性病门诊艾滋病自愿咨询检测的实践与思考

目的通过性病门诊就诊者艾滋病自愿咨询检测（voluntary counselling and test，VCT）的临床资料探讨实行VCT的必要性和可行性。方法回顾性分析498例性病门诊就诊者艾滋病VCT的临床资料，包括咨询的主要原因、危险因素评估、艾滋病相关知识的认知情况及关心的主要问题等。结果为498例咨询者提供VCT服务，其中477例（95．9％）接受了艾滋病病毒（human immunodeficiency virus，HIV）抗体检测，9例（1．8％）初筛阳性；咨询主要原因：非婚性接触339例（66．5％），自觉有艾滋病或其他性病症状187例（37．6％），配偶性病感染史23例（4．6％），拒绝报告原因15例（3％），怀疑被室友传染4例（0．8％）；危险因素评估：合并其他性病感染201例（40．4％），多性伴358例（71．9％），肛交史66例（13．3％），男男同性恋45例（9．0％）；大部分咨询者对艾滋病基本知识有所了解，对HIV三大传播途径的知晓率达到85％以上，但仍存在着不少误区；咨询者关心的问题有艾滋病的传播途径（98．2％）、预防知识（98．0％）、临床表现（73．3％）。结论性病门诊是艾滋病高危人群集中的场所，医护人员认真履行VCT服务，做好咨询者的健康教育、心理护理、行为干预等综合关怀工作，对艾滋病的防治具有重要意义。

Practice and Consideration on Voluntary Counseling and Testing for HIV among Outpatients in STD Department

Objective To investigate the necessity and feasibility of voluntary counselling and testing（VCT）for HIV through an analysis of the clinical data of VCT among outpatients in STD department. Methods Retrospective analysis was performed on the clinical data of VCT for HIV of 498 STD outpatients concerning their major reasons for consultation,assessment of risk factors, cognition on AIDS related knowledge and their major concerns. Results Of the 498 outpatients undergoing VCT service, 477 patients（95.9 %） received HIV antibody testing with 9（1.8% ） positive cases in first screening. The main reasons for consultation included non-marital sexual contact in 339 cases（66.5%）,self-awareness of symptoms of AIDS and other STD in 187 cases（37.6%）, history of spouse infection in 23 cases（4. 6%）,refusal to report their experience（reason） in 15 cases（3%）, suspicious infection of roommate（0.8%）. Assessment of risk factors indicated combined transmitted diseases in 201 cases（40.4%）,multi-sexual partners in 358 cases（71.9%）,anal sex history in 66 cases（13.3%） ,gay men in 45 cases（9.0%）. The majority of the consultants had basic knowledge about AIDS. The awareness status of the three major route of transmission was over 85% except for a few misunderstandings. The major concerns were route of transmission for AIDS（98.2%）, prevention knowledge（98.0%）and clinical manifestation（73. 3%）. Conclusion STD department is a gathering place for high-risk people infected with AIDS. Health care workers must seriously complete VCT services and integrated care including health education,psychological care and behavioral intervention, which is of great importance in preventing and treating AIDS.