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目的评价以妇幼保健网络为基础的预防艾滋病母婴传播(Prevention of mother to child transmission,PMTCT)健康教育干预措施,对孕妇孕期艾滋病病毒(HIV)抗体检测率的影响。方法现场干预研究。选择社会特征相近的两个地区分别作为干预地区和对照地区,在基线调查的基础上,对干预地区的孕妇开展为期一年的预防艾滋病母婴传播健康教育干预活动。干预前后分别对两地区孕妇进行问卷调查,比较调查对象孕期HIV抗体检测率的变化,评价健康教育的干预效果。结果共调查1541名孕妇,其中干预地区933人,对照地区组608人。干预后,干预地区孕妇孕期HIV抗体检测率,由干预前的34.27%提高至干预后的72.49%;对照地区孕妇孕期HIV抗体检测则由5.83%提高到20.38%。干预地区孕妇孕期HIV抗体检测率高于对照区52.11%,差异有显著的统计学意义(χ2=24.60,P<0.01)。多因素分析结果显示,预防艾滋病母婴传播健康教育干预措施有效,干预效应OR值为2.01(95%CI:1.60,2.49)。结论依托妇幼县、乡、村三级保健网络,由基层妇幼保健工作人员具体实施,针对育龄妇女(包括孕妇)的预防艾滋病母婴传播健康教育,可有效提高孕妇对HIV抗体检测服务的接受和利用。
Objective To evaluate the impact of maternal and child health network-based prevention of mother to child transmission (PMTCT) health education interventions on pregnancy rate of pregnant women with HIV antibody testing. Methods Field intervention research. Two areas with similar social characteristics were selected as intervention areas and control areas respectively. Based on the baseline survey, one-year health education intervention for preventing mother-to-child transmission of AIDS was carried out on pregnant women in the intervention areas. Before and after the intervention, pregnant women in the two regions were surveyed. The changes of HIV antibody detection rate during pregnancy were compared, and the intervention effect of health education was evaluated. Results A total of 1541 pregnant women were investigated, including 933 intervention areas and 608 control areas. After intervention, the detection rate of HIV antibody during pregnancy was increased from 34.27% before intervention to 72.49% after intervention. The detection of HIV antibody during pregnancy was increased from 5.83% to 20.38% in control area. The detection rate of HIV antibody in pregnant women during pregnancy was 52.11% higher than that in control area (χ2 = 24.60, P <0.01). Multivariate analysis showed that interventions to prevent mother-to-child transmission of AIDS were effective and the intervention effect OR was 2.01 (95% CI: 1.60, 2.49). Conclusion Relying on the three-level health care network of county, township and village level, the grass-roots MCH staff implement the HIV / AIDS mother-to-child health education for women of child-bearing age, including pregnant women, which can effectively improve the acceptance of HIV antibody testing services use.