摘要
目的评价以社区为基础针对吸毒人群实施减少毒品危害措施的干预效果。探索、建立可持续发展的社区艾滋病防治模式。方法针对新疆伊宁市吸毒人群开展为期两年的社区干预实验。设实验组和对照组。实验组充分利用当地资源,采取社会动员、外展服务、培训、讲座、专题小组讨论、社区或家庭帮教、同伴教育、HIV自愿检测与咨询、健康教育材料发放、低价针具销售和安全套促销等综合干预措施,对照组无特殊干预活动。通过对实验组吸毒者干预前后HIV血清流行率(吸毒人群HIV抗体筛查,Elisa法)、相关危险行为、安全套使用率和知识水平的比较以及实验、与对照组的组间比较评价研究效果。结果干预前,当地社区吸毒人群艾滋病防治知识匮乏,共用注射器比例72.7%,安全套使用率23.5%,HIV血清流行率74.2%。干预后调查,实验组艾滋病防治知识知晓率普遍提高;注射吸毒比例、月吸毒次数、共用注射器比例和共用人次有所下降、但其变化与文化程度关系密切,单纯干预只能针对部分人群产生效应。此外,实验组发生性关系平均人次也有所下降,安全套使用率明显提高。对照组以上指标无明显变化。对实验组HIV筛查阴性吸毒者追踪调查表明,HIV血清流行率仅为34.8%(HIV抗体筛查,Elisa法),远低于当地吸毒人群HIV血清流行率的平均水平。
Objective Via community based intervention under the harm reduction strategy, to observe the effects of the intervention for drug users and to explore approaches in order to setup a continuously development model for HIV/AIDS prevention and control. Methods A two-year RCT among injecting drug users was carried out in Yining City of Xinjiang. Two groups had been set up at similar community as the trial group and control group respectively. Comprehensive methods including social mobilization, training, outreach, focus group discussions, workshops, peer education, community based cares, family based cares, health education material distributions, the provision of voluntary HIV testing with counseling and low price syringe and condom marketing had been used as a harm reduction approach in the trial group. No specific activities happened in control group. The effects of the study mainly based on the contrast of the evaluation indicators such as the understanding level of knowledge and the formative rates of behaviors in terms of HIV/AIDS that came from pre and post intervention within the trial group or between the two groups. Results The baseline survey showed that the HIV/AIDS prevention and control knowledge among drug users in the community was poor, the proportions of injecting drug and sharing needles/syringes were 85.3% and 72.7%. Only 23.5% of interviewees had ever used condoms, and the prevalence rate of HIV among drug users reached 74.2%. After intervention, the understanding rate of knowledge among drug users in the trial group increased commonly, the proportions of injecting drug, sharing needles/syringes and the numbers of shared persons decreased significantly. All changes had strong relationship with education background of the drug users, and which demonstrated that the simple intervention could only make effects on certain population. Meanwhile, the average numbers of the multiple sexual partners also decreased and the rate of condom utilization was raised. The same indicators in the control group had not been changed. A follow up study among (HIV) negative drug users found only 34.8% of them were infected (Elisa screening testing), which was lower than the average prevalence rate of the drug users in the community. Conclusions Community based intervention under the harm reduction strategy can obviously reduce the high risk behaviors and raise the awareness of the drug users as well as make contribution to minimization of the HIV transmissions.
出处
《地方病通报》
2005年第2期48-52,共5页
Endemic Diseases Bulletin
关键词
吸毒人群
干预
HIV血清流行率
Drug users
Intervention
HIV serological prevalence rate
