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建筑劳务输出人员和渔民性病/艾滋病高危行为流行病学研究
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摘要
目的
     了解建筑劳务输出人员和渔民的性病/艾滋病高危行为,分析影响因素;了解该人群性病及性病症状报告率。
     方法
     横断面研究,采用定性研究和定量研究相结合的方法,收集目标人群的人口学信息、职业特征、性病/艾滋病高危行为、性病/性病症状报告率及相关卫生服务现状等资料;定性资料根据半结构式访谈条目进行分析整理,定量资料分析,均数比较用t检验,率的比较用x~2检验,高危行为的影响因素分析采用非条件Logistic回归。
     结果
     1调查建筑劳务输出人员1625人,渔民817人,全为男性。临时性行为和商业性行为是目标人群感染性病/艾滋病的主要高危行为,建筑劳务输出人员报告率分别为15.8%和14.2%;渔民报告率18.1%和28.9%。
     建筑劳务输出人员高危性行为的相关因素:无出国经历(OR=0.745,p=0.043)、初次性行为≥22岁(OR=0.437,p<0.001)、不接受多性伴现象的态度(OR=0.437,p<0.001)、平时性生活频次高(OR>1,p=0.043)、不能正确使用安全套(OR=0.473,p<0.001)以及已婚状态等(OR=0.338,p=0.004)。定性研究结果显示:企业管理、劳务输出地、同伴影响、防病意识等对建筑劳务输出人员的性行为有影响。
     渔民高危性行为的相关因素:流动性(OR=1.516,p=0.038)、艾滋病知识得分低(OR=1.110,p=0.006)、平时性生活频次高(OR=1.422,p=0.002)、离异或丧偶婚姻状态(OR=22.527,p=0.041)、喝酒少(OR=0.803,p=0.053)、不能正确使用安全套(OR=0.634,p=0.010)、无性病史(OR=0.268,p=0.001)、初次性行为≥22岁(OR=0.440,p<0.001)以及不接受多性伴(OR=0.662,p=0.023)和商业性行为合法化的态度(OR=0.612,p=0.007);定性研究结果显示,职业、家庭的宽容、缺乏防病意识等对渔民的高危性行为有影响。
     2建筑劳务输出人员性病及性病症状报告率为0.4%和2.8%,渔民为1.7%和7.2%。
     结论
     建筑劳务输出人员和渔民高危性行为发生比例高,并有较高的性病及性病症状报告率,应尽快开展适于职业人群的干预活动。
Objective
     To investigate the high-risk behaviors for HIV/STDs infection among migrant construction laborers and fishermen,analyze potential risk factors associated with high risk behaviors and assess the self-reported rates of STDs history and STD-related symptoms.
     Methods
     Cross-sectional study was designed for this study.Qualitative and quantitative methods were conducted to investigate the participants' demographic characteristics, occupation,high-risk behaviors associated with HIV/STDs,prevalence rates of STDs history and the STD-related symptoms,and current health service provided to them. Qualitative data was analyzed according to the items of semi-structured interviews. T-tests were performed to measure the means difference.Tests of association between certain categorical variables were conducted using chi-square tests.Logistic regression was performed to measure associations between potential risk factors and reported potential high-risk sexual behavior(defined as having lifetime casual or commercial sexual partners).
     Results
     1.1,625 migrant construction laborers and 817 fishermen participated this study. All participants were male.Casual or commercial sex was the main high-risk behavior for HIV/STDs infection in the target population.The rates of casual and commercial sex reported were 15.8%and 14.2%among migrant construction laborers,and the corresponding rates for fishermen were 18.1%and 28.9%.
     Factors associated with HIV/STDs related high-risk behavior among migrant construction laborers were never working abroad(OR=0.745,p=0.043),age of initial sexual intercourse equal or more than 22 years(OR=0.437,p<0.001),negative attitude toward multiple sexual partners(OR=0.437,p<0.001),high lifetime sex frequency (OR>1,p=0.043);using condoms incorrectly(OR=0.473,p<0.001) and being married(OR=0.338,p=0.004).The results from qualitative study showed that enterprise management,different migrant countries,peer affection and lack of awareness of HIV/STDs prevention were also associated with high-risk behavior.
     Factors associated with HIV/STDs related high-risk behaviors among fishermen were mobility(OR=1.516,p=0.038),low AIDS knowledge scores(OR=1.110,p=0.006), higher lifetime sex frequency(OR=1.422,p=0.002),unmarried status(OR=22.527,p=0.041),low intake of alcohol(OR=0.803,p=0.053),using condoms incorrectly(OR=0.634,p=0.010),negative STD history(OR=0.268,p=0.001), age of initial sexual intercourse equal or more than 22 years(OR=0.440,p<0.001), negative attitude toward multiple sexual partners(OR=0.437,p<0.001) and legitimation for commercial sex(OR=0.612,p=0.007).The results from qualitative study showed that occupation,family tolerance to risk sexual behaviors,lack of awareness of disease prevention were also associated with high-risk behavior.
     2.STD history and STD-related symptoms were reported 0.4%and 2.8%among migrant construction laborers.Corresponding rates for fishermen were 1.7%and 7.2%.
     Conclusions
     The reported rates of high-risk behaviors associated with HIV/STDs are high,as well as the self-reported rates of STDs history and STD-related symptoms. Appropriate interventions should be carried out to reduce the high-risk behaviors of the target population.
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