建筑业劳务输出人员性病艾滋病影响因素定性研究

目的了解建筑业劳务输出人员性病艾滋病相关危险行为及其影响因素,为该人群的性病艾滋病防治工作提供依据。方法采用半结构式访谈方法,对劳务输出人员、劳务公司负责人、中介公司老板、南通市对外贸易经济合作局、当地疾病预防控制中心的相关工作人员等26名关键知情人进行访谈。结果商业性行为是建筑劳务输出人员感染性病艾滋病的主要高危行为,其影响因素包括劳务输出地的性服务市场情况、企业管理制度的执行力度、同伴影响、经济收入、艾滋病知识认知不足以及工人的自身素质等。结论应重视劳务输出人员性病艾滋病的防制,并采取适当的干预措施减少高危行为的发生。     

珠海市斗门区男性外来务工人员艾滋病认知程度及相关行为调查

目的掌握斗门区男性外来务工人员艾滋病知识及相关行为,为流动人口预防艾滋病健康教育与干预提供科学依据。方法按照《流动人口人群哨点监测(健康调查问卷)》一对一问卷调查,采集血清检测HIV抗体。结果调查823名男性外来务工人员,艾滋病传播途径知晓率为73.39%,非传播途径知晓率较低;近一年,与固定性伴发生性行为时,每次使用安全套的占18.51%,从未使用的占46.52%;与性服务人群发生过性行为的有41人,每次使用安全套的占51.22%,从未使用的占14.63%;与临时性伴发生过性行为的有135人,每次使用安全套的占44.44%,从未使用安全套的占16.30%。有10人曾有吸毒行为,1人注射吸毒,未与他人共用针具。未发现艾滋病病毒抗体阳性者。结论促进流动人口性观念转变和安全性行为的建立对于预防艾滋病尤为重要。     

外来务工人员艾滋病知识、行为和艾滋病病毒感染状况调查

目的了解外来务工人员艾滋病相关知识知晓状况、危险行为以及艾滋病病毒感染状况。方法采用分层随机抽样的方法，对东部沿海某市18-60岁外来务工人员进行问卷调查，收集艾滋病知识和行为的信息，并采集静脉血进行艾滋病病毒抗体检测。结果1190名调查对象对艾滋病的传播途径全部回答正确的占71．9％。对于非传播途径和预防措施全部回答正确的分别占18．2％和7．1％，所有问题均能正确回答的仅占2．5％。在有过性经历者中，非婚性行为者占41．7％，有过商业性行为者占11．4％。在与固定性伴和商业性性伴发生性行为时，最近一次性行为时使用安全套的比例分别为32．9％和46．7％。多因素分析显示，正确知晓传播途径与文化程度和有性经历有关。无论与固定性伴，还是商业性性伴，最近一次性行为使用安全套的均与正确知晓传播途径有关。1125名工人艾滋病病毒抗体检测结果均为阴性。结论针对外来务工人员艾滋病知识的薄弱环节，开展宣传教育。通过艾滋病知识知晓率的提高，促进高危行为的改变。同时需要加强对该人群的监测。     

江西省某市建筑业农民工艾滋病“知信行”现况调查

目的了解江西省某市建筑业农民工艾滋病相关知识、态度和行为状况,为建筑业农民工艾滋病的预防与控制提供科学的理论依据。方法采用分层整群抽样的方法抽取该市3家建筑企业475名男性农民工进行问卷调查,应用描述性分析和χ2检验对数据进行统计学分析。结果该市建筑业农民工对艾滋病相关问题知晓率较低,为58.32%。年龄越大、文化程度越低,农民工对艾滋病的知晓率越低,差异具有统计学意义（χ2年龄=30.892,P〈0.001;χ2文化程度=25.301,P〈0.001）。71.79%的农民工愿意给AIDS病人更多的帮助;而认为＂应该同情通过性途径和吸毒途径感染HIV病毒者＂的农民工只占17.26%。农民工的高危行为主要表现为曾与工友共用剃须刀41.47%;卖血、有≥2个性伴侣、商业性行为、最近1年内与临时性伴发生过性行为的农民工分别占3.58%、18.11%、11.37%、9.89%。结论该市建筑业农民工对艾滋病非传播途径了解甚少,对HIV感染者/AIDS患者的态度有待改善,存在艾滋病高危行为。     

2008－2014年中国预防艾滋病经性传播干预措施落实情况分析

目的 分析我国自2008年艾滋病综合防治信息网络直报系统建立以来,艾滋病经性传播高危人群的干预措施落实情况。方法 收集2008－2014年MSM人群、暗娼人群和外来务工人员的干预数据和哨点监测数据,采用历史资料的描述性统计方法分析干预工作各项指标的变化趋势。结果 2008－2012年,MSM人群的月均干预人数和月均干预覆盖率分别从4.9万人和8.6%升至25.2万人和78.5%,暗娼人群月均干预人数和月均干预覆盖率分别从32.9万人和30.9%升至62.5万人和87.0%。2013－2014年两类人群上述指标有小幅回落。全国哨点监测数据显示:MSM人群和暗娼人群的行为学、知晓率指标逐年提高。外来务工人员的干预覆盖率从2008年的4.7%升至2014年的10.0%左右,哨点监测数据显示,男性流动人口的行为学、知晓率指标低于其他高危人群。结论 艾滋病经性传播高危人群的干预措施得到有效落实,干预工作取得一定成效,但新的疫情态势又为艾滋病干预工作提出新的挑战。     

男性流动农民工艾滋病相关知识及行为调查

[目的]了解男性农民工的艾滋病知识及行为，探讨针对不同类型的流动务工人员开展性病艾滋病干预的切入点及干预方法。[方法]在昆明选择4家餐馆、3家建筑工地的流动农民工305人，进行问卷调查及个人访谈，主要调查内容是一般情况、艾滋病相关知识、危险性行为及原因、相关信息的获取途径。[结果]58．7％的调查对象处于性活跃年龄，平均流动时间为3．9年，寂寞、性观念的改变等导致高危性行为普遍，60．3％的调查对象回答“同行人中，配偶或女朋友不在身边的人在外找小姐”。蚊虫叮咬不传播，可以做抽血检测答对率均少于5％，对艾滋病相关信息需求强烈。[结论]对男性农民工的艾滋病干预工作显得尤为迫切，加强多部门的协调，有效开展全国农民工预防艾滋病宣传教育工程；不同层次的农民工艾滋病干预重点及方法不同。     

Survey of tuberculosis incidents in hospital healthcare workers, England and Wales, 2005

BACKGROUND: Tuberculosis (TB) incidence has increased in England and Wales since 1987, with much of the increase in migrants from high TB incidence countries. The National Health Service increasingly depends on healthcare workers (HCWs) trained abroad, often from areas of high TB incidence. A retrospective survey of TB incidents in hospital-based HCWs was carried out to describe their frequency, distribution and characteristics. METHODS: Reports of HCWs with TB in hospitals were identified among routine surveillance of TB incidents. Additional data on these and reports of further incidents fitting the study definition were obtained by contacting local and regional Health Protection Units. RESULTS: At least 105 incidents of TB in hospital-based HCWs occurred in England and Wales in 2005. Most involved HCWs from high incidence countries, and most cases had pre-employment occupational health screening. We found no evidence of onward transmission within hospitals. CONCLUSIONS: Pre-employment screening for active disease may not be enough to prevent the occurrence of these incidents. A high index of suspicion among HCWs with TB symptoms is needed. Detection of latent infection with interferon gamma release assays, and the use of preventive treatment, should be evaluated.     

丽江市古城区娱乐场所性工作者HIV、梅毒监测报告

[目的]为了解古城区娱乐场所女性性工作者中性病／艾滋病的分布及其发生频率、现状和流行趋势，为古城区防治性病／艾滋病策略提供依据。[方法]按照全国AIDS／STD检测工作规范要求，对女性性服务人群进行检测。[结果]对483名娱乐场所女性性工作者进行监测，查出艾滋病病毒感染者4例，梅毒4例。[结论]在女性性工作者中检出率较高，应加大对女性高危人群的干预力度，增强其自我保护意识，推广使用安全套，规范性病诊治，加大对古城区预防控制艾滋病／性病传播的有力措施。     

2010～2011年泰安市建筑民工结核病防治知识干预效果评价

[目的]评价政府主导,非政府组织参与,对建筑民工结核病防治知识健康教育效果。[方法]2010年7月至2011年8月采用整群随机抽样方法,选择泰安市4处大型建筑工地民工共378人。随机分为对照组和健康教育干预组(以下简称健康教育组),健康教育组开展张贴宣传画、发放宣传单和健康工具包等不同形式的结核病防治知识健康教育活动,并在健康教育后进行问卷调查,对照组不进行结核病防治知识健康教育活动,直接进行问卷调查。[结果]泰安市建筑民工结核病防治知识知晓率低,为50.02%;非政府组织进行健康教育干预后,知晓率明显高于对照组,为77.72%。健康教育组和对照组结核病防治知识知晓率差异有统计学意义(P<0.01)。[结论]非政府组织参与建筑民工结核病防治知识健康教育效果良好,可有效提高该人群结核病防治知识知晓率。     

农村外出务工人员艾滋病知识、态度及高危行为分析

目的了解农村外出务工人员艾滋病防治知识、相关态度和高危行为状况,为开展艾滋病干预工作提供科学依据。方法采用多阶段抽样方法,在流出地选择返乡外出务工人员454人,利用自制问卷面对面调查。结果外出务工人员对艾滋病3大传播途径回答正确率为43．6％～68．6％,对一般日常生活接触是否传播MDS的知晓率偏低,如蚊虫叮咬不会传播的知晓率只有19．3％;93．1％的外出务工人员认为自己感染艾滋病的机会很小,仅有48．1％的人表示同情并愿意给予艾滋病患者帮助;21．6％的人有婚前性行为,71．0％的人与固定性伴发生性关系时从不使用安全套。结论外出务工人员艾滋病防治知识缺乏,普遍存在危险性行为。     

Complexities of Short-Term Mobility for Sex Work and Migration among Sex Workers: Violence and Sexual Risks,Barriers to Care,and Enhanced Social and Economic Opportunities

Despite research on the health and safety of mobile and migrant populations in the formal and informal sectors globally, limited information is available regarding the working conditions, health, and safety of sex workers who engage in short-term mobility and migration. The objective of this study was to longitudinally examine work environment, health, and safety experiences linked to short-term mobility/migration (i.e., worked or lived in another city, province, or country) among sex workers in Vancouver, Canada, over a 2.5-year study period (2010–2012). We examined longitudinal correlates of short-term mobility/migration (i.e., worked or lived in another city, province, or country over the 3-year follow-up period) among 646 street and off-street sex workers in a longitudinal community-based study (AESHA). Of 646 sex workers, 10.84 % (n = 70) worked or lived in another city, province, or country during the study. In a multivariate generalized estimating equations (GEE) model, short-term mobility/migration was independently correlated with older age (adjusted odds ratio (AOR) 0.95, 95 % confidence interval (CI) 0.92–0.98), soliciting clients in indoor (in-call) establishments (AOR 2.25, 95 % CI 1.27–3.96), intimate partner condom refusal (AOR 3.00, 1.02–8.84), and barriers to health care (AOR 1.77, 95 % CI 1.08–2.89). In a second multivariate GEE model, short-term mobility for sex work (i.e., worked in another city, province, or country) was correlated with client physical/sexual violence (AOR 1.92, 95 % CI 1.02–3.61). In this study, mobile/migrant sex workers were more likely to be younger, work in indoor sex work establishments, and earn higher income, suggesting that short-term mobility for sex work and migration increase social and economic opportunities. However, mobility and migration also correlated with reduced control over sexual negotiation with intimate partners and reduced health care access, and mobility for sex work was associated with enhanced workplace sexual/physical violence, suggesting that mobility/migration may confer risks through less control over work environment and isolation from health services. Structural and community-led interventions, including policy support to allow for more formal organizing of sex work collectives and access to workplace safety standards, remain critical to supporting health, safety, and access to care for mobile and migrant sex workers.     

深圳市2004年收容人员性病感染调查

目的了解深圳市收容教育所收容人员性传播疾病感染情况。方法对2004年深圳市某收容教育所1329名学员进行问卷调查、身体检查和性传播疾病实验室检测。收集相关资料进行流行病学分析。结果1329名收容人员，检出性传播疾病249例，感染率为18．7％。女学员性病检出率明显高于男学员；文化程度越高，性病检出率越低；反之，文化程度越低，性病检出率越高。结论收容教育所收容人员中存在性传播疾病的传染源，加强对收容人员的性病流行病学监测是预防和控制性病流行的有效措施之一。     

思茅区CSW艾滋病干预和服务效果比较

[目的]为了充分利用有效的卫生资源，探讨女性性工作者艾滋病干预服务的有效途径，评价项目实施的效果。[方法]比较思茅区基线调查与综合监测女性性工作者艾滋病知识知晓率、获得艾滋病知识信息主要来源以及接受预防艾滋病服务情况。[结果]思茅区通过第四轮全球基金项目的实施，2007年与2005年相比，女性性工作者艾滋病知识知晓率、获得艾滋病知识信息主要来源、接受预防艾滋病服务情况均有明显提高，CSW获得性病／艾滋病免费咨询和性病检查治疗的比例2007年比2005年有所下降，说明这两项工作没有实质性改变。[结论]利用项目工作的开展，加强了项目地区多部门的交流与合作，以妇女健康中心为平台，通过开展外展工作、同伴教育、VCT、性病诊疗、转介、安全套推广等对女性性工作者开展综合干预活动取得了明显效果，但今后的项目工作中还应进一步加大VCT、规范性病诊疗服务的工作力度。     

Presence and awareness of infectious disease among Chinese migrant workers

This cross-sectional study set out to identify the health status and health beliefs and behaviors with regard to TB and HIV-AIDS among 407 rural male migrant workers in China. Surveyed workers' awareness level for AIDS transmission was 67.7% and for TB transmission 56.8%. These workers had high rates of acute illness in the previous month (depression 18.3%, physical injury 16.3%, dermatological ailment 9.6%, respiratory infection 9.4%). One or more of the four symptoms of TB were found in 22.3% of the workers. Prevalent TB symptoms were associated with previously having had TB (chi-square = 69.98, p = .000) and having previously lived with a TB patient (F = 13.99, p = .000). The relative risk for having had TB if the worker had lived with someone with TB was 5.69 (chi-square 7.65, p = .006). Screening for TB symptoms, a history of having lived with someone with TB, or having previously had TB, has the potential to serve as a cost-effective and easy first-line TB screening among large mobile populations.     

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.     

建筑工人艾滋病相关行为及HIV感染状况调查

目的 了解凭祥市建筑工人艾滋病(AIDS)相关行为与艾滋病病毒( HIV)感染状况,以便采取有针对性的高危行为干预措施.方法 于2011 - 01/03,采用整群抽样方法抽取凭祥市9个建筑工地的405名工人进行调查,分析艾滋病相关知识知晓率、婚内性行为、商业性行为、非婚非商业临时性行为、吸毒行为及HIV、梅毒和丙型肝炎病毒(HCV)实验室检测结果.结果 在接受调查的405名建筑工人中,HIV感染率为0.49％,梅毒感染率为3.95％,丙肝感染率为0.99％.调查对象答对6条以上的艾滋病知识知晓率为72.28％,93.24％的在婚调查对象最近1年与固定性伴有性关系,并且与固定性伴发生性关系时坚持每次都使用安全套的比例仅为8.69％;5.68％的调查对象最近1年曾与非婚非商业临时性伴发生性行为,13.39％的男性最近1年曾嫖娼,发生商业性行为时每次都使用安全套的比例为62.22％,0.74％的调查对象有吸毒行为.单因素分析结果显示,男性发生嫖娼行为的比例与受教育程度、艾滋病知识知晓率有关(P＜0.05).结论 凭祥市建筑工人存在着多种艾滋病高危行为的协同作用,正在成为艾滋病感染和传播的高危人群和桥梁人群,应采取更有针对性的高危行为干预措施,遏制艾滋病传播扩散.     

Spatial analysis of tuberculosis cases in migrants and permanent residents, Beijing, 2000-2006

To determine the role of the migrant population in the transmission of tuberculosis (TB), we investigated the distribution and magnitude of TB in permanent residents and migrant populations of Beijing, People's Republic of China, from 2000 through 2006. An exploratory spatial data analysis was applied to detect the "hot spots" of TB among the 2 populations. Results, using the data obtained from 2004-2006, showed that people who migrated from the western, middle, and eastern zones of China had a significantly higher risk of having TB than did permanent residents. These findings indicate that population fluctuations have affected the rate of TB prevalence in Beijing, and interventions to control TB should include the migrant population.     

宁明县3类人群艾滋病哨点监测结果分析

目的 了解中越边境地区 - 宁明县静脉吸毒、暗娼、孕（产）妇三类人群艾滋病知识水平、相关行为特征及艾滋病病毒感染情况,为今后艾滋病防治工作提供科学依据。方法 根据全国哨点监测实施方案的要求,对三类人群进行问卷调查和血清艾滋病病毒、梅毒、丙型肝炎病毒检测。 结果 2011 - 2013年共监测静脉吸毒者944人,艾滋病病毒阳性率10.49%,梅毒阳性率17.27%,丙型肝炎病毒阳性率71.4%,艾滋病知晓率88.03%,47.67%曾共用注射器吸毒,42.58%最近1次商业性行为不使用安全套。共监测暗娼1 202人,艾滋病病毒阳性率1.58%,梅毒阳性率9.48%,丙型肝炎病毒阳性率2.7%,87.02%最近一次与固定性伴性行为不使用安全套,最近一次商业性行为使用安全套率中国籍95.49%高于越南籍78.26%,差异有统计学意义,艾滋病知晓率中国籍98.56%高于越南籍86.57%,差异有统计学意义。共监测孕(产)妇1 200人,艾滋病病毒阳性率0.5%,梅毒阳性率0.83%,HCV丙型肝炎病毒阳性率0.25%,艾滋病知识知晓率75.83%。结论 宁明县静脉吸毒和暗娼人群艾滋病性病感染率高,高危行为普遍,应加强对其行为干预,特别是注重越南籍暗娼干预,同时应开展阻断母婴传播,控制艾滋病的流行蔓延。     

Tuberculosis risk among migrant farm workers on the Delmarva peninsula.

A survey was conducted to ascertain the risk of tuberculosis (TB) among migrant farm workers on the Delmarva peninsula. Relevant histories were obtained from 842 migrants; a total of 709 skin tests were completed, and 239 sputum specimens were examined for acid-fast bacilli (AFB) and culture. No cases of infectious tuberculosis were ascertained by history or AFB examination. One sputum culture was positive for M. tuberculosis and 13 were positive for various species of nontuberculous mycobacteria. Thirty-seven per cent of migrants tested had significant skin test reactions of 10 mm or more. Reaction rates for men were 41 per cent and for women 25 per cent. Age specific rates ranged from 14 per cent in children aged 5-14 to 54 per cent for ages 45-54. Rates for the principal national/ethnic groups were Haitians 55 per cent, Mexicans 36 per cent, US Blacks 29 per cent and US-born Latinos 20 per cent. Based on these results and other information currently available, it is recommended that current Centers for Disease Control (CDC) recommendations for TB prophylaxis continue to be applied for migrant workers, but that mass screening by skin testing in camp populations not be emphasized. Other recommendations focus on: case finding of active disease, improving continuity and follow-up, increasing coordination among involved agencies, and actively supporting improved economic and living conditions for migrant farm workers.