性病门诊就诊者行为及艾滋病性病知识调查

目的 了解性病门诊就诊者的求医行为、出现性病相关症状后的性行为状况及其艾滋病性病相关知识态度水平。方法 2003年8月中旬连续2周时间，对前来北京市性病防治所就诊的325名性病门诊就诊者进行了问卷调查，调查采用不记名、面对面逐项询问的方式。结果 调查对象出现性病相关症状后3天内就诊者占24．7％。出现性病相关症状后继续有性生活者占43．2％，其中多性伴侣者占12.8％，平均性伴侣数为6．1，但无再与商业性伴侣发生性关系者。出现性病相关症状后与临时性伴侣的性生活平均为6．4次，坚持使用安全套者占22．2％，发生性关系时临时性伴侣知情者占15．0％。艾滋病传播知识全部回答正确者占27．3％。结论 调查对象的性病求医行为需要引导和促进。出现性病相关症状后仍具有较多的无保护性行为，且对方多不知情，存在着传播性病艾滋病的潜在危险。艾滋病性病传播、预防知识的知晓率水平均较低，应在该人群中加强宣传教育干预，开展自愿咨询检测，以降低危险性行为，遏制艾滋病性病的流行和传播。     

对城市娱乐场所小姐开展性病干预服务模式探讨

目的探讨在中国城市娱乐场所小姐中开展性病干预服务模式并进行评估。方法每月由性病门诊医务人员以外展服务形式，向福州市18家娱乐场所的149名小姐提供性病预防治疗服务，全部现场监服阿奇霉素和灭滴灵，连续3个月。结果61．7％的小姐干预前有生殖道感染症状，干预后下降到43．6％。衣原体和滴虫感染检出率从干预前27．5％和3．4％，下降到干预后5．9％和1．0％。91．1％的小姐希望在开展宣传教育的同时提供方便、规范的性病服务。结论医务人员走出门诊为娱乐场所小姐提供以性病预防治疗为主的健康服务受到欢迎。其中采用给所有小姐定期口服阿奇霉素的方法，对控制娱乐场所小姐的衣原体感染有较好效果，但有一定局限性。今后应探索将性病预防治疗与行为干预(健康教育、咨询和安全套促进)相结合的综合干预模式。     

低层次场所的暗娼STD/AIDS相关认知危险行为的调查分析

目的分析低层次场所暗娼的性病／艾滋病（STD／AIDS）相关认知、危险行为。方法选择洗头房、路边店等场所的小姐，以自行设计的调查表进行调查，收集人口学资料，STD／AIDS相关知识、安全套使用及求医行为等信息；同时采集宫颈分泌物、血液进行STD／HIV检查。结果调查的199名小姐中63．6％的人未婚，36．4％的已婚、离异或分居。性病病症、性病后果的危害性及正确预防艾滋病的知识知晓率低，性病易感性的认识不足，67．3％的人不认为自己可能染上性病。商业性伴关系中，最近3次每次安全套使用率为79．9％，其中21．8％的人报告最近一周有过安全套破裂现象。患病后采取的措施依次为去医院治疗（50．2％）、自己买药治疗（24．3％）、附近个人诊所治疗（17．8％）、去医院检查后自己治疗（7．7％）。性病的总检出率为50％。结论被调查者性病病症、性病后果的危害性及正确预防艾滋病的知识知晓率低；安全套正确使用率低，安全套破裂率高，不足以预防性病艾滋病的传播；性病检出率高，在该人群中不安全性行为是普遍存在的；有接近半数的人不能规范求医；应采取有针对性的干预策略。     

在暗娼中预防AIDS综合干预研究

目的 降低暗娼感染HIV的危险性。方法 营造支持环境，对暗娼实施流动宣传和100％的安全套推广使用，提供规范的、可及的性病诊治服务，开展同伴教育等综合干预措施。结果 目标人群的性病艾滋病防治知识的知晓率得到了普遍的提高，能正确回答有关艾滋病传播途径8个条目的人数从7％上升到96％；安全套使用率明显提高，与临时性伴侣最近一次性行为使用安全套的比例从34．7％上升到84％；性传播感染(STI)的感染率从61．4％下降到36．7％；在目标人群中建立了一支同伴教育者队伍。结论 对暗娼实施综合干预可有效降低STI的感染率和感染HIV的危险性。     

在预防AIDS/STD中影响安全套推广使用的相关因素分析

目的通过对育龄人群中安全套的使用状况、接受程度、影响因素的分析，探讨在预防艾滋病，陛传播疾病（AIDS／STD）中推广使用安全套的行动措施。方法对育龄人群、管理服务人员等进行相关因素的问卷和访谈调查。结果511例未用过安全套的青年中，有57．73％和72．21％的对象分别知道安全套可以预防AIDS／STD，85％以上的知晓者愿意使用安全套；180例安全套使用者中，有67．78％和76．11％的对象分别知道安全套可以预防AIDS／STD，知晓者安全套使用满意程度高于未知者；知道如何正确使用安全套者认为安全套不影响性生活者，安全套使用满意程度亦高。安全套使用率低的影响因素较多，主要与安全套预防AIDS／STD知晓程度、安全套的提供、获取及对性生活有无影响等因素有关。结论进一步加强预防AIDS／STD宣传教育，健全安全套发售网络，与计生服务相结合推广安全套的使用。     

性病患者安全套使用情况及自我效能的研究

目的　了解性传播疾病 (STD)患者安全套自我效能及影响安全套使用的因素 ,为AIDS高危人群干预措施提供依据。方法　采用时间 /空间定位抽样法 ,在济南市两所性病诊所确诊的STD患者中抽取 4 0 0名作为研究对象 ,用专门设计的调查表调查人口学特征、性病史、性行为史、安全套的使用情况以及自我效能 ,进行统计学分析。采用检验 再检验法评估调查资料的可靠性。结果　STD患者安全套使用频率较低 ,过去 30天内的性生活中 ,>80 %的肛交和 >90 %的口交从未使用过安全套 ,38 1%的STD患者在与其男 /女朋友阴道性交时从未使用过安全套 ,>6 0 %的STD患者在与其配偶或其他人阴道性交时从未用过安全套。个人责任感、与性伴侣交流技能以及安全套的获取 ,是影响安全套使用的主要因素 ;而正确使用安全套的能力、性伴侣的反应和使用安全套的自我感觉则影响不大。结论　在对AIDS高危人群的干预中 ,重点应是提高人们对于社会、家庭和个人的责任意识 ,传授给他 /她们与性伴侣交流、沟通、协商的技能 ,克服购买、免费索取安全套时的羞辱感     

上海市长宁区娱乐场所女性服务人员STD/AIDS现况调查及相关影响因素的研究

目的了解上海市长宁区娱乐场所女性服务人员(FEW)的性病(STD)/艾滋病(AIDS)相关知识、态度、行为(KAP)现况及感染情况,为在长宁区娱乐场所进一步开展STD/AIDS健康教育与健康促进提供依据。方法选取2家大场所KTV、8家小发廊、15家小足浴房,采用分层抽样方法,抽取125名FEW进行问卷调查和STD/艾滋病病毒(HIV)感染初筛。结果 FEW对AIDS知晓率为60.8%(76/125),STD知晓率为81.6%(102/125),其差异有统计学意义(P<0.01,χ2=13.19)。FEW安全套使用率为78.8%(63/80),5种性病感染率分别为:HIV感染率0,梅毒感染率2.4%,淋病感染率4.8%,疱疹感染率4.8%,衣原体感染率16.0%。性病感染率为20.8%。结论长宁区FEW使用安全套防护意识低,需加大STD/AIDS相关预防知识的干预力度。     

乌鲁木齐市部分吸毒者和暗娼艾滋病/性病知识及性行为调查

为了解乌鲁木齐市羁押吸毒人群和暗娼行为学特征及艾滋病性病感染状况，通过匿名KABP调查，了解吸毒人群和暗娼行为学特征与AIDS／STD的关系，并采集血液进行AIDS／STD检测，结果表明吸毒人群和暗娼能够正确回答预防艾滋病方法的分别占82．48％和53．72％，吸毒中存在性乱问题，共用注射器吸毒占54．88％，两类人群的安全套使用率均很低。吸毒中HIV感染率为14．45％，暗娼中性病总感染率为46．82％。乌鲁木齐市静脉吸毒的HlV感染和暗娼的性病感染率高，有针对性开展两类人群的干预措施刻不容缓。     

4 224例性病门诊就诊者尿道(宫颈)炎分泌物相关病原体检测分析

目的比较分析性病门诊淋病和非淋菌性尿道炎（NGU）的发病情况，探讨淋病合并NGU感染、沙眼衣原体（Ct）合并解脲脲原体（Uu）和人型支原体（Mh）感染的意义。方法对所有患者均同时检测淋球菌（Gc）、Ct、Uu、Mh。结果2004年到性病门诊就诊的患者共4224例，检出淋球菌感染459例，感染率10．87％。其中129例为Gc、Ct和Uu合并感染，感染率3．05％；检出NGU感染1370例（32．43％），其中363例为单纯Ct感染，感染率为8．51％；552例为单纯Uu感染，感染率为13．07％；110例为Mh感染，感染率为2．60％。Ct、Uu合并感染216例，感染率为5．11％。结论NGU感染阳性率明显高于淋球菌感染，在对性传播疾病（STD）怀疑NGU感染的高危人群检查或复查时，应同时检测Ct和Uu，尤其不能忽视高度怀疑Gc感染，同时合并Ct、Uu感染或淋球菌感染后非淋菌性尿道炎的发生。     

1999年全国性病监测系统不同人群性病患病率调查

目的 了解不同人群的性病患病率。方法 在性乱人群、供血员和孕妇中分别连续抽样采集标本，直到完成要求的监测样本量，并统一进行检测。结果 性乱人群淋病、梅毒病患病率分别为6．64％和4．32％，HIV感染率为1．06％；供血员梅毒感染率为0．32％，HIV感染率为0．22％；孕妇淋病感染率为0．37％；梅毒感染率为0．13％。结论 性乱人群为性病感染的高危人群，应加强主动发现病人的筛查工作；供血员、产前检查妇女为STD感染的低危人群，但这两种人群易于接近，可将STD检测纳入常规工作中。     

性病门诊外来人员就诊者性行为情况调查

目的了解性病门诊求医的外来人员的性行为及性病患病情况。方法对在性病门诊求医的外来人员进行问卷调查。结果未婚性行为率60.0%,第一次性行为发生在婚前率为47.6%,有2人以上性伴占46.8%,安全套使用率<50%。被调查者中性病患病率为37.1%。感染≥2次性病率为12.2%,占性病患病数的32.8%。结论应推广性病门诊规范化服务,采用各种宣传方式。提供健康信息,提高高危人群性病预防知识,转变态度并提倡安全性行为。     

Predictors of visits to commercial sex workers by male attendees at sexually transmitted disease clinics in southern Vietnam.

OBJECTIVES: To determine the HIV/sexually transmitted disease (STD) status of male patients at STD clinics and factors associated with frequent visits to commercial sex workers (CSW) in southern Vietnam. DESIGN: Cross-sectional survey. METHODS: Confidential interviews and physical and laboratory evaluation of 804 male patients at STD clinics in two semi-rural provinces in the Mekong delta. RESULTS: HIV seroprevalence was 0.5%. The prevalence of urethritis syndrome was 19.3%, gonorrhea 10.2% (Gram-stain positive) and syphilis 2% (reactive rapid plasma reagin test). All the men had visited CSW in the past and 58% had their first sexual experience with a CSW; 73% had visited a CSW in the last 3 years. Married men were equally as likely as single men to have casual partners or to have visited a CSW. The men recruited CSW more from the streets (45%) than from brothels (38%). Factors independently associated with visiting a CSW in the last 3 years included being single [odds ratio (OR), 2.2], age under 20 years (OR, 1.9), having first sexual intercourse with a CSW (OR, 2.1), not having a current girlfriend (OR, 2.1), using alcohol before sex (OR, 2.7) and drug use (OR, 1.8). Only 7% of men used condoms consistently; 70% had never used them. Only 37% had used a condom last time they had intercourse with a CSW. CONCLUSIONS: Prevention programs for men in Vietnam, particularly those who are young or single, need to focus on reducing drug and alcohol consumption and improving condom use with CSWs.     

Sexual activities of patients with STDs in the interval between noticing symptoms and presenting for treatment

Examining the patterns of and reasons for sexual behaviors of patients with sexually transmitted diseases (STDs) while symptomatic may help to develop effective prevention strategies for both STDs and AIDS. However, little is known about patients' sexual activities after noticing STD symptoms in China, where AIDS and STDs are spreading rapidly. We conducted a cross-sectional study at four STD clinics in Hefei, China. Patients' reported sexual activities were queried, using a tape recorder and earphones. A consecutive sample of 406 male patients with STDs were interviewed. One hundred sixty-four (40%) men reported having sex after having STD symptoms; 45% were married, 27% were single, and 47% cohabiting or divorced. Their sex partners included spouses, girlfriends, and prostitutes. Only 10% of patients with STDs who had sex after noticing STDs reported frequently using condoms or using them for every act of sex. Approximately 60% had never used a condom. Logistic regression analysis indicated that having sex after noticing STD symptoms was associated with lower education, having a previous STD episode, having low HIV/STD knowledge, and having other urethral discharge not caused by C. trachomatis or gonorrhea. Our findings suggest that male patients with STDs may serve as a bridge population linking the STD, and potentially, HIV epidemic from individuals at higher risk to the general population. Intervention programs including health education and condom promotion need to target both those at high risk and those at apparently lower risk.     

204例MSM人群HIV／梅毒感染状况及行为学特征分析

目的了解天津市部分男男同性性行为人群（MSM）艾滋病相关危险行为,以及艾滋病病毒（HIV）、梅毒（SP）感染状况,为预防性病、艾滋病传播提供依据。方法采用横断面调查,对进入酒吧的男同性恋者进行问卷调查,同时抽取血样进行梅毒和HIV的实验室检测。结果调查的204人中,HIV感染率为5．9％,梅毒感染率为18．7％。艾滋病知识知晓率为81．4％,近6个月每次性行为均使用安全套的比例为47．9％,HIv感染者安全套使用率低,仅为11．1％,71．4％的HIV感染者最近6个月存在多性伴现象。结论天津市MSM人群危险性行为普遍存在,安全套使用率低,HIV、梅毒感染率较高,应加强对该人群艾滋病性病相关的宣传教育及干预工作,控制HIv的传播。     

Partner notification: can it control epidemic syphilis?

STUDY OBJECTIVE: During 1987, the rate of syphilis among heterosexual adults in Oregon increased 159%, yet the number of cases of gonorrhea remained stable. Our study was done to evaluate why the same control measures contained gonorrhea but not syphilis in this population. DESIGN: Exploratory case-control study. SETTING: Public health clinics in Portland, and Salem, Oregon. PATIENTS: All 146 heterosexual adults with early syphilis and all 164 heterosexual adults with acute gonorrhea reported to the public health clinics during April to July 1988. INTERVENTION: A questionnaire was administered to all syphilis case-patients and control patients (those with gonorrhea) at the beginning of the routine, sexually transmitted disease (STD), investigative interview. MEASUREMENTS AND MAIN RESULTS: Syphilis case-patients had contact with an average of 5.0 sex partners for whom they could not supply locating information sufficient to initiate partner notification. In contrast, patients with gonorrhea had contact with an average of 0.4 sex partners for whom they could not supply locating information (P less than 0.005). The 28% (41 of 146) of syphilis case-patients who reported having exchanged sex for drugs or money accounted for 72% (527 of 729) of the unlocatable partners exposed to syphilis. In contrast, the 17% (28 of 164) of patients with gonorrhea who reported having exchanged sex for drugs or money accounted for 36% (25 of 69) of the unlocatable partners exposed to gonorrhea. CONCLUSIONS: Because patients infected with syphilis have relatively large numbers of anonymous sexual encounters, prevention strategies that supplement partner notification are urgently needed to control the syphilis epidemic among adults.     

妇科门诊就诊者生殖道感染调查

目的了解妇科门诊阴道分泌物异常就诊者生殖道感染状况,为制订妇女性病艾滋病干预计划提供基础信息。方法对2004年1~12月上海市闸北区妇幼保健所和宁波市海曙区马园卫生院妇科门诊,主诉阴道分泌物异常的1 565例初诊病例进行生殖道感染调查。结果上海、宁波本地户口病例753例,以无待业、工人居多;外地812例,以工人、服务员居多。3.9%的人近3个月有1个以上新性伴,8.1%的人经常使用安全套。60.2%(942例)有生殖道感染。12.6%(197例)合并2~4种感染,多为外地病例。检出率最高的是细菌性阴道病(23.2%),其次是衣原体感染(16.7%)。外地病例淋菌感染检出率(5.3%)、近3个月有1个以上新性伴的比例(6.8%)、初中以下文化的比例(87.2%),均高于当地病例(43.6%)。经常使用安全套的比例(3.2%)低于当地病例(13.3%)。结论妇科门诊就诊者以常见生殖道感染居多。法定报告的性病(淋菌和衣原体感染)占一定比例,应引起足够重视。外地病例合并生殖道感染较多,安全套使用率低,存在较多传播性病艾滋病的危险因素。应针对她们文化程度较低的特点和对生殖健康的需求,加强有关性病艾滋病防治的宣传和咨询,积极开展生殖道感染预防、性病诊疗、安全套促进和行为干预工作。     

AIDS and STD knowledge, condom use and HIV/STD infection among female sex workers in Bali, Indonesia

The objectives of this paper were to examine changes in AIDS/STD knowledge and behaviour from 1992-1998, current levels of STD infection and psychosocial and demographic determinants of condom use and STD infection among female sex workers. Data for the study were drawn from cross-sectional surveys of female sex workers conducted in 1992, 1994 and 1997-8. For each survey, women participated in a face-to-face interview in the brothel complexes. Survey questions included information on AIDS/STD knowledge, demographics, sexual history and psychosocial factors related to condom use. After the last survey, women were offered a vaginal exam for STD diagnosis and treatment. Sera were tested for HIV infection (anonymous, Elisa/Western blot) and syphilis (TYPHA, RPR). Cervical mucous was tested for chlamydia (LcX), gonorrhea (LCx), herpes (pcr) and HPV (pcr). Knowledge of AIDS and awareness of STDs has increased tremendously in this population since 1992. Reported condom use has also increased substantially (69.9%). Perceived susceptibility toward HIV infection remains low. Ineffective preventive strategies such as medication use continue to be common. HIV infection remains very low in this population (0.2%), although the prevalence of other STDs such as gonorrhea (60.5%), chlamydia (41.3%) and HPV (37.7%) were very high. STD knowledge and self-efficacy were significantly related to condom use as were the sex workers' perceived susceptibility to STD and HIV infection. Women with a larger number of partners were more likely to be infected with gonorrhea, chlamydia and HIV. Women who had come to Bali recently were more likely to be infected with HIV and gonorrhea.     

各类性病门诊中患者求医行为的因素研究

目的了解性病患者求医行为与特征、预防性病、艾滋病的意识与需求.方法采用横段面调查.在浙江省选取省、地(市)、县三级共5个性病门诊为现场,对求医者开展访谈式调查.结果 412名求医者中,外地146名,占35.4%,三类门诊中外来省份数差别不大;表现症状后求医者占78.4%;7天之内有症状者45.1%;7～14天有症状者31.3 %.50.0%以"找不到性伴"和29.3%的求医者怕"隐私披露"不愿让性伴同时进行治疗.结论性病防治工作重点应不仅扩大到基层,而且急需加强性病、艾滋病预防健康教育.     

在性病门诊促进安全性行为的有利条件和障碍因素——18个性病门诊的经验

目的 探讨在性病门诊开展咨询和推广避孕套的影响因素。方法 对上海市18个性病门诊的18名医生进行了2个集中小组访谈。结果 揭示了有利条件和障碍因素。绝大多数医生(14/18)认为有必要在性病门诊发放避孕套。所有医生一致认为性病门诊是推广避孕套使用的最佳场所,但至今尚未找到发放避孕套的最佳模式,主要原因是政策上不允许将避孕套列为处方内容或在公立门诊出售避孕套,而免费发放又缺乏经费。所有性病门诊医生都意识到咨询的重要性和必要性,然而大多数门诊尚未开展正规的咨询,主要障碍是医生认为没有时间,门诊认为没有效益。结论 (1)卫生部门应从政策上支持建立提供整合性病服务的示范门诊;(2)取消在医院或门诊内销售避孕套的限制,将避孕套列入性病门诊特需和合法的处方项目,并同计生部门协商解决避孕套的免费发放或鼓励社会市场营销活动以保证社区内避孕套的持续供应。(3)为保证能充分提供有关性病的咨询,公立性病门诊应将咨询纳入性病常规服务的范围,培训中级人员专职负责提供咨询服务。