在一年级大学生中开展艾滋病/性病/安全性行为同伴教育效果的定性评价

1998年9月～12月，在北京某医科和某工科大学一年级新生中开展艾滋病／性病／安全性行为同伴教育后，组织了10个专题小组讨论，17人的个人深入访谈，收集对该教育的反馈信息，并对效果作定性评价。     

599名江苏农村孕产妇性病／艾滋病防治知识和生殖道患病情况调查

目的了解江苏农村孕产妇性病／艾滋病防治知识知晓情况和生殖道患病情况，以便制订针对性的防治策略和措施。方法自制性病／艾滋病防治知识调查表，逐级培训调查员，按照分阶段抽样，在淮安、盐城两市抽取两个县，2006年4月至2007年12月在每个县抽取300名孕产妇进行性病／艾滋病防治知识、相关行为及生殖道感染情况调查。结果农村孕产妇性病／艾滋病防治知识知晓率很低，除了听说过性病、梅毒的人数超过60％，调查的其他性病和艾滋病知晓率均在20％以下；对性病／艾滋病传播途径如与性病患者握手是否会传染、与性病患者一同游泳或洗澡是否会传染、艾滋病母亲哺乳是否会将艾滋病传播给婴儿的知晓率均在20％以下。性病／艾滋病常见症状知晓率较低，性病患者可能出现尿急尿痛、性病患者可能出现生殖器部分溃烂、性病患者可能出现全身皮疹、性病患者生殖器部位长赘生物、艾滋病患者早期可能发热消瘦腹泻等知晓率均在11％以下。安全套对性病／艾滋病的预防作用的知晓率为7．0％；高中以上与初中以下学历孕产妇对性病／艾滋病防治知识知晓率有统计学差异（x^2=13．01，P〈0．01）；孕产妇累计生殖道感染率达10．8％。结论农村孕产妇的性病／艾滋病知识知晓率较低，应该加强健康教育，发挥电视、广播等媒体作用，控制性病／艾滋病经孕产妇传播。     

医学生预防艾滋病/性病同伴教育效果追踪评价

为探讨大学生预防艾滋病／ 性病同伴教育效果的持续作用， 采用非等同比较组设计， 以某两所医科大学九八级新生为研究对象， 在对干预组开展预防艾滋病／ 性病同伴教育活动并进行教育后一周评价的基础上， 于教育后六个月进行效果追踪评价。结果表明： 教育前干预组男、女生艾滋病知识、性病知识均分分别为１４－４、１３－９ 和１３－２、１１－３； 教育后一周， 干预组男、女生艾滋病知识、性病知识均分分别为１９－３、２１－５ 和１９－０ 、２１－０。教育后六个月， 干预组男、女生艾滋病知识、性病知识均分分别为１８－９ 、１９－７ 和１９－０、１９－２ 。教育后六个月与教育后一周比较： 干预组男女生艾滋病／ 性病知识均分有所下降（Ｐ＜０－０５）， 内、外对照组男、女生艾滋病／ 性病知识均分有所上升（Ｐ＜０－０５、Ｐ＜ ０－０１） 。教育后六个月干预组与内、外对照组比较， 干预组男、女生艾滋病／ 性病均分仍均高于内、外对照组（Ｐ＜ ０－０５）， 干预组男、女生对艾滋病病人持某些正向态度的比例也高于内、外对照组。研究结果表明同伴教育具有一定的延续作用。     

STD门诊644例梅毒螺旋体抗体检测结果分析

梅毒螺旋体(TP)是引起梅毒的病原菌[1],主要传播途径为性传播、血液传播及母婴传播,感染后出现皮疹、溃烂及多器官、脏器的损害,给人们的工作生活带来很大的影响.据报道11P感染可使HIV的感染风险增加4～5倍[2],TP的治疗原则为早发现、早治疗,以防止演变成晚期或传染他人[3].     

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。     

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。     

<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.