性教育和生殖健康服务对促进上海市郊未婚青年避孕的效果

目的　评价在社区开展性教育和生殖健康服务对促进未婚青年避孕的效果。方法　在上海市郊区两个镇开展以社区为基础的干预性研究 ,干预组和对照组 15～ 2 4岁未婚青年分别为 12 0 0和 10 0 7名。干预活动的形式包括发放宣教材料、播放教育录像、组织讲座和小组讨论、提供咨询、提供避孕指导及避孕药具。干预持续 2 0个月 ,随访率为 92 %。通过问卷调查对干预的效果进行评价。结果　干预前两组性行为的发生率为10 .4 %和 12 .1% ,干预后为 30 .8%和 33.1%。在干预后有性行为的对象中 ,干预组经常或每次性行为时采取避孕措施的比例为 89.0 % ,对照组为 4 4 .6 % (两组比较P <0 .0 0 0 1)。在调整了其他可能影响避孕的因素后 ,干预组的OR为 10 .30 (95 %CI:6 .77～ 15 .6 7)。干预组有 5 7.7%的对象在首次性行为时采取避孕措施 ,其中使用避孕套的占 84 .4 % ;对照组则有 30 .5 %的人采取避孕措施 ,其中 6 7.2 %使用避孕套 (两组比较P <0 .0 0 0 1和 <0 .0 5 )。干预组调整OR分别为 3.0 8(95 %CI:2 .0 5～ 4 .6 1)和 13.37(95 %CI:7.13～ 2 5 .0 8)。男女对象采取避孕措施的情况无显著差异。多元Logistic回归分析表明 ,干预是影响采取避孕的惟一重要的因素。 结论　干预活动可明显促进干预组对象采取避孕。

Effects of Sex Education and Reproductive Health Service on Contraceptive Use among Unmarried Youths in Suburban Shanghai

Purpose To evaluate the effectiveness of a community-based sex education and reproductive health service program on contraceptive use among unmarred young people. Methods Two towns in Shanghai were selected as the research sites,one as the intervention and the other as control.The intervention lasted 20 months and comprised by building awareness,offering counseling and services for 15-24 aged unmarried young people.In order to test the feasibility and effectiveness of the intervention,baseline survey was conducted in both sites prior to the implementation of the intervention,then similar survey was conduc-ted in both sites after the intervention.Totally,1 220 unmarried young people from the intervetion site, 1 007 from the control site enrolled,and about 92% of these were re-interviewed at follow-up. Results At baseline,10.4% subjects in the intervention group and 12.1% in the control group reported sexual experience;this proportion increased to 30.8% and 33.1% at post-intervention respectively.Based on the post-intervention survey,89.0% of sexually active subjects in the intervention group were practicing some form of contraception at each intercourse or at most of intercourses,compared to 44.6% of those in the control group(P<0.000 1).57.7% of subjects in the intervention group used contraception at debut during the intervention period,among which 84.4% used condom,compared to 30.5% and 67.2% respectively in the control group(P<0.000 1 and P<0.05).There were no significant difference of contraception use between males and females.Adjusted odds ratios suggested that in comparison to the control group,participants of the intervention were 10.30(95% CI:6.77-15.67) times more likely to have practiced contraception regularly( every time or most of intercouses) over the period of the intervention.Those from the intervention group who initiated sexual relations during this period were,similarly,3.08 times as likely as those from the control group to have used contraception at debut(95% CI:2.05-4.61).And sexually active youth in the intervention group were 13.37 times as likely(95% CI:7.13-25.08) to have used condoms. Conclusions The community-based sex education and reproductive health services can indeed enhance safe sex behavior of unmarried young people in suburban Shanghai.