西昌市社区吸毒人群艾滋病行为干预

目的 目前国内艾滋病高危人群的行为干预均在探索阶段。该研究旨在探索社区吸毒人群预防艾滋病的行为干预模式。方法 干预方法主要是以同伴为基础的社区健康教育、建立医学咨询服务点、避孕套及注射器市场营销。结果 1998－1999年四川省性病艾滋病防治协会在凉山州西昌市3个村开展了社区吸毒人群艾滋病干预项目。社区人群及吸毒人员干预后艾滋病知识均有明显提高（P＜0．01）。吸毒人员均放弃了共用注射器行为,但避孕套的推广使用不理想。结论 以同伴为基础的社区健康教育和避孕套及注射器营销在预防控制艾滋病方面是有效的手段,但避孕套的推广工作有待进一步改进。     

西藏国境口岸目标人群预防艾滋病行为干预分析评估

目的西藏国境口岸目标人群艾滋病(AIDS)高危行为干预,是预防艾滋病(HIV)传播的有效方法,并可以提出开展艾滋病相关知识宣传的对策和科学依据。方法采用整群抽样的方法于2010年4月-9月对四个口岸的目标人群为干预对象;对调查对象开展健康教育及行为干预活动;部分高危人群(酒吧、舞厅小姐)进行艾滋病抗体检测;评价健康教育和行为干预效果;探讨、制定今后在口岸目标人群中开展健康教育和行为干预方案和措施。结果西藏口岸目标人群的艾滋病基本知识干预前后有明显效果:知道艾滋病的病原体的培训前后有显著差异χ2=22.19P<0.001;知道艾滋病的传播途径的培训前后有显著差异χ2=44.54P<0.001;不同文化程度间艾滋病传播途径培训前后有显著差异χ2=255.841P<0.001;不同职业间使用安全套可以预防艾滋病的培训前后有显著差异χ2=317.094P<0.001;口岸目标人群对艾滋病行为态度有明显提高如怀疑自己感染艾滋病会到正规医院去的干预前后有显著差异χ2=41.376P<0.001;血液传播艾滋病但义务献血去正规医院和血液中心的干预前后有显著差异χ2=58.89P<0.001;同情和愿意帮助艾滋病病人和感染者的人数培训前后有显著性差异χ2=45.129P<0.001。结论对西藏口岸目标人群的艾滋病基本知识普遍较低,经过本次的多种形式的宣传、培训有明显效果,通过宣传教育把有关预防知识交给群众,预防为主,群体预防,提高群众的自我保护能力,是目前预防和控制艾滋病最有效方法之一。     

对"板板茶"行为干预的初步探索

在“通过雇主对商业性性工作者 (ＣｏｍｍｅｒｃｉａｌＳｅｘＷｏｒｋｅｒＣＳＷ)作行为干预”项目活动中发现 ,有些ＣＳＷ没有雇主 ,也没有固定工作场所。通常是在茶馆兜揽顾客、在极简陋的条件下 (有时是在一块门板上 ,“板板茶”以此得名 )以极低的价格提供性服务。她们可能还要受某种黑社会性质团伙的盘剥。这类ＣＳＷ性卫生问题特别严重 ,是切断性病艾滋病传播不得不重视的途径。但对她们的行为干预有相当的危险性。2 0 0 2年 7月 ,在线人的帮助下秘密访问了 5名“板板茶ＣＳＷ ,用个别访谈的方式探索行为干预的可能性 ,报告如下。1　…     

行为转变理论模式与艾滋病行为干预

由艾滋病病毒(HIV)感染引起的艾滋病(AIDS)是一种新的传染病,自1981年世界第1例被报道以来,它的流行与危害以及所造成的严重后果已日益引起全世界的广泛重视.艾滋病与人类历史上曾经肆疟一时的天花、麻疹、脊髓灰质炎等其他传染病不同,目前尚无有效的疫苗和彻底治疗方法.全世界对此已达到的共识是,在可以预见的将来,同艾滋病作斗争的最大希望在于帮助人们选择比较安全的行为,以使他们不那么容易感染和传播艾滋病病毒 [1].     

社区行为干预对早期颈椎病的作用

目的探讨行为干预对早期颈椎病的作用。方法将100例早期颈椎病患者随机分成两组,对照组50例,接受常规治疗护理,干预组50例,在常规治疗的同时再给行为干预。结果干预组症状的发生程度明显低于对照组(P<0.05)。结论行为干预能有效减轻颈椎病的临床表现。     

泸州市男男性行为人群行为干预效果分析

目的 评价泸州市2009-2011年对男男性行为(MSM)人群进行健康教育和行为干预的效果,确定未来干预工作的重点方向.方法 采用“滚雪球”的方法对泸州市MSM人群进行行为干预,采用非概率抽样方法选取调查对象并进行问卷调查.结果 2009-2011年泸州市MSM人群接受健康教育和行为干预的比例分别为89.50％、97.75％和98.75％,呈上升趋势;艾滋病基本知识知晓率分别为94.25％、92.75％和92.50％,差异无统计学意义;最近1次与同性发生肛交性行为时使用安全套的比例分别为58.00％、84.46％和73.76％,最近1次发生商业性行为时使用安全套的比例分别为50.00％、64.00％和92.86％,最近1次与异性发生性行为时使用安全套的比例是80.85％、47.54％和75.00％.结论 泸州市MSM人群艾滋病基本知识知晓率较高,但坚持使用安全套比例较低.普遍存在感染艾滋病的高危行为与较高的艾滋病基本知识知晓水平严重分离的现象.     

昆明市官渡区女性性工作者行为干预前后效果评价

[目的]对昆明市官渡区部分女性性工作者进行行为改变干预后,了解她们与艾滋病相关知识和高危险行为是否发生改变,探讨行为干预措施的有效性,为今后的干预提供理论依据。[方法]随机抽样官渡区部分女性性工作者,在开展行为改变干预前后对她们进行行为监测问卷调查。[结果]调查结果表明,在开展行为改变干预活动后,官渡区的性工作者艾滋病相关知识有了很大的提高,商业性性行为中安全套的使用率也明显增加,这些行为的变化是当地开展艾滋病综合干预活动的结果。[结论]官渡区对女性性工作者的综合干预取得了明显的效果,但若要进一步降低高危性行为的发生,遏制住艾滋病病毒在当地性工作者中的传播速度,还需要进一步加强综合干预的力度和广度。     

如何在出入境人员中实现行为转变理论模式对爱滋病行为干预

行为转变理论模式经过十多年的发展和完善.在爱滋病行为的预防和控制方面越来越显示其卓有成效的效果.本文对行为转变理论模式进行了详细介绍.从行为干预计划的制定、行为干预的实施和行为干预效果的评价等方面,重点探索如何在出入境人员中实现行为转变理论模式对爱滋病行为干预.目的 是为了在检验检疫系统内规范行为干预的方针、策略和评价体系.共同担负起完成我国(1998-2010)中长期抑制爱滋病的传播和流行的宏伟目标的任务.     

如何在出入境人员中实现行为转变理论模式对爱滋病行为干预

行为转变理论模式经过十多年的发展和完善.在爱滋病行为的预防和控制方面越来越显示其卓有成效的效果.本文对行为转变理论模式进行了详细介绍.从行为干预计划的制定、行为干预的实施和行为干预效果的评价等方面,重点探索如何在出入境人员中实现行为转变理论模式对爱滋病行为干预.目的是为了在检验检疫系统内规范行为干预的方针、策略和评价体系.共同担负起完成我国(1998-2010)中长期抑制爱滋病的传播和流行的宏伟目标的任务.     

MSM人群艾滋病性病防治行为干预效果评价

目的 探索针对男男性行为者(MSM)人群特征的有效行为干预方法.方法 建立疾病预防控制中心(CDC)主导与MSM志愿者骨干实施相结合的MSM人群艾滋病性病防治组织模式,以核心同伴宣传(POL)干预方法为主,结合网络宣传、外展服务等进行MSM行为干预,2006年12月、2007年7月、2008年1月分别采用应答者驱动招募法(RDS)对MSM人群进行基线、中期及期终评估招募调查,对调查结果进行比较分析.结果 基线调查201人,中期200人,期终203人.基线、中期、期终调查比较:不同性伴性行为安全套坚持使用率分别为:近6个月31.4%、43.4%、51%,近3次38.1%、58.2%、64.2%,近1次56.8%、72.8%、82.1%,差异均有统计学意义,上升趋势显著(P<0.05);近6个月不同类别性伴数,差异均无统计学意义(P>0.05);固定性伴(BF)性行为方式分别为58.7%、71%、63.1%,差异有统计学意义(X2=6.782,P<0.05). 结论 CDC为主导、MSM志愿者骨干实施的组织模式下,通过为期1年的POL为主,结合网络、外展等干预,有效提高了MSM社群安全性行为意识.     

发挥部门职能优势开展对强制戒毒人员的艾滋病干预

发挥云南省公安厅禁毒局的部门职能优势，在10个强制戒毒所开展中英性病艾滋病防治合作项目，在干警能力建设和吸毒者同伴教育两个方面都达到了项目的要求，取得了一定的经验。     

Implications of directly observed therapy in tuberculosis control measures among IDUs.

Tuberculosis (TB) is a rapidly growing problem among injecting drug users (IDU), especially those infected with human immunodeficiency virus. The authors review IDUs'' responses to current TB control strategies and discuss the implications of their findings for the proposed implementation of directly observed therapy (DOT), a method for ensuring that patients take prescribed medication. Field workers carried out 210 ethnographic interviews with 68 IDUs in a Brooklyn, NY, community during 1990-93. Case studies suggested that many IDUs are uninformed about TB and often misinformed about their personal TB status. Ethnographic interviews and observations indicated that the threat of TB-related involuntary detainment may lead IDUs to avoid TB diagnostic procedures, treatment for TB, or drug abuse treatment, and to avoid AIDS outreach workers and other health-related services. IDUs who tested positive for the purified protein derivative (PPD) of TB sometimes have left hospitals before definitive diagnoses were made, because of a perceived lack of respectful treatment, fear of detention, or lack of adequate methadone therapy to relieve the symptoms of withdrawal from drugs. Current TB diagnosis and treatment systems are, at best, inadequate. The threat of TB-related detention discourages some IDUs from seeking any type of health care. There is an urgent need to educate IDUs about TB and to educate and sensitize health care providers about the lifestyles of IDUs. DOT may help in servicing this difficult-to-serve population, particularly if techniques are incorporated that have been developed for other successful public health interventions for IDUs.     

2010-2011年乌海市吸毒人群中丙型肝炎病毒感染调查

目的 了解我市吸毒人员中丙肝感染的情况及其高危因素,为控制丙肝流行提供科学依据.方法 对2010-2011年乌海市监测哨点中吸毒人群进行了调查及血清抗-HCV抗体检测分析.结果 2010-2011年合计检测911人,检出血清抗-HCV抗体阳性者580例,阳性率为63.67％.其中血清抗-HCV抗体阳性率青壮年人群显著高于其它人群(x2=40.81,P＜0.05),静脉吸毒人群显著高于口吸人群(x2=312.46,2＜0.01).结论 吸毒人群中血清抗-HCV抗体阳性率远远超过自然人群的感染率,而且通过注射方式吸毒是HCV感染的高危因素,说明该人群存在着丙肝传播与流行的高危因素,是丙肝防治的重点人群.     

HIV outbreak among injecting drug users in the Helsinki region: social and geographical pockets

BACKGROUND: Incidence of newly diagnosed HIV infections among injecting drug users (IDUs) in Helsinki rose from 0 per 100,000 inhabitants in 1997 to 2.9 in 1998 and to 11.1 in 1999. Thereafter incidence declined to 2.1 in 2003. METHODS: Data were collected from interviews with HIV-positive IDUs who attended the University Hospital in Helsinki from 1998 until 2003. We studied the sociodemographic profile and spatial distribution of IDUs who were diagnosed in the beginning of the outbreak and those diagnosed later. The indicator for the spatial differentiation within the metropolitan area is % employed males aged 25-64. RESULTS: The outbreak occurred among a marginalized population of IDUs characterized by a long history of injecting drug use (10.7 years), mean age 32 years, homelessness (66.3%), history of imprisonment (74.7%) and psychiatric hospital care (40.6%). Compared with 98 early cases diagnosed during the first 2 years until 2000, 47 recent cases diagnosed after 2001 were 4 years older, and as marginalized. Except for the city centre, both early and recent cases had been living or using drugs in the same deprived neighbourhoods with the highest unemployment rates. Up to 40% of cases in the two big geographical clusters did not have contact with the city centre, where the needle exchange services were available. CONCLUSIONS: The Finnish HIV outbreak is restricted socially to a very marginalized IDU population, and spatially to local pockets of poverty. In low prevalence countries, prevention programs should be targeted early at high-risk areas and populations.     

Taking advantage of security opportunities in new hospitals--large and small

Although in many parts of the country the trend is for hospitals to merge, consolidate, or even shut down due to financial constraints and increased competition from managed care, in other areas new hospitals are being built--and with more advanced security systems for protecting patients, visitors, and staff. In this report, we'll give details on the security planning involved in the building of four new facilities, ranging in size from 56 to 400 beds, each in a different region of the country.     

上海市浦东新区吸毒人群艾滋病知、行、信调查分析

目的 了解吸毒人群预防艾滋病核心知识的掌握情况、生存状态主观评价及对待艾滋病的态度,为今后该人群的HIV检测及预防干预策略的制定提供参考依据.方法 对浦东新区中致社管理的吸毒人员进行HIV检测和问卷调查.结果 共调查吸毒人员429人,其中男性333人,占到73％,发现HIV阳性2例,感染率为0.5％;共用注射器、输血、...     

南宁市注射吸毒人群共用针具行为及影响因素分析

目的了解南宁市注射吸毒人群共用针具现状及分析影响因素。方法采用匿名填写问卷的方式,对来自社区和戒毒所的733名注射吸毒人员进行艾滋病预防知识和行为的问卷调查。结果该市注射吸毒人群曾经共用针具的比例为53.3%。391名曾经共用针具的注射吸毒者中有51人在最近一次注射吸毒时仍然共用针具。对是否与别人共用过针具的多因素lgistic回归分析显示,文化程度、首次吸毒年龄、是否在戒毒所戒过毒、最近一年是否与商业性伴发生过性关系是具有统计学意义的影响因素。对与商业性伴发生性关系的多因素lgistic回归分析显示,性别、首次注射吸毒年龄、是否与他人共用过注射器是具有统计学意义的影响因素。对最近一次注射吸毒是否共用针具的多因素logistic回归分析显示,文化程度、是否在戒毒所戒过毒是具有统计学意义的影响因素。结论文化程度是影响注射吸毒者曾经共用针具和最近一次注射吸毒共用针具行为的共同因素;在戒毒所接受过戒毒的注射吸毒者其共用针具行为会发生改变;掌握艾滋病预防知识不一定能减少注射吸毒人群共用针具的行为。在加强艾滋病防治知识宣教的同时,要更加侧重于行为的干预。     

Exploring intergenerational changes in perceptions of gender roles and sexuality among Indigenous women in Oaxaca

The south of Mexico has traditionally faced disproportionate social, health and economic disadvantage relative to the rest of the country, due in part to lower levels of economic and human development, and barriers faced by Indigenous populations. The state of Oaxaca, in particular, has one of the highest proportions of Indigenous people and consistently displays high rates of maternal mortality, sexually transmitted infections and teenage pregnancy. This study examines how social values and norms surrounding sexuality have changed between two generations of women living in Indigenous communities in Oaxaca. We conducted semi-structured in-depth interviews with 19 women from two generational cohorts in 12 communities. Comparison views of these two cohorts suggest that cultural gender norms continue to govern how women express and experience their sexuality. In particular, feelings of shame and fear permeate the expression of sexuality, virginity continues be a determinant of a woman’s worth and motherhood remains the key attribute to womanhood. Evidence points to a transformation of norms, and access to information and services related to sexual health is increasing. Nonetheless, there is still a need for culturally appropriate sex education programmes focused on female empowerment, increased access to sexual health services, and a reduction in the stigma surrounding women’s expressions of sexuality.     

A model to facilitate outcome assessment of obstructive sleep apnea

OBJECTIVES: Obstructive sleep apnea is a common disorder with significant morbidity and effects on quality of life. Management can include a range of mechanical, behavioral, and surgical approaches. This paper aims to devise a model of management options to assist in initial cost-effectiveness investigations. METHODS: In the absence of practice pattern data and widely accepted guidelines, we reviewed published literature and devised a model of treatment options to facilitate initial studies of outcomes, costs, and cost-effectiveness. RESULTS: Obstructive sleep apnea is rarely addressed by conservative behavioral-based strategies because these options, while inexpensive, have only limited effectiveness. Effective treatment most often relies on nasal continuous positive airway pressure, but poor tolerance or compliance sometimes leads to treatment with oral appliances or surgery. Patients treated by one modality may try another if the initial strategy is ineffective. Laboratory evidence that sleep apnea is effectively treated, and long-term follow-up, are necessary regardless of the treatment modality chosen. CONCLUSIONS: Each patient's treatment plan must be individually tailored, but the management model proposed here reflects available evidence-based literature and the authors' impression of current practice patterns. This model should be useful for initial cost-effectiveness investigations.