青年学生常规与同伴艾滋病自愿咨询检测服务干预效果评价

陈希; 贺婷婷; 陈梦清; 梁清儿; 李顺铭; 陈韵聪; 罗业飞; 蔡衍珊; 韩志刚

doi:10.16835/j.cnki.1000-9817.2023.10.007

青年学生常规与同伴艾滋病自愿咨询检测服务干预效果评价

doi: 10.16835/j.cnki.1000-9817.2023.10.007

1.
广州市疾病预防控制中心艾滋病预防控制部, 广东 510440
2.
广州医科大学公共卫生学院预防医学专业
3.
杭州市上城区疾病预防控制中心结核病艾滋病性病防制科

基金项目:

2024年度广州市校(院)企联合资助专题项目 SL2024A03J00782

详细信息

作者简介:
陈希(1985-), 女, 广东省人, 硕士, 副主任医师, 主要研究方向为艾滋病防制

通讯作者:
韩志刚, E-mail: gzcdc_hanzg@gz.gov.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R512.91 R167 R179
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- HTML全文浏览量: 133
- PDF下载量: 31
- 被引次数: 0
出版历程
- 收稿日期: 2023-07-06
- 修回日期: 2023-07-29
- 网络出版日期: 2023-10-27
- 刊出日期: 2023-10-25

Evaluation of the intervention effect of conventional and peer AIDS voluntary counseling and testing services among young students

1.
Department of AIDS Prevention and Contronl, Guangzhou Center for Disease Control and Prevention, Guangzhou (510440), China

摘要

摘要: 目的探讨两种自愿咨询检测(VCT)服务对青年学生艾滋病相关知识和行为的影响，为进一步完善和推广VCT服务提供新思路。方法于2017年4月—2018年12月，在广州市12个高校巡回检测点和固定检测点，采用非劣性试验计算样本量，按1∶1匹配同期接受服务的青年学生为研究对象，纳入常规VCT共113名，同伴VCT共186名。采用χ²检验分析两种VCT干预前后艾滋病相关知识和行为的差异，并对满意度进行调查。结果青年学生接受常规VCT服务后，艾滋病基本常识总知晓率从80.53%上升至93.75%，最近1年异性性行为时每次使用安全套的频率升高29.17百分点(χ²值分别为4.49，4.10，P值均＜0.05)。接受同伴VCT服务后的青年学生，“四免一关”怀政策总知晓率从34.95%升高至58.26%，最近半年同性肛交性行为比例和最近半年≥2个同性性伴比例分别降低14.84，29.43百分点(χ²值分别为15.69，4.82，10.97，P值均＜0.05)。结论接受两种VCT服务后，青年学生的艾滋病相关知识和行为均得到改善，两种VCT服务的成效各有侧重。可将常规VCT与同伴教育优势互补，形成更有效的艾滋病干预方式。
- 获得性免疫缺陷综合征 /
- 咨询 /
- 干预性研究 /
- 学生
Abstract: Objective To explore the influence of two voluntary counseling and testing(VCT) services on young students' acquired immune deficiency syndrome(AIDS)-related knowledge and behaviour, so as to provide a new idea for further improvement and promotion of VCT services. Methods From April 2017 to December 2018, the sample size, selected from 12 patrol and fixed monitoring sites in colleges in Guangzhou, was calculated by non-inferiority trial, and the students who received services at the same period were 1∶1 matched. A total of 113 students received conventional VCT and 186 recerived peer VCT services. The Chi-square test was used to analyse the difference of AIDS-related knowledge and behavior before and after intervention, and a survey was conducted on satisfaction. Results After young students received conventional VCT services, the overall awareness rate of AIDS basic knowledge increased from 80.53% to 93.75%, and the frequency of condom use every time during heterosexual sexual activity in the past year increased by 29.17 percentage points (χ²=4.49, 4.10, P < 0.05). After young students received peer VCT services, the awareness rate of the Four Frees and One Care Policy increased from 34.95% to 58.26%, the rates of homosexual anal sex and more than or equal to 2 sexual partners in the past half a year decreased by 14.84 and 29.43 percentage points, respectively(χ²=15.69, 4.82, 10.97, P < 0.05). Conclusion After young students receive two modes of VCT services respectively, the AIDS-related knowledge and behavior have been improved, and the influence of the two VCT services has different advantages. The combination of conventional VCT and peer education might be a more effective way of AIDS intervention.
- Acquired immunodeficiency syndrome /
- Counseling /
- Intervention studies /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 广州市接受常规VCT和同伴VCT服务青年学生干预前后艾滋病常识和政策知晓率比较

Table 1. Comparison of AIDS general knowledge and policy awareness rate among young students receiving conventional VCT and peer VCT services in Guangzhou before and after intervention

项目	选项	常规VCT				同伴VCT
项目	选项	基线(n=113)	随访(n=48)	χ²值	P值	基线(n=186)	随访(n=115)	χ²值	P值
艾滋病基本常识	艾滋病不可治愈	81(71.68)	41(85.42)	3.46	0.06	121(65.05)	72(62.61)	0.19	0.67
	主要由男同性行为传播	78(69.03)	36(75.00)	0.58	0.45	125(67.20)	82(71.30)	0.56	0.46
	不能通过外表判断感染	94(83.19)	45(93.75)	3.19	0.07	173(93.01)	110(95.65)	0.88	0.35
	日常接触不会感染	95(84.07)	46(95.83)	4.28	0.04	169(90.86)	111(96.52)	3.51	0.06
	安全套可以减少风险	109(96.46)	48(100.00)		0.32^*	181(97.31)	114(99.13)	1.20	0.27
	新型毒品可以增加风险	83(73.45)	43(89.58)	5.15	0.02	151(81.18)	96(83.48)	0.25	0.61
	高危行为后应该主动咨询	107(94.69)	47(97.92)	0.84	0.33	177(95.16)	115(100.00)		0.02^*
	感染者权益受法律保护	79(69.91)	40(83.33)	3.15	0.08	147(79.03)	97(84.35)	1.31	0.25
	总知晓	91(80.53)	45(93.75)	4.49	0.03	164(88.17)	106(92.17)	1.23	0.27
四免一关怀政策	提供免费HIV检测	106(93.81)	48(100.00)		0.10^*	171(91.94)	113(98.26)	5.34	0.02
	提供免费治疗药物	93(82.30)	40(83.33)	0.03	0.87	138(74.19)	99(86.09)	6.00	0.01
	提供救治关怀	87(76.99)	40(83.33)	0.81	0.37	157(84.41)	105(91.30)	3.00	0.08
	提供免费母婴阻断药物	73(64.60)	36(75.00)	1.67	0.20	143(76.88)	99(86.09)	3.82	0.05
	提供免费义务教育	66(58.41)	29(60.42)	0.06	0.82	115(61.83)	83(72.17)	3.82	0.07
	总知晓	47(41.59)	24(50.00)	0.97	0.39	65(34.95)	67(58.26)	15.69	＜0.01
注：()内数字为知晓率/%；*为Fisher确切概率法。

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表 2 广州市接受常规VCT和同伴VCT服务青年学生干预前后性行为比较

Table 2. Comparison of sexual behaviour among young students receiving conventional VCT and peer VCT services in Guangzhou before and after intervention

性行为	选项	常规VCT				同伴VCT
性行为	选项	基线(n=113)	随访(n=48)	χ²值	P值	基线(n=186)	随访(n=115)	χ²值	P值
最近1年异性性行为	是	48(46.15)	16(37.21)	0.99	0.32	96(65.31)	52(63.41)	0.08	0.77
	否	56(53.85)	27(62.79)			51(34.69)	30(36.59)
最近1年异性性伴数量	0	56(53.85)	27(62.79)	1.18	0.56	51(34.69)	30(36.59)	0.09	0.96
	1	18(17.31)	5(11.63)			42(28.57)	23(28.05)
	≥2	30(28.85)	11(25.58)			54(36.73)	29(35.37)
最近1年使用安全套的频率	非每次都用	26(54.17)	4(25.00)	4.10	0.04	51(53.13)	20(38.46)	2.91	0.09
	每次都用	22(45.83)	12(75.00)			45(46.88)	32(61.54)
最近1年临时性行为	是	28(58.33)	6(37.50)	2.09	0.15	47(48.96)	20(38.46)	1.50	0.22
	否	20(41.67)	10(62.50)			49(51.04)	32(61.54)
最近1年商业性行为	是	13(27.08)	1(6.25)		0.16^*	4(4.17)	2(3.85)		0.65^*
	否	35(72.92)	15(93.75)			92(95.83)	50(96.15)
最近半年同性肛交性行为	是	65(90.28)	26(92.86)		0.51^*	59(90.77)	41(75.93)	4.82	0.03
	否	7(9.72)	2(7.14)			6(9.23)	13(24.07)
最近半年同性性伴数量	0	7(9.72)	2(7.14)		0.95^*	6(9.23)	13(24.07)	10.97	＜0.01
	1	27(37.50)	10(35.71)			17(26.15)	22(40.74)
	≥2	38(52.78)	16(57.14)			42(64.62)	19(35.19)
最近半年使用安全套的频率	非每次都用	47(72.31)	6(23.08)	18.51	＜0.01	28(47.46)	18(43.90)	0.12	0.73
	每次都用	18(27.69)	20(76.92)			31(52.54)	23(56.10)
最近半年同性临时性行为	是	37(56.92)	18(69.23)	1.18	0.28	35(59.32)	21(51.22)	0.65	0.42
	否	28(43.08)	8(30.77)			24(40.68)	20(48.78)
最近半年同性商业性行为	是	7(10.77)	3(11.54)		0.59^*	2(3.39)	1(2.44)		0.64^*
	否	58(89.23)	23(88.46)			57(96.61)	40(97.56)
发生性行为前是否使用药品	是	20(19.23)	11(25.58)	0.74	0.39	26(17.69)	17(17.89)	0.00	0.97
	否	84(80.77)	32(74.42)			121(82.31)	78(82.11)
注：()内数字为构成比/%；*为Fisher确切概率法；问卷选项涉及跳转，自动跳转后则不计入该项人数。

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表 3 广州市青年学生对常规VCT和同伴VCT服务的满意度比较

Table 3. Comparison of satisfaction of conventional VCT and peer VCT services among young students in Guangzhou

维度	选项	常规VCT (n=86)	同伴VCT (n=169)
客观因素维度	预约检测程序	81(94.19)	162(95.86)
	检测地点的交通	71(82.56)	140(82.84)
	等待时间	77(89.53)	144(85.21)
	咨询检测流程	78(90.70)	160(94.67)
	隐私保护	80(93.02)	156(92.31)
	场所的环境	82(95.35)	156(92.31)
咨询员表现维度	让人舒服自在	83(96.51)	162(95.86)
咨询员表现维度	让人畅所欲言	83(96.51)	164(97.04)
	细心聆听	83(96.51)	165(97.63)
	了解所关心的问题	83(96.51)	162(95.86)
	解释清晰	82(95.35)	163(96.45)
	协助了解自身健康	84(97.67)	166(98.22)
	表达出关心和热忱	83(96.51)	164(97.04)
	态度认真	84(97.67)	165(97.63)
	对人尊重	83(96.51)	166(98.22)
主观感受维度	更了解艾滋病	80(93.02)	164(97.04)
	恐艾滋病感减少	75(87.21)	160(94.67)
	心情轻松很多	79(91.86)	166(98.22)
总体		82(95.35)	163(96.45)
注：()内数字为报告率/%。

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参考文献(21)

[1]	罗健斌, 杨燕君. 广州高年级大学生艾滋病知识知晓与性行为趋势[J]. 中国公共卫生, 2019, 35(5): 598-602. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201905021.htm LUO J B, YANG Y J. Change trends in AIDS-related knowledge and sexual behaviors among senior university students in Guangzhou City[J]. Chin J Public Health, 2019, 35(5): 598-602. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201905021.htm
[2]	LI G, JIANG Y, ZHANG L. HIV upsurge in China's students[J]. Science, 2019, 364(6442): 711. doi: 10.1126/science.aay0799
[3]	樊莉蕊, 陈希, 陈韵聪, 等. 2011—2020年广州市学生人群艾滋病疫情及相关行为变化分析[J]. 医学动物防制, 2021, 37(9): 821-825, 829. https://www.cnki.com.cn/Article/CJFDTOTAL-YXDZ202109002.htm FAN L R, CHEN X, CHEN Y C, et al. Analysis on AIDS epidemic and related behaviors among students in Guangzhou from 2011 to 2020[J]. J Med Pest Control, 2021, 37(9): 821-825, 829. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXDZ202109002.htm
[4]	高洁, 周景林, 邹林, 等. 北京市通州区疾病预防控制中心2017—2021年自愿咨询检测门诊HIV检测结果分析[J]. 中国病毒病杂志, 2022, 12(5): 381-384. https://www.cnki.com.cn/Article/CJFDTOTAL-ZRYX202205011.htm GAO J, ZHOU J L, ZOU L, et al. Analysis of HIV screening results in voluntary counseling and testing clinic in Tongzhou CDC during 2017-2021[J]. Chin J Viral Dis, 2022, 12(5): 381-384. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZRYX202205011.htm
[5]	梁海旭, 梁潇, 郭悦萍, 等. 2018年我国青年学生对艾滋病自愿咨询检测服务接受意愿及其影响因素分析[J]. 实用预防医学, 2020, 27(2): 149-155. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYY202002007.htm LIANG H X, LIANG X, GUO Y P, et al. Willingness to accept HIV/AIDS voluntary counseling and testing service and its influencing factors among young students in China, 2018[J]. Pract Prev Med, 2020, 27(2): 149-155. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SYYY202002007.htm
[6]	LI Y, JIAO K, WANG L, et al. The impact of peer education on HIV testing for Chinese men who have sex with men: the mediation effect of accompanying friends for testing[J]. Am J Mens Health, 2022, 16(2): 155.
[7]	ALEM A T, SISAY M M, ALEMAYEHU A M. Factors affecting voluntary HIV/AIDS counseling and testing service utilization among youth in Gondar City, Northwest Ethiopia[J]. HIV AIDS (Auckl), 2020, 12: 667-673.
[8]	ADEOMI A A, ADEOYE O A, ASEKUN-OLARINMOYE E O, et al. Evaluation of the effectiveness of peer education in improving HIV knowledge, attitude, and sexual behaviours among in school adolescents in Osun State, Nigeria[J]. AIDS Res Treat, 2014, 2014: 131756.
[9]	陈梦清, 程伟彬, 徐慧芳, 等. 广州市大学生对同伴艾滋病自愿咨询检测服务接受意愿及其影响因素分析[J]. 中国学校卫生, 2018, 39(2): 203-206. doi: 10.16835/j.cnki.1000-9817.2018.02.014 CHEN M Q, CHENG W B, XU H F, et al. Analysis of factors associated with willingness to accept peer HIV voluntary counseling and testing among college students in Guangzhou[J]. Chin J Sch Health, 2018, 39(2): 203-206. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2018.02.014
[10]	中国疾病预防控制中心性病艾滋病预防控制中心. 关于印发全国艾滋病哨点监测实施方案操作手册的函[A]. 2017-03-29. The Center for STD and AIDS Prevention and Control of the Chinese Center for Disease Control and Prevention. Notice on the issuance of the Operation Manual of the National AIDS Sentinel Surveillance Implementation Program[A]. 2017-03-29. (in Chinese)
[11]	何蔚云, 李顺铭, 韩志刚, 等. 广州市大学生同伴艾滋病自愿咨询检测服务模式效果评估[J]. 华南预防医学, 2020, 46(3): 324-328. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF202003036.htm HE W Y, LI S M, HAN Z G, et al. Evaluation of effectiveness of peer HIV/AIDS voluntary counseling and testing service model among college students in Guangzhou[J]. South Chin J Prev Med, 2020, 46(3): 324-328. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF202003036.htm
[12]	中华人民共和国国务院办公厅. 关于印发《中国遏制与防治艾滋病"十三五"行动计划》的通知[EB/OL]. (2017-02-05)[2023-02-01]. https://www.gov.cn/zhengce/zhengceku/2017-02/05/content_5165514.htm. The General Office of the State Council of the PRC. Notice on the issuance of China's 13th Five-Year Plan of Action for the Prevention and Treatment of AIDS[EB/OL]. (2017-02-05)[2023-02-01]. https://www.gov.cn/zhengce/zhengceku/2017-02/05/content_5165514.htm. (in Chinese)
[13]	葛梦林, 孙艳玲, 翁桂闽, 等. 广州市某高校大学生艾滋病与性健康教育情况调查[J]. 河南预防医学杂志, 2022, 33(6): 450-453. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYF202206013.htm GE M L, SUN Y L, WENG G M, et al. Survey of AIDS education and sexual health in a university in Guangzhou[J]. Henan J Prev Med, 2022, 33(6): 450-453. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HNYF202206013.htm
[14]	ALI M, OSMAN O B, IBRAHIM M, et al. The effect of AIDS peer health education on knowledge, attitudes, and practices of secondary school students in Khartoum, Sudan[J]. AIMS Public Health, 2015, 2(4): 718-726.
[15]	潘峥, 姚宁, 秦冰, 等. 广西高校少数民族学生艾滋病教育方法效果评价[J]. 中国学校卫生, 2019, 40(8): 1148-1150. doi: 10.16835/j.cnki.1000-9817.2019.08.008 PAN Z, YAO N, QIN B, et al. Effectiveness analysis of AIDS education method for minority students in college of Guangxi[J]. Chin J Sch Health, 2019, 40(8): 1148-1150. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.08.008
[16]	NEWMAN P A, AKKAKANJANASUPAR P, TEPJAN S, et al. Peer education interventions for HIV prevention and sexual health with young people in Mekong Region countries: a scoping review and conceptual framework[J]. Sex Reprod Health Matters, 2022, 30(1): 2129374.
[17]	连大帅, 洪翔, 李珊, 等. 同伴教育模式在大学生性教育中的应用效果评价[J]. 中国学校卫生, 2016, 37(5): 760-763. doi: 10.16835/j.cnki.1000-9817.2016.05.038 LIAN D S, HONG X, LI S, et al. Evaluation of the effectiveness of the peer education model in the application of sex education for university students[J]. Chin J Sch Health, 2016, 37(5): 760-763. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2016.05.038
[18]	樊荣丽, 严关明, 李慎坚, 等. 同伴推动干预在男男同性恋人群艾滋病防治中应用分析[J]. 中国初级卫生保健, 2019, 33(4): 69-70. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCW201904027.htm FAN R L, YAN G M, LI S J, et al. Analysis on the application of peer promotion intervention in AIDS prevention and treatment among MSM population[J]. Chin Prim Health Care, 2019, 33(4): 69-70. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCW201904027.htm
[19]	李婧, 岳晓丽, 蒋宁, 等. 我国3城市女性性工作者性病求医意向与行为分析[J]. 中国艾滋病性病, 2017, 23(6): 546-549. https://www.cnki.com.cn/Article/CJFDTOTAL-XBYA201706021.htm LI J, YUE X L, JIANG N, et al. Analysis of health seeking inclination and behaviors among female sex workers[J]. Chin J AIDS STD, 2017, 23(6): 546-549. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XBYA201706021.htm
[20]	王文倩, 周建芳, 蒋悦. 中国大学生艾滋病健康教育效果的Meta分析[J]. 预防医学, 2019, 31(12): 1233-1240. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX201912011.htm WANG W Q, ZHOU J F, JIANG Y. Effects of AIDS related health education on Chinese university students: a Meta-analysis[J]. Prev Med, 2019, 31(12): 1233-1240. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX201912011.htm
[21]	王玉仲, 彭颖, 张彩虹, 等. 同伴教育在高职学生艾滋病健康教育中的效果[J]. 中国艾滋病性病, 2021, 27(3): 288-291. https://www.cnki.com.cn/Article/CJFDTOTAL-XBYA202103022.htm WANG Y Z, PENG Y, ZHANG C H, et al. Effect of peer education on AIDS related knowledge for college students[J]. Chin J AIDS STD, 2021, 27(3): 288-291. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XBYA202103022.htm