducted at an obstetric-gynecology clinic in the largest “soapland” area in Tokyo. Among 208 CSWs interviewed, only half (107) regularly requested (RR) the clients to use condoms. Sixty-two percent of RR had learned from others (“learners”) oral application of condoms while only 39% of NRR (non-regular requesters) did (“non-learners”) (p = 0.001). Seventy-six percent of the learners were only “rarely” or “never” detected by the clients regarding condom application compared with only 23% of the non-learners (p< 0.001). While 90% of additionally recruited 40 NRR reported that they would request condom use by a “suspicious” client, none had experienced violence even when the clients found the secretive application. The oral application of condoms appears to be a transferable and potentially effective preventive behavior. An erratum to this article is available at .     

成都市男男性工作者艾滋病性病知信行定性研究

目的旨在了解成都市男男性工作者艾滋病性病的知信行情况,并为相关健康教育策略制定提供参考。方法运用半结构式访谈法,对访谈对象进行一对一的访谈。结果共调查21名男男性工作者（MB）,年龄中位数为23岁。访谈对象普遍知道的HIV主要传播途径包括血液传播和性传播;普遍认为在同志圈和MB圈内艾滋病性病的感染率较高。21名MB中,16人报告与顾客发生肛交行为时坚持每次使用安全套,5人有时使用。联系客人的方式包括会所老板、MB朋友、常客、网络聊天室、QQ和微信等交友软件。结论 MB人群对于艾滋病性病的一般知识有一定的了解,但仍旧存在一些错误认识,如认为高危行为后及时清洗消毒可以避免HIV感染,肛交中的插入方可以不使用安全套,口交不会传染艾滋病性病等,且存在不坚持使用安全套的现象。应注意消除认识上的误区以及意识与行为间的不一致。     

县级娱乐场所性服务者艾滋病知识与行为调查

目的 了解艾滋病综合防治示范区性服务者艾滋病相关知识与行为状况，为改善其性行为干预提供依据。方法 由当地卫生专业人员担任调查员，采取单独面对面访谈的形式，记录并完成问卷的填写。结果512名性服务者艾滋病相关知识的总体知晓率为74．6％，其中对防治知识、传播途径和非传播途径的知晓率分别为68．5％，88．4％，73．2％。20岁年龄段对传播途径的知晓率最高，为89．5％，30岁年龄段对传播途径的知晓率最低，为58．0％。宴际获得知识途径的前3位为电视（85．9％）、招贴画和挂图（57．8％）、报纸杂志，希望获得知识的途径前3位．则为电视（76．8％）、医生（40．0％）和报纸杂志（31．1％）。过去3个月性服务中每次使用安全套的占57．9％，与固定性伴每次使用的占13．4％。结论 应加强对性服务者艾滋病非传播途径及预防知识的教育，并以高年龄组为重点；要突出大众媒介以及医生在健康教育中的作用，从单纯关注性服务者的知识了解转变为促进其行为改变。     

湖北省4类艾滋病高危人群高危行为分析

[目的]通过分析湖北省全球基金艾滋病项目基线调查资料,了解湖北省4类艾滋病高危人群高危行为情况。[方法]采用描述性分析方法对艾滋病高危人群的高危行为进行对比。[结果]4类高危人群最近1次性行为安全套使用率平均为52.5%,暗娼人群安全套使用率最高,为92.8%,吸毒者和性病门诊就诊者次之,为26.7%,有偿献血人群最低,为22.3%。高危人群在过去3个月内发生性行为总是使用的人占17.1%,暗娼过去3个月性行为安全套使用率最高,总是使用的占65.4%;性病患者在过去3个月与非婚性伴发生性行为总是使用的有8.8%。暗娼人群中吸毒率为0.94%。吸毒者有24.9%采取口吸的方式,60.3%采取注射方式。性病门诊就诊者中吸毒率为0.48%,并且3种吸毒方式都存在。[结论]安全套使用项目应该扩大高危人群覆盖面,并加强健康教育的力度,降低艾滋病高危人群的高危行为。