安全套使用项目对降低我国艾滋病性病传播的作用及其可行性研究

目的探索在中国实施娱乐场所100％安全套使用项目的有效性和可行性。方法采用非概率抽样法选择武汉市黄陂区木兰镇和前川镇，对性服务娱乐场所中所有女性性工作者实施现场干预流行病学研究，分干预前和干预后第3、6、9个月共4次，进行包括安全套使用情况等内容的面对面问卷访谈和艾滋病、衣原体血清学检验。结果共352人次接受本次调查，未发现艾滋病毒阳性感染者。研究对象安全套坚持使用率由干预前的32．86％逐步上升至干预后的第3、6、9个月分别为50．00％、63．22％和69．09％，干预前后差异有统计学意义（x^2=5．558，P〈0．05）。坚持使用安全套与未坚持和从不使用安全套的研究对象，其衣原体感染率差异有统计学意义（x^2=248．72，P〈0．01），从不使用安全套感染衣原体的危险性是坚持使用者的10．91倍。使用安全套预防性传播疾病的总有效性为85．82％。结论坚持正确使用安全套能有效减少性传播疾病的发病率；通过有效的政策倡导，在我国现行的法律政策范围内可以开展娱乐场所100％安全套使用项目。

Effectiveness and Feasibility of a Condom Use Program in Reducing Transmission of HIV/STDs in Female Sex Workers in China

Objective To examine the relationship between condom use and decreased HIV/STDs risk and the effectiveness and feasibility of a 100% condom use program(100% CUP)in female sex workers working in entertainment establishments in China. Methods Educational and behavioral interventions were conducted among female sex workers non-probability selected from two townships(Mulan and Qianchuan),Huangpi District,Wuhan.The frequency of condom use were collected by anonvmous questionnaires through individual interview,and the prevalence of HIV and chlamydia were examined by ELISA and immunochromatography before intervention and 3 times after interventions from January 2002 to January 2003. Results There was no HIV positive case among 352 female sex workers who enrolled in the study.Reported consistent condom use was increased from 32.86%(before intervention)to 50.00%(3 months after intervention),63.22%(6 months after intervention)and 69.09%(9 months after intervention),and meanwhile the prevalence rate of chlamydia was decreased from 30%(before intervention)to 22.14%(3 months after intervention),14.94%(6 months after intervention)and 14.55%(9 months after intervention).The frequency of condom use(always,sometimes,rarely or never)was associated with the prevalence of chlamydia.The risk of chlamydia infection caused by rarely or never using condom was 10.91 times that of always using condom.The overall effectiveness of consistent condom use for STDs prophylaxis was 85.82%. Conclusion Consistent condom use can significantly reduce STDs incidence,and reduce the sexual transmission of HIV.There fore,our results suggest that 100% CUP in entertainment astablishments is aneffective and feasible strategy for AIDS/STDs control in China.