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目的 通过同伴教育减少静脉注射毒品者感染和传播艾滋病病毒的高危险行为。方法 在昆明市强制戒毒所和劳教戒毒所的戒毒人员中开展为期两年的减少伤害同伴教育活动 ,在干预前后进行两次随机抽样调查 ,并在干预后开展焦点问题小组讨论和个案随访 ,比较干预前后高危险行为变化 ,评估干预效果。结果 基线和干预后分别随机抽取 30 6人和 418人进行调查。比较干预前后 ,共用注射器由 6 8.3%下降到 6 2 .0 % (χ2 =2 .6 1,P <0 .0 1) ,从来不清洗注射器从 3.3%上升到15 .8% (χ2 =19.41,P <0 .0 1) ,将用过的注射器丢弃到垃圾桶内的比例从 5 8.4%上升到 81.8% (χ2 =40 .2 3,P <0 .0 1)。对 34名戒毒人员进行跟踪随访 ,6 7.6 %不再共用注射器 ,无人在性生活中使用避孕套。结论 在戒毒所内开展同伴教育活动减少静脉注射毒品者危险行为的效果是有限的。为遏制艾滋病在这一人群中的快速传播 ,需要尝试更为有效的干预措施。
PURPOSE To reduce peer-educated high risk behaviors of HIV infection and transmission among intravenous drug users. Methods A two-year injury reduction peer education program was carried out in detoxification centers of detoxification detention centers and reeducation-through-labor camps in Kunming. Two randomized sampling surveys were conducted before and after the interventions. Panel discussions and case-by-case visits were conducted after the intervention Changes in high-risk behaviors before and after intervention, to assess the effect of intervention. Results Baseline and intervention were randomly selected 30 6 and 418 were investigated. Before and after intervention, the number of shared syringes dropped from 6 8.3% to 62.0% (χ2 = 2.61, P <0.01), and the number of syringes never increased from 3.3% to 15.8% (χ2 = 19.41 , P <.01), the proportion of used syringes dropped into the trash increased from 5 8.4% to 81.8% (χ2 = 40.23, P <0.01). Follow-up visits were conducted to 34 drug addicts, 6 7.6% no longer shared syringes, and no one used condoms in their sex life. Conclusions Peer education programs in drug rehabilitation centers have limited effectiveness in reducing the risk behaviors of IV drug users. To stop the rapid spread of AIDS in this population, more effective interventions need to be tried.