外展服务方式对公共娱乐场所性服务小姐行为转变之效果评价--中国武汉/世界卫生组织100%使用安全套试点项目

目的 探索对公共娱乐场所性服务小姐健康行为干预的健康教育模式，为在公共娱乐场所全面推广100％使用安全套提供有参考价值的依据。方法 运用流行病学定量研究和社会学定性研究相结合的方法。以外展服务的方式到公共娱乐场所开展多种形式的健康教育干预活动。采取干预前后重复横段面知识、态度、行为、习惯(KABP)问卷调查形式。了解外展服务对性服务小姐知识、态度和行为的影响程度及安全套使用率变化情况，定期体检以掌握性服务小姐性传播疾病／艾滋病(趼D／AIDs)感染率变化。对本项目所采用的外展健康教育方式的可行性及有效性进行评估。结果 干预后评估表明：性服务小姐的预防STD／AIDS知识、态度和行为发生显著变化，她们与客人沟通协商使用安全套的能力有显著的提高。性服务小姐自我报告最近1次商业性行为中安全套使用率从60．5％(干预前)上升到94．5％(干预后)，衣原体和梅毒感染率分别从21.8％和6．5％(干预前)下降到14．5％和1．8％(干预后)。结论 摸索出一套适用于公共娱乐场所的外展服务干预模式。表明在我国公共娱乐场所全面推广100％使用安全套是切实可行且卓有成效的。

Evaluating the effectiveness of outreach services in changing behaviors among female sex workers in entertainment establishments --China Wuhan/WHO 100% Condom Use Program

Objective To explore a practicable model to provide health education and condom use promotion services to female sex workers in EEs in order to change their knowledge and behaviors and to protect them from STD/AIDS by using condom in each commercial sex activity. Methods Epidemiological qualitative and sociological quantitative studies were used together in the surveys. Baseline and post-intervention KABP surveys and interviews with female sex workers in regard with condom use and STD/AIDS knowledge information were conducted among female sex workers in EEs;Outreach services were also provided. Baseline and post-intervention evaluations were conducted. Results STD/AIDS-condom-related knowledge increased significantly during the outreach education intervention in the pilot project area. The rate of the latest condom use during commercial sex increased from 60.5% in October 2001 to 94.5% in August 2003;The prevalence of Chlamydia infection dropped from 21.1% in October 2001 to 14.5% in January 2003,and syphilis from 6.5% to 1.8%. Conclusion A series of practicable models of health education,outreach and consulting services were explored. A significant increase in condom use and decline in the prevalence of STI indicated that 100% CUP is definitely feasible to be implemented in China.