南宁市低档场所性工作者艾滋病/性病相关知、信、行的调查分析
摘要
[目的]
了解南宁市低档场所女性性工作者(以下简称为性工作者)艾滋病(英文简称AIDS)性病(英文简称STD)相关知识水平、信念态度和高危行为的特征及影响因素,为改进和完善针对该人群的健康教育和健康促进措施提供参考依据,并为政府制定预防控制决策提供科学依据。
[方法]
1、确定性工作者场所
根据低档性工作者场所的特征,采用实地考察和走访相关部门相结合的方法对南宁市的低档性工作者场所进行摸底确认,最终确定新竹路、思贤路、圆湖路、建政路、五一路、琅东市场、圆湖路北二里为抽样调查区域。
2、南宁市低档场所性工作者基本情况调查
采用自编的性工作者基本情况调查表,选取南宁市低档性工作者场所分布比较集中的四个区域进行调查工作,采用方便抽样的方法对配合调查的场所每个抽取2-3名性工作者为调查对象,共243人。调查内容包括性工作者的一般情况、艾滋病/性病相关知识及态度、职业安全行为、生殖健康、安全套使用及就医行为等。
3、统计分析
用SPSS统计软件对性工作者的生殖健康与艾滋病知、信、行情况的发生频率、分布特点进行描述,对艾滋病知识进行计分以了解性工作者认知水平;用卡方检验对不同亚群性工作者的生殖健康及艾滋病知、信、行情况进行比较分析;以非条件Logistic回归分析法对性工作者艾滋病知识及安全套使用的影响因素进行统计分析。
[结果]
1.调查问卷的信度
调查问卷的总的同质性信度Cronbach’sα系数为0.825。艾滋病相关知识情况、职业安全认知及艾滋病/性病相关行为三部分内容的Cronbach’sα系数为0.704～0.813。
2.全样本性工作者生殖健康与艾滋病相关知、信、行情况调查人群中,艾滋病相关知识平均知晓率为55.3%,各条目的正答率最低为32.1%,最高为86.4%;仅有59.7%的性工作者认为从事性工作的风险比其他职业高。安全套使用情况:每次都用占49.8%,大多数时候用为39.1%,极少使用为6.2%,从不使用占4.9 %;患病后,65.8%的性工作者选择去大医院诊疗;57.4%的人会定期进行健康检查,曾进行过艾滋病病毒感染检测的性工作者占39.9%。
3.各亚群生殖健康与艾滋病相关知、信、行情况的比较
各亚群间知\信\行存在不同程度的差异。在不同城区从业的性工作者,在性病的预防知识、知识来源、艾滋病传播途径、风险认识、安全套来源及使用、HIV抗体检测动机等方面差异有显著性意义;不同民族比较,差异有统计学意义的条目如下:接受预防艾滋病知识教育情况、风险认识、知识来源、艾滋病传播途径、安全套使用情况等;不同年龄比较,差异有统计学意义的条目有艾滋病预防知识来源、正确怀孕时间、不使用安全套原因、做HIV抗体检测动机、定期健康检查等;不同婚姻状况比较,差异有统计学意义的条目为艾滋病预防知识来源、使用安全套动机等;不同文化程度比较,差异有统计学意义的条目如下:风险认识、使用安全套动机、对人工流产危害的认识等;不同工作时间比较,差异有统计学意义的条目为艾滋病预防知识来源、使用安全套动机、老板对安全套使用的支持情况、不进行HIV抗体检测的原因等。
4.影响因素分析
(1)艾滋病认知水平的非条件Logistic回归分析结果
根据调查对象的艾滋病相关知识得分结果,以平均得为10.52分为界,将其分为高于平均分组和低于平均分组,以得分分组(高于平均分组和低于平均分组)作为应变量,以其余指标为自变量,在44个自变量中,有4个因素选入多因素回归方程,即从事性工作以前没有接受过预防艾滋病性病知识的相关教育,知识来源主要为宣传资料,性交后会用消洗液坐盆预防性病艾滋病,使用安全套的目的为预防性病。
(2)安全套使用情况的非条件Logistic回归分析结果
以性工作者是否使用安全套作为应变量,在44个自变量中,有5个因素选入多因素回归方程,即是否接受过宣传资料,知识来源主要为家长朋友,对自己从事这一行业感染性病的风险认知,使用安全套的动机,从事这一行业最希望不要感染传染病。
[结论]
1.调查问卷信度效度较好,可用于南宁市性工作者生殖健康与艾滋病知、信、行调查。
2.南宁市低档性工作者的艾滋病知识掌握尚可,但其认识的系统性及深度广度尚有待加强;对从事这一行业的感染性病艾滋病的风险认知较低;安全套使用率高于国内外学者报道结果;而自愿进行艾滋病病毒检测的性工作者较少。
3.性工作者艾滋病知识与信念及其的知识状况、知识来源、预防艾滋病性病的方式、使用安全套的目的等4个因素的影响有关;性工作者安全套的使用受到性工作者的知识接受状况、知识来源、感染性病的风险认识、使用安全套的动机、不感染传染病的愿望5个因素的影响。
[Objective]
To study the status of Sexually Transmitted Disease and AIDS knowledge and high risk behavior of low-income female sex workers(FSW ) in Nanning, to provide scientific evidence for health education and policy making related to the prevention and control,and to execut the intervention effectively.
[Methods]
1. Findout places of the low-income sex workers Findout places of the low-income sex workers in Nanning according to characteristic of the sex work places.
2. Map making
Making maps according to the result of sex work places in Nanning.
3. Investigation of baselinesurvey of low-income sex workers in Nanning. In the investigation, several area in which there are many sex work places were chosen. We use method of convenience sampling to chose two or three sex workers in each place to investigate. The investigation include general information of the sex workers, knowledge and attitude of AIDS/STD ,occupational safety, conditions of reproductive health and risk behavior.
4. Analysis
SPSS13.0 was used to analyze the incidence of knowledge attitude and behavior of AIDS of the sex workers;chi-square was used to analysis different subgroups’rate.Influence factors were explored by non-conditional logistic regression.
[Rusult]
1. Homogeneity of the questionnaire reliability
The internal consistent reliability coefficient was 0.825。
2. Situation of knowledge attitude and behavior of AIDS of the sex workers
The average status of awreness of AIDS knowledge of the sex workers was 60.3%;only 59.7% sex workers think that this work is more dangerous than other works;condom use were as follows:49.8% of sex workers use condom each time,39.1% of sex workers use condom most of the times,6.2% of sex workers seldom use condom;if they had have STD,65.8% of them would chose hospital;57.4% of sex workers have periodic health examination;39.9%of sex workers had VCT.
3. Each subgroup comparison of knowledge attitude and behavior of AIDS
Items which has statistical significance of different area comparison were as follows:prevention knowledge of STD、source of prevention knowledge、perception of risk、route of transmission of AIDS、source of condom、motive of HIV antibody detection; items which has statistical significance of different nationalities comparison were as follows:education of prevention knowledge、perception of risk、source of prevention knowledge、route of transmission of AIDS、conditions of condom use;items which has statistical significance of different ages comparison were as follows: source of prevention knowledge、right time to pregnancy、reason of non-condom use、motive of HIV antibody detection、periodic health examination;items which has statistical significance of different marital status comparison were as follows: source of prevention knowledge、motive of condom use;items which has statistical significance of different degree of culture comparison were as follows: perception of risk、motive of condom use、cognition of harm of artificial abortion; items which has statistical significance of different degree of culture comparison were as follows: source of prevention knowledge、motive of condom use、condom use from boss surpport、reason of don’t take HIV antibody detection.
4. Analysis of influence factors analysis
(1)non-conditional logistic regression analysis of AIDS knowledge
According to the results of non-conditional logistic regression analysis ,there are five influence factors,they are status of prevention knowledge education before they was engaged in sex work,source of prevention knowledge were from publicity material,how to judge whoremaster has STD/AIDS or not,how to prevent STD after sexual intercourse and the purpose to use condom is to prevent STD.
(2)non-conditional logistic regression analysis of condom use
According to the results of non-conditional logistic regression analysis ,there are six influence factors,they are receive publicity material or not、knowing pregnancy knowledge、source of knowledge are form family and friends、perception of risk、motive of condom use、hope that don’t infect STD.
[Conclusion]
1. The questionnaire has good reliability and validity,and they could be used in the sex workers in Nanning.
2. The sex workers know AIDS knowledges well,but still not overall;their perception of risk that they maybe infect AIDS/STD is low;the rate of condom use is higher than other studies;and there rare sex workers want VCT.
3. The five factors that influence AIDS knowledge are status of knowledge acception、source of the knowledges、how to judge whoremaster has STD/AIDS or not、method to prevent STD、purpose of condom use;the six factors that influence condom use are status of knowledge acception、pregnancy knowledge、source of knowledge、perception of risk that infect STD、motive of condom use、hope that don’t infect STD.
了解南宁市低档场所女性性工作者(以下简称为性工作者)艾滋病(英文简称AIDS)性病(英文简称STD)相关知识水平、信念态度和高危行为的特征及影响因素,为改进和完善针对该人群的健康教育和健康促进措施提供参考依据,并为政府制定预防控制决策提供科学依据。
[方法]
1、确定性工作者场所
根据低档性工作者场所的特征,采用实地考察和走访相关部门相结合的方法对南宁市的低档性工作者场所进行摸底确认,最终确定新竹路、思贤路、圆湖路、建政路、五一路、琅东市场、圆湖路北二里为抽样调查区域。
2、南宁市低档场所性工作者基本情况调查
采用自编的性工作者基本情况调查表,选取南宁市低档性工作者场所分布比较集中的四个区域进行调查工作,采用方便抽样的方法对配合调查的场所每个抽取2-3名性工作者为调查对象,共243人。调查内容包括性工作者的一般情况、艾滋病/性病相关知识及态度、职业安全行为、生殖健康、安全套使用及就医行为等。
3、统计分析
用SPSS统计软件对性工作者的生殖健康与艾滋病知、信、行情况的发生频率、分布特点进行描述,对艾滋病知识进行计分以了解性工作者认知水平;用卡方检验对不同亚群性工作者的生殖健康及艾滋病知、信、行情况进行比较分析;以非条件Logistic回归分析法对性工作者艾滋病知识及安全套使用的影响因素进行统计分析。
[结果]
1.调查问卷的信度
调查问卷的总的同质性信度Cronbach’sα系数为0.825。艾滋病相关知识情况、职业安全认知及艾滋病/性病相关行为三部分内容的Cronbach’sα系数为0.704～0.813。
2.全样本性工作者生殖健康与艾滋病相关知、信、行情况调查人群中,艾滋病相关知识平均知晓率为55.3%,各条目的正答率最低为32.1%,最高为86.4%;仅有59.7%的性工作者认为从事性工作的风险比其他职业高。安全套使用情况:每次都用占49.8%,大多数时候用为39.1%,极少使用为6.2%,从不使用占4.9 %;患病后,65.8%的性工作者选择去大医院诊疗;57.4%的人会定期进行健康检查,曾进行过艾滋病病毒感染检测的性工作者占39.9%。
3.各亚群生殖健康与艾滋病相关知、信、行情况的比较
各亚群间知\信\行存在不同程度的差异。在不同城区从业的性工作者,在性病的预防知识、知识来源、艾滋病传播途径、风险认识、安全套来源及使用、HIV抗体检测动机等方面差异有显著性意义;不同民族比较,差异有统计学意义的条目如下:接受预防艾滋病知识教育情况、风险认识、知识来源、艾滋病传播途径、安全套使用情况等;不同年龄比较,差异有统计学意义的条目有艾滋病预防知识来源、正确怀孕时间、不使用安全套原因、做HIV抗体检测动机、定期健康检查等;不同婚姻状况比较,差异有统计学意义的条目为艾滋病预防知识来源、使用安全套动机等;不同文化程度比较,差异有统计学意义的条目如下:风险认识、使用安全套动机、对人工流产危害的认识等;不同工作时间比较,差异有统计学意义的条目为艾滋病预防知识来源、使用安全套动机、老板对安全套使用的支持情况、不进行HIV抗体检测的原因等。
4.影响因素分析
(1)艾滋病认知水平的非条件Logistic回归分析结果
根据调查对象的艾滋病相关知识得分结果,以平均得为10.52分为界,将其分为高于平均分组和低于平均分组,以得分分组(高于平均分组和低于平均分组)作为应变量,以其余指标为自变量,在44个自变量中,有4个因素选入多因素回归方程,即从事性工作以前没有接受过预防艾滋病性病知识的相关教育,知识来源主要为宣传资料,性交后会用消洗液坐盆预防性病艾滋病,使用安全套的目的为预防性病。
(2)安全套使用情况的非条件Logistic回归分析结果
以性工作者是否使用安全套作为应变量,在44个自变量中,有5个因素选入多因素回归方程,即是否接受过宣传资料,知识来源主要为家长朋友,对自己从事这一行业感染性病的风险认知,使用安全套的动机,从事这一行业最希望不要感染传染病。
[结论]
1.调查问卷信度效度较好,可用于南宁市性工作者生殖健康与艾滋病知、信、行调查。
2.南宁市低档性工作者的艾滋病知识掌握尚可,但其认识的系统性及深度广度尚有待加强;对从事这一行业的感染性病艾滋病的风险认知较低;安全套使用率高于国内外学者报道结果;而自愿进行艾滋病病毒检测的性工作者较少。
3.性工作者艾滋病知识与信念及其的知识状况、知识来源、预防艾滋病性病的方式、使用安全套的目的等4个因素的影响有关;性工作者安全套的使用受到性工作者的知识接受状况、知识来源、感染性病的风险认识、使用安全套的动机、不感染传染病的愿望5个因素的影响。
[Objective]
To study the status of Sexually Transmitted Disease and AIDS knowledge and high risk behavior of low-income female sex workers(FSW ) in Nanning, to provide scientific evidence for health education and policy making related to the prevention and control,and to execut the intervention effectively.
[Methods]
1. Findout places of the low-income sex workers Findout places of the low-income sex workers in Nanning according to characteristic of the sex work places.
2. Map making
Making maps according to the result of sex work places in Nanning.
3. Investigation of baselinesurvey of low-income sex workers in Nanning. In the investigation, several area in which there are many sex work places were chosen. We use method of convenience sampling to chose two or three sex workers in each place to investigate. The investigation include general information of the sex workers, knowledge and attitude of AIDS/STD ,occupational safety, conditions of reproductive health and risk behavior.
4. Analysis
SPSS13.0 was used to analyze the incidence of knowledge attitude and behavior of AIDS of the sex workers;chi-square was used to analysis different subgroups’rate.Influence factors were explored by non-conditional logistic regression.
[Rusult]
1. Homogeneity of the questionnaire reliability
The internal consistent reliability coefficient was 0.825。
2. Situation of knowledge attitude and behavior of AIDS of the sex workers
The average status of awreness of AIDS knowledge of the sex workers was 60.3%;only 59.7% sex workers think that this work is more dangerous than other works;condom use were as follows:49.8% of sex workers use condom each time,39.1% of sex workers use condom most of the times,6.2% of sex workers seldom use condom;if they had have STD,65.8% of them would chose hospital;57.4% of sex workers have periodic health examination;39.9%of sex workers had VCT.
3. Each subgroup comparison of knowledge attitude and behavior of AIDS
Items which has statistical significance of different area comparison were as follows:prevention knowledge of STD、source of prevention knowledge、perception of risk、route of transmission of AIDS、source of condom、motive of HIV antibody detection; items which has statistical significance of different nationalities comparison were as follows:education of prevention knowledge、perception of risk、source of prevention knowledge、route of transmission of AIDS、conditions of condom use;items which has statistical significance of different ages comparison were as follows: source of prevention knowledge、right time to pregnancy、reason of non-condom use、motive of HIV antibody detection、periodic health examination;items which has statistical significance of different marital status comparison were as follows: source of prevention knowledge、motive of condom use;items which has statistical significance of different degree of culture comparison were as follows: perception of risk、motive of condom use、cognition of harm of artificial abortion; items which has statistical significance of different degree of culture comparison were as follows: source of prevention knowledge、motive of condom use、condom use from boss surpport、reason of don’t take HIV antibody detection.
4. Analysis of influence factors analysis
(1)non-conditional logistic regression analysis of AIDS knowledge
According to the results of non-conditional logistic regression analysis ,there are five influence factors,they are status of prevention knowledge education before they was engaged in sex work,source of prevention knowledge were from publicity material,how to judge whoremaster has STD/AIDS or not,how to prevent STD after sexual intercourse and the purpose to use condom is to prevent STD.
(2)non-conditional logistic regression analysis of condom use
According to the results of non-conditional logistic regression analysis ,there are six influence factors,they are receive publicity material or not、knowing pregnancy knowledge、source of knowledge are form family and friends、perception of risk、motive of condom use、hope that don’t infect STD.
[Conclusion]
1. The questionnaire has good reliability and validity,and they could be used in the sex workers in Nanning.
2. The sex workers know AIDS knowledges well,but still not overall;their perception of risk that they maybe infect AIDS/STD is low;the rate of condom use is higher than other studies;and there rare sex workers want VCT.
3. The five factors that influence AIDS knowledge are status of knowledge acception、source of the knowledges、how to judge whoremaster has STD/AIDS or not、method to prevent STD、purpose of condom use;the six factors that influence condom use are status of knowledge acception、pregnancy knowledge、source of knowledge、perception of risk that infect STD、motive of condom use、hope that don’t infect STD.
引文
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