【摘要】：目的 (1)分析2010-2012年昆明市某高校大學(xué)生人群的艾滋病動(dòng)態(tài)流行趨勢(shì)及影響因素,艾滋病知識(shí)知曉及相關(guān)行為特征,找出高校預(yù)防與控制艾滋病的教育的關(guān)鍵問題,強(qiáng)化高校預(yù)防艾滋病健康教育工作,改進(jìn)高校健康教育的策略與措施。 (2)分析2010-2012年昆明市某高校大學(xué)生人群艾滋病相關(guān)危險(xiǎn)行為及其影響因素,探究并提出預(yù)防措施,便于提升大學(xué)生預(yù)防艾滋病的自我保護(hù)意識(shí),為高校艾滋病健康教育探索新模式、提供新思路。 (3)通過哨點(diǎn)監(jiān)測(cè),為下一步制定艾滋病防治策略、干預(yù)措施、效果評(píng)價(jià)、改善監(jiān)測(cè)體系等工作提供依據(jù),為大學(xué)生艾滋病疫情估計(jì)和預(yù)測(cè)提供參考信息。 方法 (1)定量研究與血樣實(shí)驗(yàn)研究：采用中國衛(wèi)生部艾滋病哨點(diǎn)監(jiān)測(cè)項(xiàng)目統(tǒng)一方案進(jìn)行。采用中國疾病預(yù)防與控制中心(以下簡(jiǎn)稱中國CDC)統(tǒng)一制定的流行病學(xué)問卷進(jìn)行問卷調(diào)查,收集人口學(xué)、行為學(xué)、社會(huì)學(xué)、艾滋病知識(shí)知曉、艾滋病防治等情況特征,并采用連續(xù)的橫斷面血清學(xué)調(diào)查采集血液標(biāo)本,采集的血液標(biāo)本均由云南省CDC統(tǒng)一利用酶聯(lián)免疫吸附試劑進(jìn)行HIV、梅毒、HCV抗體的檢測(cè)。 (2)數(shù)據(jù)錄入及統(tǒng)計(jì)軟件：采用國家哨點(diǎn)監(jiān)測(cè)系統(tǒng)要求錄入數(shù)據(jù),采用SPSS17.0軟件進(jìn)行統(tǒng)計(jì)分析。 結(jié)果 三年共監(jiān)測(cè)2400人。發(fā)放調(diào)查問卷和抽取血樣2400份,剔除無效問卷56份,血樣與問卷保持一致,樣本有效完成率為97.7%。2344名畢業(yè)班大學(xué)生中,2010年共調(diào)查797人,2011年共調(diào)查755人,2012年共調(diào)查792人。2010-2011年血清學(xué)監(jiān)測(cè)結(jié)果顯示：HIV、HCV、梅毒抗體均為陰性,無陽性發(fā)現(xiàn)；2012年發(fā)現(xiàn)HCV抗體陽性1(0.1%)名、梅毒抗體抗體陽性1(0.1%)名,其余HIV、 HCV、梅毒抗體均為陰性。性行為發(fā)生率2010-2012年依次為3.3%(26/783)、13.1%(96/735)、16.1%(125/775),經(jīng)線性趨勢(shì)檢驗(yàn)呈增長趨勢(shì)(X2=26.13；P0.01),多因素Logistic回歸模型結(jié)果提示：男性、年齡越大最近一年性行為發(fā)生率更高。第一次性行為年齡方面,最小為12歲,最大為26歲,平均20.53±2.26歲；2010年平均為18.45±1.99歲,2011年平均為20.65±2.22歲,2012年平均為20.90±2.11歲,經(jīng)單因素方差分析可知,三年第一次性行為年齡有顯著統(tǒng)計(jì)學(xué)差異(F=11.921,P0.01),三年第一次性行為年齡逐年遞增趨勢(shì)。本次研究危險(xiǎn)性行為定義為非保護(hù)性臨時(shí)性行為、商業(yè)性行為或男男性行為。最近1年危險(xiǎn)性行為發(fā)生率2010-2012年依次為0.3%(2/783)、1.0%(7/735)、1.4%(11/775),經(jīng)線性趨勢(shì)檢驗(yàn)呈增長趨勢(shì)(z2=18.35；P0.01),多因素Logistic回歸模型結(jié)果提示：男性、少數(shù)民族、艾滋病知曉率低、第一次性行為年齡越早,最近一年危險(xiǎn)性行為發(fā)生率越高。艾滋病知識(shí)知曉方面,2010-2012年,大學(xué)生艾滋病知曉率為98.8%(2315/2344),三年依次為97.2%(775/797)、99.3%(750/775)和99.7%(790/792),呈現(xiàn)增長趨勢(shì),三年艾滋病知識(shí)知曉率的差異有顯著統(tǒng)計(jì)學(xué)意義(X2=22.460,P0.01)�？梢娫摳咝�(duì)青年學(xué)生艾滋病知識(shí)教育的重視導(dǎo)致該工作已見成效,也反映出學(xué)生對(duì)艾滋病知識(shí)掌握的程度比較令人滿意。最近一年是否接受預(yù)防AIDS宣傳方面,2010-2012年,大學(xué)生接受過預(yù)防AIDS宣傳為61.6%(1443/2344),三年依次為51.9%(414/797)65.0%(484/775)和69.5%(545/792)；最近一年是否參與預(yù)防AIDS宣傳方面,總體參與過預(yù)防AIDS宣傳為25.6%(601/2344),三年依次為17.1%(136/797)、29.4%(219/775)和31.4%(246/792)；經(jīng)卡方檢驗(yàn),大學(xué)生三年的行為干預(yù)方面差異均有有顯著統(tǒng)計(jì)學(xué)意義(X2=55.800、44.496,P0.01),可見在在最近一年行為干預(yù)方面,大學(xué)生三年的接受率、參與率均成增長趨勢(shì)。最近一年接受艾滋病檢測(cè)方面,2010-2012年大學(xué)生接受檢測(cè)率為5.3%(125/2344),三年依次為1.9%(15/797)、6.8%(51/775)和7.5%(59/792)；經(jīng)卡方檢驗(yàn),大學(xué)生三年的艾滋病檢測(cè)方面差異均有顯著統(tǒng)計(jì)學(xué)意義(X2=29.417,P0.01),可見在在最近一年艾滋病檢測(cè)方面,大學(xué)生三年的檢測(cè)率均成增長趨勢(shì)。在艾滋病檢測(cè)知曉方面,在參與回答的人群中,2010-2012年大學(xué)生的艾滋病檢測(cè)結(jié)果知曉率為15.7%(19/121),三年依次為26.7%(4/15)、12.2%(6/49)和15.8%(9/57)；經(jīng)卡方檢驗(yàn),大學(xué)生三年的艾滋病檢測(cè)結(jié)果知曉率差異無統(tǒng)計(jì)學(xué)意義(X2=1.805,P=0.406). 結(jié)論 雖然該高校大學(xué)生三年監(jiān)測(cè)未發(fā)現(xiàn)艾滋病感染,大學(xué)生對(duì)艾滋病認(rèn)知尚可,可見該高校對(duì)大學(xué)生艾滋病知識(shí)教育的重視導(dǎo)致該工作己見成效,也反映出學(xué)生對(duì)艾滋病知識(shí)掌握的程度比較令人滿意。但是掌握足夠的知識(shí)并不能完全避免危險(xiǎn)行為的出現(xiàn)。通過三年哨點(diǎn)監(jiān)測(cè)發(fā)現(xiàn),雖然高校青年學(xué)生文化層次較高,艾滋病預(yù)防知識(shí)知曉情況較樂觀,對(duì)防艾宣傳有一定的認(rèn)識(shí)和了解,但是自覺防范艾滋病,改變或糾正不健康行為習(xí)慣等方面的參與程度還不理想,僅少部分學(xué)生既往參與HIV檢測(cè),其中還有部分大學(xué)生甚至不愿意知道自己檢測(cè)結(jié)果,該高校大學(xué)生發(fā)生性行為、危險(xiǎn)性行為時(shí)安全套使用率也不夠理想。該高校大學(xué)生性行為、危險(xiǎn)性行為發(fā)生率依舊呈增長趨勢(shì),艾滋病在該人群中傳播蔓延的危險(xiǎn)因素仍然存在；處于中國西部地區(qū)的大理學(xué)院大學(xué)生性行為發(fā)生率為17.6%,本次研究發(fā)現(xiàn)昆明市某高校男性大學(xué)生性行為發(fā)生比例為19.2%,高于廣州地區(qū)大學(xué)生(13.5%),意味著我國西部地區(qū)也是大學(xué)生性行為發(fā)生的高發(fā)地區(qū),對(duì)性行為、危險(xiǎn)性行為問題在性健康教育中需要引起足夠重視,要控制大學(xué)生性行為、危險(xiǎn)性行為發(fā)生率,并提倡推遲第一次性行為時(shí)間,幫助他們建立正確的性行為方式與觀念,大學(xué)生容易感染艾滋病的脆弱性也是伴隨其自身肆意行為過程而造就的,應(yīng)該引起全社會(huì)足夠的關(guān)注與及時(shí)健康宣教干預(yù)。建議高校在艾滋病健康教育體系中,需要進(jìn)一步加強(qiáng)大學(xué)生性安全知識(shí)教育,強(qiáng)調(diào)“防艾教育”與學(xué)校學(xué)科知識(shí)教育齊頭并進(jìn),強(qiáng)化“防艾教育”與公民道德教育相結(jié)合,要求家庭教育與同伴教育共開展,更好的落實(shí)安全套策略,通過干預(yù)重點(diǎn)提高性伴侶間安全套的使用意識(shí),更廣泛的健康宣教與干預(yù),鼓勵(lì)更多的社會(huì)力量進(jìn)入高校開展有效的防艾健康宣教,在同伴間以點(diǎn)帶面的起到宣傳影響及正確引導(dǎo)效果。防控艾滋病健康教育的可持續(xù)發(fā)展問題比它的開展和普及更為嚴(yán)峻、更為重要,建議務(wù)必做好高校性教育的模式創(chuàng)新與工作落實(shí)。衛(wèi)生機(jī)構(gòu)也可以更大強(qiáng)度的細(xì)化哨點(diǎn)監(jiān)測(cè)工作,政府需要鼓勵(lì)并監(jiān)督社會(huì)減少艾滋病歧視心態(tài)及行為,青年學(xué)生HIV潛在感染者自愿進(jìn)行免費(fèi)咨詢檢測(cè),建議擴(kuò)大大學(xué)生人群艾滋病咨詢檢測(cè)覆蓋范圍,可提供方便可及的VCT服務(wù)或定期為大學(xué)生人群免費(fèi)進(jìn)行體檢,檢驗(yàn)結(jié)果及時(shí)告知目標(biāo)人群。陽性結(jié)果告知應(yīng)做到及時(shí)與保密,并需要及時(shí)引導(dǎo)他們正確求醫(yī)行為。總之,青年學(xué)生人群是國家的未來,大學(xué)生更是青年學(xué)生中的精英與棟梁,希望全社會(huì)共同努力參與到艾滋病預(yù)防與干預(yù)的隊(duì)伍中,奉獻(xiàn)自己的力所能及,攜手幫助他們,從而全面徹底、積極高效的一起做好預(yù)防大學(xué)生感染艾滋病工作。
[Abstract]:objective
(1) To analyze the dynamic epidemic trend and influencing factors of AIDS among college students in Kunming from 2010 to 2012, to find out the key issues of AIDS prevention and control education in Colleges and universities, to strengthen the work of AIDS prevention and health education in Colleges and universities, and to improve the strategies and measures of health education in Colleges and universities.
(2) To analyze the AIDS-related risk behaviors and their influencing factors among college students in Kunming from 2010 to 2012, and to explore and propose preventive measures, so as to enhance college students'awareness of self-protection against AIDS, and to explore a new model for AIDS health education in Colleges and universities.
(3) Through sentinel surveillance, we can provide the basis for further formulation of AIDS prevention and control strategies, intervention measures, effect evaluation, and improvement of surveillance system, and provide reference information for estimating and predicting AIDS epidemic among college students.
Method
(1) Quantitative study and blood sample experiment: The unified program of the AIDS sentinel surveillance project of the Ministry of Health of China was adopted. The epidemiological questionnaire was used to collect demographic, behavioral, sociological, AIDS knowledge, AIDS prevention and control information. The blood samples were collected by continuous cross-sectional serological investigation. All the blood samples were detected by enzyme-linked immunosorbent assay (ELISA) in Yunnan CDC.
(2) Data entry and statistical software: using the national sentinel monitoring system requirements for data entry, using SPSS17.0 software for statistical analysis.
Result
A total of 2 400 people were monitored over the past three years. A total of 2 400 questionnaires and 2 400 blood samples were sent out and 56 invalid questionnaires were rejected. The valid sample completion rate was 97.7%. Among 2 344 graduates, 797 were surveyed in 2010, 755 in 2011 and 792 in 2012. The incidence of sexual intercourse was 3.3% (26/783), 13.1% (96/735), 16.1% (125/775) in 2010-2012, and showed an increasing trend by linear trend test (X2 = 26.13; P 0.01). The results of logistic regression model showed that the incidence of sexual intercourse was higher in the last year when men were older. The age of first sexual intercourse was significantly different in three years (F = 11.921, P 0.01). The age of first sexual intercourse was increasing year by year in three years. 4% (11/775), the linear trend test showed an increasing trend (z2 = 18.35; P 0.01), the results of multivariate logistic regression model showed that: men, ethnic minorities, low awareness of AIDS, the earlier the first sexual age, the higher the incidence of dangerous sexual behavior in the last year. AIDS knowledge awareness, 2010-2012, the AIDS awareness rate of college students was 98. 9.8% (2315/2344), 97.2% (775/797), 99.3% (750/775) and 99.7% (790/792) in three years, showing an increasing trend. There was a significant difference in the three-year AIDS knowledge awareness rate (X2 = 22.460, P 0.01). It can be seen that the emphasis on AIDS knowledge education among young students in this university has led to the success of this work, and also reflects the students'knowledge of AIDS. In 2010-2012, 61.6% (1443/2344) of college students received propaganda on AIDS prevention, 51.9% (414/797) 65.0% (484/775) and 69.5% (545/792) of them took part in propaganda on AIDS prevention in three years, and 25.6% of them took part in propaganda on AIDS prevention in the last year. (601/2344), followed by 17.1% (136/797), 29.4% (219/775) and 31.4% (246/792) in three years; Chi-square test showed that there were significant differences in the three-year behavior intervention among college students (X2 = 55.800, 44.496, P 0.01). It can be seen that in the last year, the acceptance rate and participation rate of college students in three years were increasing. In 2010-2012, 5.3% (125/2344) of college students were tested for AIDS, followed by 1.9% (15/797), 6.8% (51/775) and 7.5% (59/792) in three years; by Chi-square test, there were significant differences in three years of AIDS testing (X2 = 29.417, P Among the respondents, the awareness rate of AIDS test results was 15.7% (19/121), 26.7% (4/15), 12.2% (6/49) and 15.8% (9/57) respectively in 2010-2012, and the difference was found by Chi-square test. There was no statistical significance (X2=1.805, P=0.406).
conclusion
Although the three-year surveillance of college students did not find AIDS infection, college students'awareness of AIDS is still acceptable, it can be seen that the university's emphasis on AIDS knowledge education has led to the success of the work, but also reflects the degree of students' knowledge of AIDS is relatively satisfactory. However, adequate knowledge can not be completely avoided. Through three-year sentinel surveillance, we found that although young college students have a higher level of education, an optimistic awareness of AIDS prevention knowledge and a certain understanding of AIDS prevention propaganda, their involvement in self-awareness of AIDS prevention, changing or correcting unhealthy behavior habits and other aspects is not ideal, only a small number of students learn Students have participated in HIV testing in the past, and some of them do not even want to know their test results. College students have sexual behavior, condom use rate is not ideal when dangerous sexual behavior. The incidence of sexual behavior among college students in Western China was 17.6%. This study found that the proportion of male college students in Kunming was 19.2%, higher than that of college students in Guangzhou (13.5%). The problem of risky sexual behavior needs to be paid enough attention in sexual health education. It is necessary to control the sexual behavior and the incidence of risky sexual behavior among college students, and to advocate postponing the first sexual behavior time to help them establish correct sexual behavior patterns and concepts. It is suggested that in the AIDS health education system, colleges and universities should further strengthen the education of sexual safety knowledge of College students, emphasize that "AIDS prevention education" should go hand in hand with school subject knowledge education, strengthen the combination of "AIDS prevention education" and civic moral education, and require the family. Home education and peer education should be carried out together to better implement condom strategies. Through intervention, condom use awareness among sexual partners should be enhanced. Wider health education and intervention should be conducted. More social forces should be encouraged to enter colleges and universities to carry out effective health education on AIDS prevention. Sustainable development of health education for AIDS prevention and control is more serious and important than its development and popularization. It is suggested that the mode innovation and implementation of sex education in Colleges and universities should be done well. It is suggested that the coverage of HIV counseling and testing among college students should be expanded, VCT services can be provided conveniently and accessibly, and free physical examination for college students can be carried out regularly. The test results should be informed to the target population in time. Positive results should be informed in a timely and confidential manner and should be quoted promptly. In a word, young students are the future of our country, and college students are the elite and pillar of young students. We hope that the whole society will make joint efforts to participate in the team of AIDS prevention and intervention, contribute their own strength and help them hand in hand, so that we can do a good job in preventing the University thoroughly, actively and efficiently. HIV infection.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R512.91

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 任芙蓉;;實(shí)施血液病毒核酸檢測(cè)策略的相關(guān)問題探討[J];中國輸血雜志;2010年01期

2 李延軍;;艾滋病流行趨勢(shì)及預(yù)防策略和措施[J];長春大學(xué)學(xué)報(bào);2007年04期

3 龔建林,賴日輝,陳雪梅,楊小帆;廣州地區(qū)高校大學(xué)生性觀念狀況的調(diào)查研究[J];廣東工業(yè)大學(xué)學(xué)報(bào)(社會(huì)科學(xué)版);2004年03期

4 許銳恒,林鵬;預(yù)防艾滋病,減少危害勢(shì)在必行[J];華南預(yù)防醫(yī)學(xué);2002年01期

5 劉志;陸洪光;;HIV/AIDS流行及醫(yī)源性感染[J];國外醫(yī)學(xué).皮膚性病學(xué)分冊(cè);2005年06期

6 張毅;國內(nèi)外大學(xué)生艾滋病健康教育現(xiàn)狀[J];國外醫(yī)學(xué)(社會(huì)醫(yī)學(xué)分冊(cè));2003年01期

7 周麗;董國營;張玲;袁碧濤;;深圳市大學(xué)生性行為及其影響因素分析[J];中國社會(huì)醫(yī)學(xué)雜志;2008年03期

8 王芳;宋興怡;岳f3;霍楠;徐選國;姜峰;;山西省大學(xué)生艾滋病知識(shí)、態(tài)度及行為現(xiàn)狀分析[J];中國社會(huì)醫(yī)學(xué)雜志;2011年05期

9 陳丹;羅春香;王衛(wèi)紅;何彩云;湯華清;劉麗華;何瑛;;長沙市大學(xué)生艾滋病知識(shí)、態(tài)度的現(xiàn)況調(diào)查[J];湖南師范大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2011年03期

10 趙玉霞;章涵;;河南AIDS高發(fā)地區(qū)某農(nóng)村HIV/AIDS社會(huì)心理狀況調(diào)查[J];鄭州大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2010年04期

相關(guān)碩士學(xué)位論文 前1條

1 陳萍;艾滋病傳播的社會(huì)網(wǎng)絡(luò)分析[D];山東大學(xué);2006年

，

本文編號(hào)：2240106