【作者】 王伟；

【导师】 朱会宾；

【作者基本信息】 河北医科大学 ， 流行病与卫生统计学， 2010， 硕士

【摘要】 目的:了解河北省县级城镇部分流动人口的艾滋病相关知识、态度和行为(knowledge,attitude,practice,KAP)现状,分析影响县级城镇流动人口艾滋病知晓情况的因素,评价综合性干预措施在县级城镇流动人口中预防、控制艾滋病方面的效果,为县级城镇流动人口艾滋病干预提供理论依据。方法:2009年5月,选择河北省县级城镇流动人口中的建筑工人和矿工作为调查对象,在所选择城镇随机抽取工期超过3个月的建筑工地和矿区作为调查场所,对场所内的流动人口实施为期3个月的艾滋病综合干预,进行干预前后自身对照,评价综合性干预措施的效果。干预形式包括发放宣传材料、设置宣传栏广告栏、专题讲座和开展同伴教育等。通过问卷调查,收集干预前后城镇流动人口的社会学特征以及艾滋病相关KAP相关资料。结果:1基线调查结果分别调查建筑工地和矿区流动人口1361人和545人,调查对象年龄主要集中在20-40岁之间;文化水平较低,两类人群中初中以下文化程度者分别占74.5%和85.5%;已婚者居多,分别为82.0%和78.5%。两类人群中收入在1000-2000元之间的分别占84.4%和82.2%。建筑工地流动人口对艾滋病传播途径五道题目的回答正确率平均为66.1%,对非传播途径六道题目的回答正确率平均为56.8%,对艾滋病一般常识的回答正确率平均为51.9%。矿区流动人口对艾滋病传播途径五道题目的回答正确率平均为64.9%,对非传播途径六道题目的回答正确率平均为63.3%,艾滋病一般常识的回答正确率平均为59.4%。按《中国艾滋病防治督导与评估框架》中评估艾滋病知识知晓率的方法计算,建筑工地和矿区流动人口中艾滋病知识知晓率分别为49.7%和61.5%。单因素分析显示在流动人口的社会学特征中,仅文化程度与知晓率有关。建筑工地流动人口获得艾滋病知识的最主要3条途径为电视(67.1%)、广播(33.5%)、报刊书籍(30.2%),矿区流动人口获得艾滋病知识最主要3条途径为电视(71.7%)、广播(50.1%)、免费宣传材料(29.4%)。建筑工地流动人口最希望获得艾滋病知识的三条途径为免费宣传材料、同伴互相交流、宣传栏广告栏;矿区流动人口最希望获得艾滋病知识的三条途径为免费宣传材料、宣传栏广告栏、知识讲座。建筑工地流动人口对艾滋病存在歧视态度的比例为72.1%,矿区流动人口对艾滋病存在歧视态度的比例69.5%。建筑工地流动人口中62.4%的人认为应强制隔离管理艾滋病病人和感染者;30.1%的人认为艾滋病感染者或病人是自己不检点,得病是报应;53.8%的人在自己的熟人感染艾滋病后选择断绝交往或减少来往。矿区流动人口中有69.6%的人认为应该强制隔离管理艾滋病病人和感染者;21.6%的人认为艾滋病病人或感染者是自己不检点,得病是报应;36.7%的人表示在熟人感染艾滋病后选择断绝交往或减少交往。两类流动人口最近3个月与商业性服务者发生性行为的比例分别为15.2%、7.7%,最近1次与商业性服务者发生性行为时安全套使用比例分别为50.7%和64.3%。2综合性干预措施的效果评价建筑工地和矿区流动人口艾滋病知识知晓率在干预后分别上升了34.9%和25.6%,艾滋病相关知识的15道题目干预前后的回答正确率差别皆有统计学意义。流动人口在干预后获得艾滋病知识的主要途径为电视、免费宣传材料、宣传栏广告栏。干预后,建筑工地流动人口艾滋病存在歧视态度的比例为52.8%,矿区流动人口为31.6%。建筑工地流动人口中认为应该强制隔离管理病人的比例下降了36.4%;认为艾滋病感染者是自己不检点,得病是报应的比例下降了26.5%;表示如果自己的熟人感染艾滋病后会减少或断绝交往的比例下降了33.7%。矿区流动人口中认为应强制隔离管理病人的比例下降了59%;认为艾滋病感染者得病是报应的比例下降了10.6%;表示如果自己的熟人感染艾滋病后会减少或断绝交往的比例下降了11.8%。建筑工地流动人口最近3个月发生过商业性行为的比例下降了7.9%,最近1次与商业性服务者发生性行为时安全套使用率上升了29.9%。矿区流动人口最近3个月发生过商业性行为的比例下降2.7%,最近1次与商业性服务者发生性行为时安全套使用率上升27%。结论:1河北省县级城镇流动人口中的建筑工人和矿工,人群文化水平以初中文化程度为主。与经济发达、人口流动较频繁的大中城市相比,县级城镇流动人口平均年龄较大,已婚比例较高。2县级城镇流动人口对艾滋病传播途径的回答正确率高于非传播途径,对艾滋病的一般性预防知识了解最少。文化程度是影响流动人口艾滋病知识知晓率的主要因素。大众媒体是城镇流动人口获得艾滋病知识的主要途径。3由于人们对艾滋病的认识误区,城镇流动人口中存在着较严重的对艾滋病的歧视现象,对当前的艾滋病防治工作造成影响。4城镇流动人口中建筑工人商业性行为发生比例高于矿区工人。商业性行为发生比例高于北京、东莞等大中城市。在发生高危行为时人群有一定的自我保护意识,但仍存在着传播艾滋病的风险。5通过综合性干预措施的实施,城镇流动人口对艾滋病知识的了解有不同程度的提高,但干预前回答正确率较低的题目干预后相对其它题目而言仍较低,短时间的干预较难完全改变人们对某些错误观念的认知。6干预后调查对象通过免费宣传材料、宣传栏广告栏、同伴互相交流等途径获得艾滋病知识的比例上升,综合性干预措施通过多种途径在人群中宣传艾滋病知识的作用得到体现。7干预后人群对艾滋病的态度也发生了积极变化,歧视现象有所减弱,但人群对艾滋病仍存在一定的顾虑和恐惧。8综合性干预措施的实施可以减少人群中商业性行为发生率,促使人们在发生高危行为时使用安全套,对流动人口与固定性伴发生性行为时安全套使用无影响。但干预后建筑工地流动人群高危行为发生率较大城市同类人群相比仍较高,采用综合性干预措施对流动人群进行干预必须长久、持续。更多还原

【Abstract】 Objective: To understand present situation of floating population’AIDS related knowledge, attitude, practice in county town in Hebei province. To analyze the factors which affect the floating population’AIDS knowledge rate in county towns. To evaluate the effect of comprehensive control measures for AIDS prevent and control in floating population so as to provide theoretical basis for AIDS control in county towns’floating population.Methods: Construction workers and miners, which were representative in county towns’floating population in Hebei province, were selected as investigation object. Construction sites and mining areas which exist more than 3 months were selected randomly in county towns as investigation places. Floating population in investigation places were intervened by comprehensive control measures for 3 months. The effect of comprehensive control measures were evaluated by self control before and after the intervention. The forms of intervention contains publicity materials, picture poster, column of advertisement, special lectures, peer-education propaganda and so on.Questionnaires were used to collect the information of floating population’sociological characteristics and AIDS related knowledge, attitude and behavior in county towns.Results:1 the results of baseline survey1361 construction workers and 545 miners were investigated. The investigators’ages were mainly between 20 and 40. The educational level was low. 74.5% of the construction workers and 85.5% of the miners were under junior middle school levels. 82.0% of the construction workers’and 78.5% of the miners’salary were between 1000 and 2000. The average correcting rate of AIDS transmission route in construction workers was 66.1%; the average correcting rate of non-transmission route was 56.8%; The average correcting rate of AIDS general commonsense was 51.9%. The average correcting rate of AIDS transmission route in miners was 64.9%; the average correcting rate of non-transmission route was 63.3%; the average correcting rate of AIDS general commonsense was 59.4%. The AIDS knowledge rate in construction workers was 49.7% so as 61.5% in miners. Educational level was related to the AIDS knowledge rate. TV, broadcast, papers and books were the main ways which the construction workers got AIDS knowledge. TV, broadcast, publicity materials were the main ways which the miners got AIDS knowledge. publicity materials, peer communication, special lectures, picture poster and column of advertisement were the ways which the two groups like best.The AIDS discrimination rate in construction workers was 72.1%, and the rate in miners was 69.5%. 62.4% of the construction workers and 69.6% of the miners considered isolation management to AIDS patients and infected individuals. 30.1% of the construction workers and 21.6% of the miners considered that the AIDS patients and infected individuals were retribution. 30.1% of the construction workers and 36.7% of the miners considered that they would break off or reduce communication with their acquaintances if they infected AIDS.The rates of having sexual intercourse with commercial sex workers in the last 3 months were 15.2% and 7.7%. The rates of condom use in the last time of having sexual intercourse with commercial sex workers were 50.7% and 64.3%.2 evaluation on the effect of comprehensive control measuresThe rate of AIDS knowledge rate was 84.6% in construction workers and 87.1% in miners after intervention. There were statistic significant before and after intervention in all of the 15 questions. TV, publicity materials, picture poster and column of advertisement were the main ways which the floating population got AIDS knowledge after intervention. The AIDS discrimination rate in construction workers was 52.8% after intervention, and the rate in miners was 31.6%. The rates of people considered isolation management to AIDS patients and infected individuals decreased by 36.4% in construction workers and 59% in miners. The rates of people considered that the AIDS patients and infected individuals were retribution decreased by 26.5% in construction workers and 10.6% in miners. The rates of people considered that they would break off or reduce communication with their acquaintances if they infected AIDS decreased by 33.7% in construction workers and 11.8% in miners.The rates of people who had sexual intercourse with commercial sex workers in the last 3 months decreased by 7.9% in construction workers and 2.7% in miners. The rates of condom use in the last time when they had sexual intercourse with commercial sex workers increased by 29.9% in commercial sex workers and 27 in miners.Conclusion:1 The main educational level of the floating population(construction workers and miners) in county towns was junior middle school level. The ages were larger and the rate of married was higher than some big or middle cities.2 The average correcting rate of AIDS transmission route is higher than the rate of non-transmission route. People knew the knowledge about AIDS prevention least. Occupation and educational level were the main effects which affect the AIDS knowledge rate. Mass media was the main way they got AIDS knowledge.3 Because of the misunderstanding of AIDS in floating population, they had serious discrimination to AIDS patients and infected individuals, which affected the AIDS control and prevention.4 The rate of having commercial sexual behavior in construction workers was higher than in miners. The rate is higher than the floating population in big and middle cities. People have some self-protection consciousness. More than 50% of the objects used condoms when they had high risk sexual behavior. But there’s a big gap with the requirement of“100% condom use” project.5 The floating population’AIDS knowledge rate increased through the comprehensive control measures. But the questions whose correcting rate were low before intervention were still low after intervention. Short-term intervention was hard to change some erroneous cognition absolutely.6 The rate of floating population who got AIDS knowledge through publicity materials, picture poster,column of advertisement,peer education had risen. Comprehensive control measures in the population through a variety of ways to promote the role of AIDS knowledge had been reflected. How to expand the sphere of influence is the next focus of the study.7 The population’s attitude to AIDS had undergone positive changes after the intervention. Discrimination had been weakened. But there were still some concerns and fears.8 The implementation of comprehensive control measures can reduce the incidence of commercial sex behavior among the crowd, prompting people to use condoms when high-risk behavior occurs. It had no effect when the floating population had sexual behaviors with their fixed sexual partners. After the intervention, the incidence rate of high-risk behavior in county towns’floating construction workers was still higher than the similar populations in big cities. The comprehensive control measures must be long-tern and sustainability.更多还原