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目的:探讨通过改善交流/协商技能来促进未婚流动青少年安全性行为的可能性。方法:本研究为横断面调查,对来自上海某市区若干服务场所和某郊区几个工厂的15~24岁未婚流动青少年开展交流/协商自我效能及未婚流动青少年性相关行为的问卷调查。数据采用SAS 9.1软件进行分析。结果:共调查对象1 001人,其中男性491人,女性510人。对象的平均年龄为21.0±1.9岁。将近60%的男性和22%的女性对象报告没把握在自己不想发生性行为时拒绝对方提出的性要求;15.68%的男性和36.67%的女性对象报告完全有把握在不使用避孕套时拒绝发生性行为;仅12.63%的男性和26.08%的女性对象报告完全有把握在性伴不想使用避孕套时说服其使用避孕套。在发生过婚前性行为的260例(25.97%)对象中,38.12%的男性和32.89%的女性对象与首次性行为对象认识时间不到半年;仅18.48%的男性和32.89%的女性坚持每次都使用避孕措施;接近10%的男性以及3%的女性对象有过商业性行为。多因素分析结果显示,男性对象交流/协商自我效能越高,则发生首次性行为时与性伴侣认识的时间越长(OR=1.025,95%CI:1.002~1.049),越有可能坚持每次都使用避孕措施(OR=1.041,95%CI:1.006,1.077),发生商业性行为的可能性也越低(OR=0.956,95%CI:0.920~0.994),而交流/协商自我效能高是女性对象婚前性行为发生的保护因素(OR=0.976,95%CI:0.956~0.997)。结论:在未婚流动青少年中开展性与生殖健康干预时注重交流/协商技能培训可促进安全的性行为。
Purpose: To explore the possibility of promoting the safety of unmarried migrant children through improved communication / negotiation skills. Methods: In this study, a cross-sectional survey was conducted to conduct questionnaire surveys on self-efficacy of communication / consultation and self-efficacy of unmarried migrant children aged 15 ~ 24 years old from a number of service locations in a certain urban area in Shanghai and several factories in a certain suburban area. Data was analyzed using SAS 9.1 software. Results: A total of 1 001 people were surveyed, including 491 males and 510 females. The average age of the subjects was 21.0 ± 1.9 years. Nearly 60% of men and 22% of women reported not being confident of rejecting their sexual claim when they did not want to have sex; 15.68% of men and 36.67% of women reported complete confidence in rejecting condom use Sexual behavior; only 12.63% of men and 26.08% of women reported complete confidence that condom use should be persuaded when partners do not want to use condoms. Of the 260 patients (25.97%) who had premarital sexual behavior, 38.12% of the men and 32.89% of the women had less than half a year of first-time sexual partners; only 18.48% of the men and 32.89% of the women insisted that every time Both use contraception; nearly 10% of men and 3% of women have had commercial sex. Multivariate analysis showed that the higher self-efficacy of male subjects in communication / negotiation was, the longer the first sexual intercourse with sexual partners (OR = 1.025,95% CI: 1.002-1.049), the more likely it was to persist each time (OR = 1.041, 95% CI: 1.006, 1.077), the lower the probability of having a commercial sexual behavior (OR = 0.956, 95% CI: 0.920-0.994), while the high self-efficacy of communication / negotiation was Protection of premarital sex of female subjects (OR = 0.976, 95% CI: 0.956-0.997). Conclusions: Emphasis on communication / negotiation skills training in sexual and reproductive health interventions among unmarried migrant adolescents can promote safe sexual behavior.