本文關(guān)鍵詞： 性病門診男性就診者 艾滋病病毒 隨機(jī)應(yīng)答技術(shù)　出處：《中國(guó)疾病預(yù)防控制中心》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的了解性病門診男性就診者艾滋病相關(guān)高危行為特征及HIV、梅毒、HCV抗體陽(yáng)性率;使用隨機(jī)應(yīng)答技術(shù)比較分析問(wèn)卷調(diào)查方法獲得的高危行為結(jié)果的準(zhǔn)確性,探討隨機(jī)應(yīng)答技術(shù)的可行性,為艾滋病綜合防治和科學(xué)干預(yù)提供信息和依據(jù)。研究方法采用橫斷面調(diào)查方式,在2016年4-12月使用常規(guī)問(wèn)卷調(diào)查方法調(diào)查江蘇省常州市、山西省太原市、陜西省西安市/咸陽(yáng)市的性病門診男性就診者中HIV相關(guān)高危行為,以及求診原因、患性病情況等行為特征和HIV感染狀況。同時(shí),平行利用隨機(jī)應(yīng)答技術(shù)(RRT)Simmons模型,調(diào)查最近3個(gè)月同性性行為、商業(yè)異性性行為、臨時(shí)異性性行為和注射吸毒行為的發(fā)生情況。問(wèn)卷調(diào)查結(jié)果的率和構(gòu)成比的比較使用χ2檢驗(yàn),問(wèn)卷調(diào)查結(jié)果和RRT調(diào)查結(jié)果的比較使用U檢驗(yàn)。研究結(jié)果本研究共調(diào)查1091例性病門診男性就診者,其中江蘇常州403人(36.9%),山西太原308人(28.2%),陜西西安/咸陽(yáng)380人(34.9%)。平均年齡32.9±10.4歲,已婚占59.1%,本省戶籍占86.6%,性病�？漆t(yī)院來(lái)源的占79.7%,綜合醫(yī)院占20.3%,因?qū)で笮圆≡\療服務(wù)就診占41.2%,因高危行為后咨詢檢測(cè)就診占58.8%。常規(guī)問(wèn)卷調(diào)查結(jié)果顯示,全部1091名調(diào)查對(duì)象中,過(guò)去3個(gè)月僅發(fā)生過(guò)商業(yè)異性性行為的比例為37.0%,僅發(fā)生過(guò)臨時(shí)異性性行為的比例為20.0%,僅發(fā)生過(guò)同性性行為的比例12.8%,而注射毒品的比例為0.1%。發(fā)生過(guò)商業(yè)異性和臨時(shí)異性性行為的比例為5.4%,發(fā)生過(guò)雙性性行為的比例為2.4%,22.3%的調(diào)查對(duì)象否認(rèn)最近3個(gè)月有任何高危行為。過(guò)去3個(gè)月發(fā)生過(guò)單純商業(yè)異性性行為的調(diào)查對(duì)象,找到暗娼的方式以?shī)蕵?lè)場(chǎng)所為主,占89.8%,發(fā)生商業(yè)異性性行為時(shí)從未使用過(guò)安全套的比例為26.5%;與臨時(shí)異性性伴發(fā)生性行為時(shí),從未使用過(guò)安全套的比例為47.2%;發(fā)生過(guò)單純同性性行為的調(diào)查對(duì)象尋找同性性伴的方式以通過(guò)手機(jī)APP為主,占58.3%,在同性性行為時(shí)從未使用過(guò)安全套的比例為20.0%�？偟腍IV抗體陽(yáng)性率為8.0%,梅毒陽(yáng)性率為6.1%,HCV抗體陽(yáng)性率為0.6%。有單純同性性行為史和異性+同性性行為史的調(diào)查對(duì)象HIV抗體陽(yáng)性率均較高,HIV抗體陽(yáng)性率分別為41.4%和42.3%,遠(yuǎn)高于有單純商業(yè)異性性行為史的3.2%和單獨(dú)臨時(shí)異性性行為史的0.9%。RRT調(diào)查結(jié)果顯示,過(guò)去3個(gè)月發(fā)生過(guò)商業(yè)異性性行為的比例為43.3%,發(fā)生過(guò)臨時(shí)異性性行為的比例為25.4%,發(fā)生過(guò)同性性行為的比例18.7%,而注射毒品的比例為1.4%。常規(guī)問(wèn)卷調(diào)查結(jié)果關(guān)于四項(xiàng)高危行為發(fā)生的比例均低于RRT調(diào)查結(jié)果,商業(yè)異性性行為差異無(wú)統(tǒng)計(jì)學(xué)顯著性(U=0.420,P=0.675),臨時(shí)異性性行為(U=3.016,P0.05)和同性性行為(U=2.175,P0.05)有統(tǒng)計(jì)學(xué)顯著性。30歲以上、已婚、本省戶籍、以咨詢檢測(cè)為目的、過(guò)去一年未患性病、本次診斷患性病的求診者,同性性行為結(jié)果,均是問(wèn)卷調(diào)查結(jié)果低于RRT調(diào)查(P0.05),差異具有統(tǒng)計(jì)學(xué)顯著性。研究結(jié)論性病門診男性就診者的高危行為特征:以商業(yè)異性性行為為主,其次為臨時(shí)異性性行為和同性性行為。找到暗娼的方式仍以場(chǎng)所為主,找到同性性伴的方式以通過(guò)手機(jī)APP為主。調(diào)查對(duì)象中同性性行為特征人群的HIV抗體陽(yáng)性率遠(yuǎn)高于商業(yè)異性性行為和臨時(shí)異性性行為特征人群。RRT方法能夠獲得比常規(guī)問(wèn)卷調(diào)查更高的高危行為情況,特別是在臨時(shí)異性性行為和男男同性性行為方面,RRT方法的高危行為比例要顯著高于常規(guī)問(wèn)卷調(diào)查。但是,良好的調(diào)查環(huán)境、經(jīng)驗(yàn)豐富的調(diào)查員和充分的溝通能夠獲得真實(shí)可信的高危行為信息。問(wèn)卷調(diào)查獲得的高危行為比例可能存在低估的情況,可以使用RRT方法對(duì)監(jiān)測(cè)數(shù)據(jù)定期開展評(píng)估工作,以得到更加真實(shí)可信的高危行為特征。
[Abstract]:Objective: To study the characteristics of AIDS related high-risk behaviors syphilis and HIV, mstds, HCV antibody positive rate; accuracy of the use of randomized response technique comparative analysis of risk behavior questionnaire results, to evaluate the feasibility of randomized response technique, to provide information and basis for AIDS prevention and control and scientific intervention. A cross sectional study in 2016, 4-12 months using conventional method of questionnaire survey in Jiangsu Province, Changzhou City, Shanxi Province, Taiyuan City, the relevant high-risk behavior of male STD clinic treatment in Xianyang city who HIV Shaanxi city of Xi'an province and / treatment reasons, characteristics and status of HIV infection in STD patients such as behavior. At the same time, the use of randomized response technique (parallel RRT) Simmons model, recent survey 3 months of gay sex, commercial sex behavior, toxic sex behavior and the behavior of temporary injection suction The results of a questionnaire survey. The composition rate and compared using 2 test, compared with the survey results and the results of RRT U test. The results of this study investigated a total of 1091 cases of mstds in Jiangsu, 403 in Changzhou (36.9%), Shanxi Taiyuan 308 people (28.2%), Shaanxi / Xi'an Xianyang 380 (34.9%). The average age was 32.9 10.4 years old, married accounted for 59.1%, the province accounted for 86.6% of household registration, hospital department of venereology sources accounted for 79.7%, accounted for 20.3% of general hospital, for seeking STD services were accounted for 41.2%, due to the high-risk behavior after counseling and testing on diagnosis of 58.8%. routine survey results show that all 1091 the survey in the past 3 months only occurred in commercial sex behavior, the proportion is 37%, only had casual sex ratio of 20%, only the sex ratio of 12.8%, while the drug injection ratio of 0.1%. occurred Commercial sex and temporary sex ratio of 5.4%, had a bisexual behavior, the proportion is 2.4%, 22.3% of the respondents have denied any high-risk behavior 3 months recently. The survey over the past 3 months occurred purely commercial sex behavior, sex workers find ways to entertainment places, accounted for 89.8%. Commercial sex behavior, never used condoms at the rate of 26.5%; and the temporary heterosexual sex, had never used condoms at the rate of 47.2%; the survey had a simple sex for sexual partners by way of mobile phone APP, accounting for 58.3%, the sex is never the use of condoms as the ratio of 20.0%. HIV antibody positive rate was 8%, the positive rate of syphilis was 6.1%, the positive rate of HCV antibody was 0.6%. with pure sex and heterosexual sex history + history investigation object HIV The antibody positive rate is higher, the positive rate of HIV antibody was 41.4% and 42.3%, the 0.9%.RRT survey is much higher than that of pure commercial sex behavior, the history of 3.2% and a separate temporary heterosexual history shows that over the past 3 months had commercial sex ratio of 43.3%, had casual sex ratio 25.4%, sex ratio of 18.7%, while the drug injection ratio of 1.4%. conventional survey results about four the proportion of high-risk behaviors were lower than the RRT survey results, differences in commercial sex behavior, there were no statistically significant (U=0.420, P=0.675), temporary sex (U=3.016, P0.05) and sex (U=2.175, P0.05) were statistically significant.30 years old, married, the household registration, to counseling and testing for the purpose of not suffering from sexually transmitted diseases over the past year, the diagnosis of STD patients, homosexual behavior results are The questionnaire survey results below RRT (P0.05), the difference was statistically significant. Conclusion high risk behaviors of mstds: commercial sex behavior, followed by temporary heterosexual and homosexual behavior. To find the way to the field still prostitutes, find partners of the same way to through the mobile phone APP. The positive rate of HIV antibody population characteristics sex survey is much higher than that of commercial sex behavior and temporary sexual characteristics of heterosexual group.RRT than the conventional method can obtain the questionnaire for higher risk for the situation, especially in terms of temporary heterosexual sex and homosexual behavior, the proportion of high-risk behavior the RRT method was significantly higher than conventional questionnaire survey. However, a good environment, experienced investigators and sufficient communication to obtain reliable information for risk The proportion of high-risk behaviors that may be underestimated by questionnaires can be underestimated. RRT can be used to conduct regular assessment of monitoring data, so as to get more credible and high-risk behavior characteristics.

【學(xué)位授予單位】：中國(guó)疾病預(yù)防控制中心
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R512.91

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