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.     

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。     

学校教师讲授预防艾滋病知识与大学新生知识态度及行为的关联

目的通过对某大学新生在学校期间教师对其进行预防艾滋病教育的回顾性调查,了解学校预防艾滋病教育状况,探讨学校教育与学生知识态度和行为的关联。方法以不记名问卷调查方式,对北京某大学746名入学新生进行调查。结果80%左右的大学新生报告学校教师曾讲过艾滋病的传播途径(84.0%),不传播艾滋病的活动(74.3%)和不歧视艾滋病病人(80.8%)。约10%的学生报告学校教师曾讲过如何抵御不正当的同伴压力(10.6%)、作出正确决定的技能(10.8%)、预防性侵犯知识(12.0%)和性病知识(11.0%)。只有4.7%的学生报告教师讲过正确使用避孕套。学生预防艾滋病知识和态度得分与学校教师教育有关。报告教师讲过正确使用避孕套与报告没讲过这一知识的学生,性交行为发生率没有明显的差异。85.8%的学生表示希望学习有关预防艾滋病、性病方面的知识。结论学校教师讲授预防艾滋病知识内容不够全面。应重视学校教师预防艾滋病教育的培训,确保学生从学校获得预防艾滋病所需要的知识和技能。     

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。     

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。     

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.     

凉山州2003～2004年HIV/AIDS的综合监测

目的：了解凉山州各类人群艾滋病病毒感染者／艾滋病(HIV／AIDS)的感染情况及高危行为，和其流行现状和趋势。方法：按照艾滋病行为和血清学监测方案的操作程序及调查方法对全州吸毒者、女性商业性性工作者、孕产妇进行行为及血清学监测。结果：2227例吸毒者艾滋病感染率为15．5％(346人)，吸毒者共用针具率为13．1％；女性商业性性工作者感染率为0．8％(3人)，只有51．1％的CSW(女性性商业工作者)在每次与客人发生性关系时都使用安全套；孕产妇监测中2004年发现首例HIV感染者。结论：我州HIV感染途径主要还是静脉吸毒共用针具及性乱，女性商业性性行为者性行为将在艾滋病向普通人群传播中起重要作用，应当加强综合干预措施等。     

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.     

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。     

徐汇区建筑工人性病艾滋病及安全套使用知信行状况分析

[目的]了解建筑工地工人性病艾滋病（STDs／AIDS）及安全套的知识、态度及行为,为开展健康教育提供指导依据。[方法]采取整群随机抽样的方法,对上海市徐汇区6个建筑工地的620名建筑工人进行问卷调查,主要包括性病艾滋病的知识、态度和安全套的认识及使用等内容。[结果]在性病艾滋病知识、态度及行为方面,有关“性病是可预防的”、“与艾滋病病人不用安全套的性行为可以传播艾滋病毒”、“感染艾滋病病毒的孕妇可以将病毒传染给胎儿”及“艾滋病病毒携带者可能会看起来很健康”等问题的回答正确率较高,在79．9％～96．76％之间。但对于几个关于感染途径的问题（如与艾滋病人握手,共用毛巾、马桶,接吻,咳嗽及昆虫叮咬等）,大多数人存在错误认识,回答正确率仅为4．60％～35．9％。在安全套的认识和使用方面,有关安全套的正确使用方法,仅有11．11％的人知道用食用油或凡士林作为安全套润滑剂会导致安全套破裂,27．21％的人知道戴安全套时应该把顶部小囊中的空气挤掉,29．47％的人知道在把安全套戴上阴茎之前,安全套不应该被完全展开。发生商业性性行为时,61．10％的人会选择使用安全套,但与配偶或情人发生性关系时,仅有不到25％的人使用安全套。[结论]建筑工人多数来自农村,文化程度较低,大多居住在建筑工地,与外界相对隔绝,对性病艾滋病知识比较缺乏,安全套的认识及使用率较低,应采取有针对性的宣教方式,加强对建筑工人相关防治知识的宣传及安全套的推广使用,使性病艾滋病防治知识得以提高。     

重庆市主城区建筑农民工艾滋病防治知识、态度和高危行为调查

目的:了解重庆市主城区建筑农民工免疫缺陷病毒(HIV)/艾滋病(AIDS)防治知识、态度及高危行为。方法:随机选取重庆市主城区3个区建筑农民工,由专业人员进行问卷调查,内容包括HIV/AIDS相关知识、态度及高危行为等。结果:共调查1 243人,8个HIV/AIDS防治知识问题中回答正确占33.95%～80.13%,全部回答正确的占总调查人数的15.12%;10种获得艾滋病知识途径中处于前3位的分别是:电视53.50%、广播37.01%、宣传材料31.62%;最近1年与配偶(或同居者)发生性关系每周≥1次占44.2%,最近1年从未使用过安全套的占44.0%;发生过商业性行为占14.9%,其中使用安全套的占21.1%;7.9%与临时性伴发生过性关系,使用安全套的占58.2%;性疾病感染人数为75人(6.03%),3个区感染率差异有统计学意义(χ2=24.54,P<0.05)。结论:重庆市主城区农民工HIV/AIDS防治知识全面掌握率较低,存在商业性行为和临时性伴发生性行为,安全套使用率较低,是艾滋病传播的高危人群。     

HIV risk factors, HIV antibody testing, and AIDS knowledge among African Americans age 55 years and older

This study uses data from the 1992 AIDS Knowledge and Attitudes Supplement to the National Health Interview Survey to assess AIDS knowledge, prevalence of HIV testing, and HIV risk factors among 745 African Americans age 55 years and older. The results revealed that only one of the six respondents who reported an HIV risk factor had been tested for HIV. Overall, the respondents were very knowledgeable about the major modes of transmission, but they still had misconceptions about the likelihood of transmission through casual contact. Prevention programs aimed at African Americans age 55 years and older should focus on dispelling misconceptions about the transmission of HIV through casual contact, and enhancing their knowledge about the effectiveness of condoms in preventing the spread of AIDS.     

HIV/AIDS Knowledge and Attitudes Among Chinese College Students in the US

This study assessed knowledge and attitudes about HIV/AIDS and sources of HIV/STI information among Chinese college students living in the USA and explored specific factors associated with knowledge levels and types of sources of information. We surveyed 133 Chinese students enrolled in three US universities. About 41.4 % believed that HIV could be contracted through mosquito bites, and 22.6 % were unaware that condoms could prevent HIV. Sources of HIV/STI information were the mass media. Males were more likely to demonstrate a higher HIV/AIDS knowledge level than females. Graduate students were more likely to cite television as a source of information, and less likely to mention school teachers, than were undergraduate students. These ethnic minority immigrant students held misconceptions about HIV transmission and prevention, and possibly utilized information of varying quality. Accordingly this study identifies specific objectives for education, including basic biology and diversity issues from evidence-based sources.     

武汉地区女大学生性病艾滋病知识知晓状况

目的了解女大学生性病及艾滋病知识知晓状况,为开展相关的健康教育提供科学依据。方法在武汉地区的高校中,分层整群抽取2365名女大学生,以无记名自填式问卷进行调查。结果女大学生对艾滋病、淋病和梅毒的知晓率均在60%以上,对艾滋病三大传播途径的知晓率为88.33%。除对同性恋知晓率较低外,女大学生对艾滋病主要高危行为和高危人群的知晓率为72.18%。有33.49%的女生认为蚊虫叮咬会传播艾滋病,知道“100%安全套行动”的仅占0.89%,知道“性行为中女性比男性更容易感染艾滋病”的也仅占26.72%。结论女大学生具有一定的性病、艾滋病防治知识,但仍需进一步提高。     

Using focus groups to investigate the educational needs of female injecting heroin users in Taiwan in relation to HIV/AIDS prevention

This study investigated educational needs of female injecting heroin users in Taiwan relating to HIV/AIDS prevention via six focus group discussions in a prison. All sessions were audio-taped with respondents' consent and the discussions transcribed verbatim. The findings indicated that respondents had adequate knowledge about HIV/AIDS, but held misconceptions regarding the modes of HIV transmission. Many respondents who did not perceive themselves susceptible to AIDS rarely used condoms and occasionally shared needles. Stigma surrounding AIDS is pervasive among respondents and they considered contracting cancer would be preferable to having AIDS; the latter could precipitate suicide. Lastly, many respondents had no confidence in assurances of confidentiality regarding HIV testing. Issues of misconceptions, high-risk behaviors, stigma surrounding AIDS and confidentiality of HIV testing must be addressed in appropriate HIV/AIDS education programmes with respect to the needs of female injecting heroin users.     

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。     

Sexual behavior among truck drivers

A cross-sectional study was conducted on Lucknow highway in Bareilly district of Uttar Pradesh to study the knowledge of truck drivers about HIV transmission and prevention and to study the sexual behaviour of these drivers with reference to HIV/AIDS. Age, marital status, education, income, drinking alcohol, length of stay away from home, knowledge about transmission and prevention of HIV, and HIV-prone behavior of truck drivers were studied. Chi-square, mean, and SD were calculated. In all, 289 (97.6%) drivers had heard about HIV/AIDS. Only 242 (81.8%) were aware of HIV transmission by heterosexual route. Misconceptions such as HIV transmission by mosquito bites, living in same room, shaking hands, and sharing food were found. Out of 174 (58.8%) who visited Commercial Sex Workers (CSW), 146 (83.9%) used a condom. 38 (12.8%) visited more than 5 CSW in the last 3 months. Time away from home on the road, marital status, alcohol use, and income class were associated with visiting CSW. High-risk behavior was established in the study population. Safe sex and use of condoms need to be promoted among the truck drivers and better condom availability needs to be assured on highways.     

A pilot study for an HIV prevention programme among commercial sex workers in Bulawayo, Zimbabwe

In a health education pilot study for a programme to reduce HIV transmission among commercial sex workers (CSWs), 113 CSWs were interviewed and observed in Bulawayo, Zimbabwe during 1989. The educational level of the sample was low and less than a quarter had another job, either as a self-employed vendor/hawker or a domestic servant. Inability to earn income in other ways was the major reason cited for engaging in commercial sex. Nearly half the sample went for check-ups every 3 months or more often. All interviewees had heard about AIDS, but they were uniformed about several facets of AIDS. CSWs reported that they worked an average of 3.6 nights a week, averaged 1.3 clients a night and charged a mean of U.S. $2.8 a session and U.S. $6.5 a night. CSWs reportedly saw a total of 221 clients in the past 7 days and used condoms with 87 (39.3%) clients. Nearly all CSWs said they had done something to reduce the risk of getting AIDS, but when asked what they had done, only 40% said they were using condoms more frequently and many cited ineffective precautions. CSWs who had a job, charged higher fees, experienced little client violence and believed that they were susceptible to AIDS were more likely to use condoms. Clients were a cross-section of Bulawayo society, with widely varying education, incomes and occupations and shared little except an interest in commercial sex. Ethnographic approaches demonstrated a lack of cohesion among CSWs and a consequent need to foster organized, motivated groups for health education, the importance of incorporating clients in health education and the feasibility of using bar security and sales personnel as health educators. It is concluded that health education is urgently needed among CSWs, but that it is equally important to direct health interventions at clients, many of whom are resistant to condom use.     

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。     

工厂外来女工艾滋病干预模式研究

目的 了解珠江三角洲工厂外来女工艾滋病相关知识、态度、信念、行为(KABP)，探索适合该人群的有效的艾滋病干预模式。方法 采用匿名问卷法对外来女工进行基线调查后开展针对该人群的艾滋病综合干预措施，并对干预结果进行评价。结果 工厂外来女工艾滋病知晓程度非常低，缺乏自我保护意识和能力，生殖健康状况较差，是艾滋病的脆弱人群。干预后，其对艾滋病传播途径和预防方法的知晓率显著提高，安全性行为率增高，安全套使用率增高。结论 干预模式取得明显效果，可在该类人群中推广。