【作者】 周建波；

【导师】 孙业桓；

【作者基本信息】 安徽医科大学 ， 流行病与卫生统计学， 2008， 硕士

【摘要】 目的了解铁路建筑工地流动人口的艾滋病相关知识、态度和行为(KAP)现状及其影响因素,为制定相应的艾滋病健康教育及行为干预策略与措施提供依据;并评价行为干预对铁路建筑工地流动人口在预防、控制艾滋病方面的效果。方法对整群抽取的合肥市某铁路施工企业在外施工的2个工地943名流动人口进行问卷调查,通过单因素分析、相关分析与多元Logistic回归分析流动人口的艾滋病相关知识、态度和行为影响因素。在基线调查的基础上对干预对象进行为期4-5个月的小媒介宣传和同伴教育等综合干预,之后再随访调查进行评估。结果建筑工地流动人口总体上对艾滋病知识缺乏了解;文化程度和收入越高、打工时间越长者艾滋病相关知识水平越高。在听说过艾滋病的734人中,仅有37.5%(275)的人对艾滋病感染者持同情态度。943名调查对象中,不反对“婚前性行为”、“卖淫”和“嫖娼”者分别占39.6%、7.3%和6.9%。9.5%的被调查对象(90人)承认最近三个月内有过非婚性行为,其中28.6%(22人)承认从未使用安全套,仅10.4%(8人)的每次使用。文化程度和艾滋病知识得分越高者安全套使用频率越高;探亲时间间隔和打工时间越长,安全套使用频率越低。通过对比干预前943名和干预后随访到的671名建筑工地流动人口有关艾滋病的知识、态度和行为,发现行为干预在不同程度上使建筑工地流动人口对艾滋病传播途径、预防知识等知晓率普遍提高,自我保护意识明显增强;因恐惧和歧视心理而采取消极态度者分别由9.8%、10.5%降至6.3%、3.5%(P值均<0.05);承认最近三个月内有过非婚性行为者的比例由干预前的24.8%下降到3.8%(P<0.01);最近一次非婚性行为使用安全套者由干预前的41.9%提高到64.3%(P<0.05),但在最近三个月内非婚性行为安全套使用频率干预前后比较未见显著性差异。新进入人群的艾滋病相关知识掌握程度、个人自我保护意识等与基线人群相比无统计学差异;但随访组人群艾滋病知识、对艾滋病态度和个人保护意识要明显高于新进入人群(P<0.01)。结论铁路建筑工地流动人口存在HIV感染的危险性,对其开展有针对性的艾滋病健康教育和行为干预迫在眉睫。本研究结果显示,健康教育和行为干预对建筑工地流动人口在预防和控制艾滋病方面是有效的措施;但要长期的改变民工与STI/AIDS有关的高危性行为应建立长效的行为干预机制。更多还原

【Abstract】 Objective To investigate the status and influencing factors of knowledge, attitude and practice (KAP) about AIDS among the migrant workers in railway construction sites and to provide evidence for constituting strategies and measures for AIDS health education and behavioral intervention.To evaluate the effect of behavioral intervention for the prevention of AIDS among the migrant workers in railway construction sites.Methods 943 migrant workers from two railway construction sites were surveyed by cluster sampling. Univariate analysis, multivariate Logistic regression and correlation analysis were used to explore their influencing factors of knowledge, attitude and practice about AIDS among the migrant workers. Health education and behavioral intervention on AIDS were carried out among the migrant workers for 4 to 5 months, which included mini-media, peer education and so on. Questionnaire survey was conducted among them before and after the intervention to evaluate the effect of behavioral intervention.Results The migrant workers in railway construction sites had poor AIDS knowledge as a whole. People with high educational level and income had higher AIDS-related knowledge than other groups. There were only 37.5% (275) of 734 migrant workers who heard about the name of AIDS sympathized for people with HIV/AIDS. There were 39.6%, 7.3% and 6.9% of 943 migrant workers did not object to“pre-marital sex”,“prostitution”and“wenching”. There were 90(9.5%) migrant workers admitted having non-marital sex among three months before the survey, but 22(28.6%) admitted never using condoms, and only 8(10.4%) had used each time. The higher educational level and scores about AIDS knowledge were, the higher the usage of condom was. The longer time interval for visiting their families and working time were, the higher the usage of condom was.The results showed that the knowledge awareness of the migrant workers on the transmission routes, preventions of AIDS and self-protection consciousness increased significantly by comparing the indexes of 943 before-intervention with those of 671 after-intervention workers. After intervention procedures , the rate of those workers who would adopt negative attitudes towards the HIV infected persons because of fear and discrimination was decreased from 9.8%,10.5% to 6.3%, 3.5% (both P<0.05); the rate of those workers admitted having non-marital sex among three months before the survey was decreased from 24.8% to 3.8% (P<0.01); the rate of those workers, who used condoms recently once when having non-marital sex, was raised from 41.9% to 64.3% (P<0.05). There was no statistical significance in the usage of condoms of the subjects between before- and after-intervention among three months before the survey. There was no statistical significance in the scores about AIDS knowledge and self-protection consciousness of the subjects between 139 new migrant workers and the population of baseline survey. But the knowledge awareness on AIDS-related knowledge, positive attitudes towards the HIV infected persons and self-protection consciousness of 671 after-intervention workers were higher than those of 139 new migrant workers(P<0.01).Conclusions Migrant workers in construction sites are potential high risk population for HIV/AIDS. AIDS health education and behavioral intervention work should be carried out imminently. The behavioral intervention based on the construction sites for migrant workers were effective measures in AIDS prevention and control. But if altering migrant workers’high rish sexual behaviors on STI/AIDS, we need make unremitting efforts to carry through behavioral intervention.更多还原