贵州省1994～2001年性病流行病学分析

目的；分析贵州省性病流行趋势和掌握性流行特点，为制订预防和控制性病防治措施提供依据。方法：对1994－2001年贵州省性病疫情资料进行整理和统计学分析。结果：性病发病数和发病率逐年上升，发病率由1994年的12．49／10万上升至2001年的48．45／10万，淋病是历年所报告的各种性病中发病最高的，非淋菌性尿道（宫颈）炎（NGU）1995年超过尖锐湿疣（CA）上升至第二位，梅毒发病数增长缓慢，但2001梅毒大幅上升，HIV／AIDS主要是通过血液传染，性传播有增长趋势，男性发病普通高于女性，各病种发病年龄集中在20－30岁两个阶段，占性病总数的74．54％，结论：性病患病人数逐年上升且有加速上升趋势，必须尽快研制防治对策，控制性病疫情蔓延。     

江门市桑拿沐足场所从业人员的HIV/STD感染情况调查分析

桑拿、沐足场所已逐步成为性病、艾滋病潜在的传播场所,江门市涉及此类场所的人群中梅毒、淋病、衣原体、支原体的感染率分别是1.12％、3.02％、5.83％、32.09％,还未发现有HIV感染病例,其感染率仅略低于性病门诊的感染率。感染者中,中学学历者占90％以上,且多来自农村,流动性大,性病艾滋病知识水平低,是性病艾滋病传播的重点人群,应针对性采取宣传、防治和干预等综合措施,控制性病艾滋病在此类人群中的传播。     

Underrecognition of Cervical Neisseria gonorrhoeae and Chlamydia trachomatis Infections in the Emergency Department

Objectives : 1) To quantify the frequency of underrecognized Neisseria gonorrhoeae and Chlamydia trachomatis cervical infections in women tested in the ED, 2) to describe and compare the characteristics of those treated and not treated during the initial visit, and 3) to quantify the delay interval until treatment was provided. Methods : A 2-year, retrospective consecutive case series was performed from June 1, 1992, to May 31, 1994. There were 148 women with ≥1 discrete occurrence of culture-proven cervical N. gonorrhoeae or C. trachomatis infection studied. All the patients were evaluated in a university-affiliated, tertiary care hospital-based ED with a large rural referral area. The main outcome measures were the proportions of patients with positive cultures both treated and not treated in the ED, the clinical characteristics of each group, and the proportion remaining untreated or experiencing treatment delays of ≥ 2 weeks after attempted phone, mail, and public health follow-up. Results : Of 157 occurrences of positive cultures for N. gonorrhoeae or C. trachomatis, 86 (53%) were treated with a regimen suggested by the CDC prior to ED release. The proportion of women with isolated C. trachomatis infections that were underrecognized and untreated initially was larger than the proportions with isolated N. gonorrhoeae or combined infections (79% vs 27% and 53%, respectively, p < 0.0001). Women with findings suggestive of advanced disease (history of fever or chills, or examination evidence of temperature >38°C, purulent vaginal discharge, or any uterine/salpinx/ovarian tenderness) were more often recognized and treated with appropriate antibiotics initially (p = 0.02 to <0.00001 for all). After phone, mail, and public health follow-up, treatment could not be documented for 25% of the occurrences, in all cases due to an inability to locate the patient. An additional 20% of the women did not receive treatment for 14–60 days. Conclusions : In this population, both N. gonorrhoeae and C. trachomatis cervical infections are frequently underrecognized in the ED, with isolated C. trachomatis infections associated with significantly higher proportions of underrecognition. Many affected women remain untreated for extended intervals, creating public and individual health risks. Improved point of contact detection, follow-up, and treatment policies are needed to limit these risks.     

北京市五所高校大学生对艾滋病/性病防治干预需求的定性研究

目的 探讨大学生对AIDS/STD预防教育/干预的看法和需求。方法 应用专题小组讨论(FGDs)方法。结果 14组FGDs结果表明:“恐艾症”和“认为AIDS离大学生很遥远”两种不同方向的认知在大学生中普遍存在;高校开展AIDS/STD防治干预活动是学生的共同愿望和需求;绝大多数学生主张干预内容应与性/生殖健康教育相结合,并强烈呼吁增加安全性行为(尤为避孕套知识和技能)教育的内容。干预活动易采用多种形式并用,以便具有不同特征的对象自主选择他们所喜欢的方式。另外,学生建议利用大众媒体创造良好的社会支持环境。结论 大学生对AIDS/STD预防教育的看法为有效地设计和实施教育项目提供了重要依据。在首都大学生中开展包括性教育在内的综合AIDS/STD防治干预活动势在必行。     

上海市嘉定区性病门诊健康促进服务质量调查研究

目的了解嘉定区性病门诊健康促进服务开展情况及相关影响因素。方法采用定性和定量相结合的方法,对嘉定区5所医疗机构性病门诊健康促进服务质量进行评估。结果共回收有效问卷402份,对14位医生进行个人访谈。安全套促进、性伴通知和自愿咨询检测提供率分别是40.3%、77.1%和83.3%,性传播疾病（STD）服务质量指标2仅为33.1%,而不同医疗机构就诊者获得STD服务的差异有统计学意义。定性访谈结果显示：性病门诊医生具有开展健康促进服务的意识,但由于激励机制、人力、物力、时间、安全套来源、患者等因素的影响,开展情况还不容乐观,尤其是安全套促进方面。结论嘉定区5所医疗机构的性病门诊健康促进服务质量不一,服务质量有待进一步提高,应加强医务人员培训,制定奖励机制,加强与计生部门的合作。     

2010年乌鲁木齐市高新区(新市区)性病监测点性病流行病学分析

目的了解新疆维吾尔自治区乌鲁木齐市高新区(新市区)性病监测点性病的发病趋势和流行特征,为今后制定监测点性病防治策略提供科学依据。方法采用中国疾病预防控制信息系统"疾病监测信息报告管理系统"和Excel 2003统计软件对乌鲁木齐市高新区(新市区)2010年网络直报的性病疫情数据进行分析,并与2009年进行比较。结果高新区(新市区)累计报告5种性病2 307例,其中男性1 166例,女性1 141例,男女性别比为1.02∶1;总报告发病率为576.75/10万;报告病例最多的病种为梅毒(71.09%),其次为尖锐湿疣(12.96%);年龄以≥50岁与20～40岁为主,实验室诊断占85.83%;职业以待业人员(1 111例)和农民(281例)为主。结论 2010年新疆维吾尔自治区乌鲁木齐市高新区(新市区)性病监测点性病报告发病率除梅毒和生殖道沙眼衣原体感染报告病例较2009年有所增长外,余4种性病报告病例数均有不同程度下降。     

性病门诊患者支原体检测及药敏分析

目的 了解近年性病（Sexually transmitted diseases,STD）门诊患者支原体感染及耐药情况。方法对446例STD门诊患者进行支原体培养,并对阳性标本做9种抗生素药敏试验。采用支原体培养、鉴定、药敏一体化试验盒进行检测。结果446例中支原体阳性211例,感染率为47．31％。解脲脲原体（UU）、人型支原体（MH）及UU＋blH混合感染的阳性率分别为39．46％（176例）、2．02％（9例）、5．83％（26例）。UU对9种药物敏感性最高的是交沙霉素（99．43％）,其次是美满霉素（96．02％）。耐药性最高为氧氟沙星（76．14％）,其次为左氧氟沙星（67．05％）。结论STD门诊支原体感染率高达47．31％,主要为UU引起（39．46％）;交沙霉素是治疗泌尿生殖道UU感染的首选药物。     

Prevalence of HIV,Hepatitis B,Syphilis, and Chlamydia Among Adults Seeking Treatment for a Mental Disorder in Southern India

This study estimated the prevalence, and identified the correlates, of HIV, chlamydia, syphilis, and Hepatitis B among patients seeking treatment for a mental disorder in India. Patients (n = 948) submitted a blood sample for serologic testing and participated in a brief interview. Lifetime prevalence rates were nearly 2% for HIV, 10% for chlamydia, 3% for Hepatitis B, and 3% for syphilis; 15% of patients had evidence of at least one infection. Bivariate associations between infection status and patient characteristics, including age, gender, psychiatric diagnosis, did not reveal any consistent risk profile. Instead, behavioral characteristics (i.e., multiple partners, exchanging sex for money, and engagement in anal sex) were associated with infection status. Recommendations for the sexual health care of psychiatric patients in India are provided. SUPPORT: R01-MH54929 and K02-MH01582 from the National Institute of Mental Health.     

Conducting Internet-Based HIV/STD Prevention Survey Research: Considerations in Design and Evaluation

The aim of this paper is to advance rigorous Internet-based HIV/STD Prevention quantitative research by providing guidance to fellow researchers, faculty supervising graduates, human subjects’ committees, and review groups about some of the most common and challenging questions about Internet-based HIV prevention quantitative research. The authors represent several research groups who have gained experience conducting some of the first Internet-based HIV/STD prevention quantitative surveys in the US and elsewhere. Sixteen questions specific to Internet-based HIV prevention survey research are identified. To aid rigorous development and review of applications, these questions are organized around six common criteria used in federal review groups in the US: significance, innovation, approach (broken down further by research design, formative development, procedures, sampling considerations, and data collection); investigator, environment and human subjects’ issues. Strategies promoting minority participant recruitment, minimizing attrition, validating participants, and compensating participants are discussed. Throughout, the implications on budget and realistic timetabling are identified.