上海市徐汇区性病服务质量再评估

目的 为了评价上海市在近些年中性病相关的政策和具体措施对性病服务质量产生的影响,为今后的性病决策提供科学依据,我们于1996年和1999年对该市的徐汇区的公立性病服务质量进行了两次评估。方法 采用定性和定量的研究方法,以统一的问卷对所有的性病服务机构进行调查,以统一的访谈提纲对部分机构进行深入访谈。定量资料用SAS软件分析。结果 1996年～1999年期间性病服务质量得到明显改善:设置性病专科门诊的机构从26.3％增至38.1％;配有男、女性病专科医生由68.4％和73.7％分别增加到90.5％和95.2％;临床和实验室医生受专科培训的比例增加;复诊率由1996年的36.3％增至1999年的57.1％;淋病的诊断方法1996年以涂片为主,1999年则以培养为主,衣原体的诊断方法1996年以病征处理为主,而1999年以金标法为主;支原体的诊断方法1996年以病征处理为主,而1999年以培养为主;1999年100％的性病服务门诊建议使用或提供避孕套、及鼓励性伴同治,1996年分别为15.8％和78.9％;提供咨询服务从68.4％增至90.5％。结论 本研究提示加强机构建设、人员培训、依法管理等促进了性病服务质量的改善;在今后的卫生体制改革中,应继续加强性病防治三级网络的机构和功能的建设。     

青岛市在押劳教人员性病艾滋病相关知识及高危行为的调查分析

目的 研究在押劳教人员对性病/艾滋病相关知识的了解程度及性病/艾滋病高危行为,为制定针对该人群的性病/艾滋病防制措施提供科学依据。方法 采用现场不记名问卷方式对某劳教所在押劳教人员进行调查,用SPSS统计软件进行数据分析。结果 52.00％的被调查者能正确回答艾滋病的三种主要传播途径,41.50％的人认为使用避孕套能预防艾滋病。33.00％的人有婚外性伴,其中多性伴者占22.50％。32.50％从不使用避孕套。22.00％的人有性病史,3.50％的人有吸毒史。结论 在押劳教人员对性病有关知识了解甚少,较多具有性病/艾滋病高危行为,是感染和传播性病/艾滋病的高危人群。提示今后应针对该人群的特点,在对他们进行道德、法制教育的同时,采取有效干预措施预防性病/艾滋病在该人群的流行。     

河南省1999年HIV哨点监测结果分析

目的 为制定我国和河南省实施预防和控制艾滋病的规划,达到预防和控制HIV感染的目的,对1999年河南省HIV哨点监测的工作进行总结和分析。方法 按照卫生部《关于开展HIV哨点监测工作的通知》中的方案进行监测工作。结果 两个监测点两次共监测1062例,其中STD人群两次共监测549例,暗娼人群共监测513例,第一次监测在暗娼人群中发现两例HIV抗体阳性者,第二次监测在STD人群中发现两例HIV抗体可疑阳性者(待确认)。结论 HIV经性途径传播已在河南省发现,将成为HIV传播的主要途径。     

High-risk human papillomavirus infection of the genital tract of women with a previous history or current high-grade vulvar intraepithelial neoplasia

Human papillomavirus (HPV) infection is associated with high-grade vulvar intraepithelial neoplasia (VIN-3). The prevalence of anogenital HPV infection in women with previously treated VIN-3 has not been documented yet. This cross-sectional study compared high-risk HPV DNA detection rates in women with past (n = 30) and current (n = 22) VIN-3 to those without current or past VIN (n = 86). HPV DNA was detected in vulvar and cervical samples with Hybrid Capture 2 (HC-2). Smoking was associated in multivariate analysis with current VIN-3 (odds ratio (OR) 8.3, 95% confidence interval (CI) 2.0-8.2) and any VIN-3 history (OR 6.5, 95% CI 2.5-16.5). High-risk HPV DNA was found on the vulva of 64%, 33%, and 20% of women with current VIN-3, past VIN-3, and without previous or current VIN, respectively. After controlling for age and smoking, high-risk HPV vulvar infection was associated with cervical high-risk HPV infection (OR 8.6, 95% CI 2.8-26.5; P = 0.001). After controlling for age, HPV infection was more often multifocal in women with current VIN-3 compared to women with previous but no current VIN-3 lesion (OR 17.6, 95% CI 1.4-227.2). Multifocal vulvar HPV infection was detected in women with previous or active VIN-3. Longitudinal studies are required to determine if the multifocality of HPV infection on the vulva could explain the high recurrence rate of VIN-3.     

密云县2005—2009年性病门诊就诊者艾滋病哨点监测分析

目的了解密云县性病门诊就诊者艾滋病性病感染状况,为制定防治对策提供科学依据。方法参照《全国艾滋病监测工作规范》,对性病门诊就诊者进行问卷调查,采集静脉血进行HIV及梅毒血清学检测。结果密云县在2005—2009年间共监测性病门诊就诊者1395人,监测对象以已婚中青年男性为主,48.24%的监测对象承认在最近3月内有非婚性伴,在发生非婚性行为时每次使用安全套仅占4.31%。性病感染率为42.94%,主要感染病种为尖锐湿疣、非淋菌性尿道炎、淋病、梅毒。检出HIV抗体阳性1例,阳性率为0.07%。结论密云县性病门诊就诊者的性病感染率较高,加强对性病门诊就诊者健康教育和行为于预,有效控制艾滋病经性途径传播。     

深圳市405例男性高危人群性病患病率及行为危险因素调查

目的了解性病门诊男性人群性病患病状况和人口学与行为学特征,为制定性病艾滋病干预措施和评估干预效果提供依据。方法收集深圳市性病门诊男性就诊者的静脉血,尿道拭子及调查问卷,进行性病艾滋病的检测,并对调查资料进行统计学分析。结果在450例受调查者中检出梅毒15例,占3.33%;淋病24例,占5.33%;生殖道沙眼衣原体感染43例,占9.56%;单纯疱疹病毒Ⅱ型感染82例,占18.22%;艾滋病HIV阳性2例,占0.44%;合并两种以上感染者20例,占4.45%。患者多以未婚的20-30岁青年、高中（中专）学历者为主,多来自农村。性病门诊男性就诊者对淋病、梅毒、艾滋病有较高的认知率,但对尖锐湿疣、生殖器疱疹、非淋菌性尿道炎及软下疳等认知率较低;大部分了解艾滋病的3条传播途径,但对日常生活不传播艾滋病存在着认识误区;安全套使用率低;接受过艾滋病病毒检测的仅占6.41%。结论针对性病门诊男性就诊者宣传艾滋病性病知识和安全性行为,倡导正确的求医行为,对降低性病艾滋病的流行具有重要意义。     

<Emphasis Type="Italic">Chlamydia</Emphasis> screening and management practices of primary care physicians and nurse practitioners in California

BACKGROUND: Because sexually transmitted chlamydial infections are common among young women, it is critical that providers screen and manage these infections appropriately.
OBJECTIVE: To assess the Chlamydia care practices of California primary care physicians and nurse practitioners.
DESIGN: Cross-sectional, self-report mail survey.
PARTICIPANTS: A stratified random sample of primary care physicians and a convenience sample of primary care nurse practitioners in California.
MEASUREMENTS AND MAIN RESULTS: Survey content included 5 topic areas: sexual history taking, management of cervicitis, management of a nonpregnant Chlamydia -infected patient, availability of onsite STD services, and Chlamydia screening practices and attitudes. Main outcome measure was the reported frequency of Chlamydia screening of sexually active women age 25 and younger. Respondents included 708 physicians (49% response rate) and 895 nurse practitioners (63% response rate). Nearly half of physicians (47%, 95% confidence interval [CI], 42% to 51%) and a majority of nurse practitioners (79%, 95% CI, 77% to 82%) reported routine Chlamydia screening of women under age 20; similar proportions reported routinely screening women aged 20 to 25 years. Independent predictors of screening among physicians were adolescent medicine specialty, female gender, practicing in a nonprivate setting, and having a higher volume of female patients. Additional findings included the overscreening of women over age 25 by nurse practitioners and the shared concern among providers that Chlamydia screening may not be reimbursed.
CONCLUSIONS: The Chlamydia care practices of many California primary care providers are inconsistent with current guidelines. Targeted provider education and improved reimbursements are potential strategies for improvement.     

Infections of the cervix uteri with human papillomavirus and Chlamydia trachomatis.

Apart from infection with human papillomavirus (HPV), other microorganisms may be involved in the development of cervical neoplasia. To study concomitant infections with HPV and Chlamydia trachomatis, cervical specimens from 4 groups of women were examined for the presence of these microorganisms by the polymerase chain reaction. The first group consisted of 143 consecutive samples from women with no cytological abnormalities who participated in a triennial screening program to prevent cervical cancer. In this group 2 samples were found positive for HPV and 2 additional samples were found positive for C. trachomatis. In the second group of 46 cytologically abnormal smears, HPV DNA was detected in 71.7% of the samples and C. tra chomatis in 4.3%. In a third group of 94 histological abnormal biopsies, the HPV prevalence ranged from 15% in mild dysplastic lesions up to 92% in invasive cervical carcinomas. Only 2 biopsies of this group (2.1%) were found positive for C. trachomatis. Finally, a group of cervical scrapes was obtained from women attending a clinic for sexually transmitted diseases. In 52 samples positive for C. trachomatis and 60 samples negative for C. trachomatis, no significant (P = 0.57) difference in the frequency of HPV infections was found (11.5% and 8.3%, respectively). The data show that in these study groups HPV and C. trachomatis are independently occurring agents.     

影响公众防治性病爱滋病知识,态度,行为的因素分析

目的分析影响公众防治性病爱滋病知识（Ｋ）、态度（Ａ）、行为（Ｐ）的因素，确定传播重点。方法随机对城市公众的工人，饮食服务人员、干部和学生共３９２人，用自行设计的ＳＴＤ／ＡＩＤＳＫ、Ａ、Ｐ量表和大众媒介覆盖等级式量表进行调查，数据用Ｆｏｘｂａｓｅ建库，以ｓｐｓｓ／ｐｓ＋包进行多元逐步回归分析。结果看报纸、电视和广播传播ＳＴＤ／ＡＩＤＳ知识的次数越多和文化程度越高，则Ｋ、Ａ、Ｐ水平越高。而男性，饮食服务人员、工人的Ｋ、Ａ、Ｐ水平则低。结论大众媒介应重点向男性、低文化程度、工人和饮食服务人员传播防治信息，提高收看覆盖率，促成科学的态度和行为。     

广州地区性病患者解脲支原体感染的流行病学研究

１９９０年１月￣１９９３年１２月，对４４４３例非淋菌性尿道炎、淋病、尖锐湿疣、生殖器疱疹、软下疳等５种性传播性疾病患者和１４０例解脲支原体感染的性伴侣，以及２６０名健康人，进行了解脲支原体培养，基阳性率分别是４１．６６％、３４．９１％、３４．６８％、３３．７１％、３２．００％、３４．２９％、３４．２９％和８．４６％。结果显示，ＵＵ在国内各种性传播性疾病中，在性伴侣中流行广，感染率高，这是我国性病防