文章摘要
陈韵聪,徐慧芳,罗业飞,古羽舟,樊莉蕊,韩志刚,蔡衍珊,何蔚云,姚芷潞,梁清儿,杜瑶瑶,顾菁.基于Andersen模型探讨自评HIV感染风险高的学生接受检测服务的影响因素[J].中华流行病学杂志,2021,42(11):1930-1936
基于Andersen模型探讨自评HIV感染风险高的学生接受检测服务的影响因素
Analysis on influencing factors of HIV testing services utilization in students with self-assessed high risk of HIV infection based on Andersen's model
收稿日期:2021-03-17  出版日期:2021-11-20
DOI:10.3760/cma.j.cn112338-20210317-00214
中文关键词: Andersen模型;学生;艾滋病病毒检测;影响因素
英文关键词: Andersen's model;Student;HIV testing;Influencing factors
基金项目:广州市卫生健康科技项目(20191A010042,20201A011053)
作者单位E-mail
陈韵聪 广州市疾病预防控制中心艾滋病预防控制部 510440  
徐慧芳 广州市疾病预防控制中心艾滋病预防控制部 510440
广东省性病艾滋病防治协会, 广州 511430 
 
罗业飞 广州市疾病预防控制中心艾滋病预防控制部 510440  
古羽舟 广州市疾病预防控制中心艾滋病预防控制部 510440  
樊莉蕊 广州市疾病预防控制中心艾滋病预防控制部 510440  
韩志刚 广州市疾病预防控制中心艾滋病预防控制部 510440  
蔡衍珊 广州市疾病预防控制中心艾滋病预防控制部 510440  
何蔚云 广州市疾病预防控制中心艾滋病预防控制部 510440  
姚芷潞 广州市疾病预防控制中心艾滋病预防控制部 510440
广东省性病艾滋病防治协会, 广州 511430 
 
梁清儿 广州市疾病预防控制中心艾滋病预防控制部 510440  
杜瑶瑶 中山大学公共卫生学院, 广州 510080  
顾菁 中山大学公共卫生学院, 广州 510080 gujing5@mail.sysu.edu.cn 
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中文摘要:
      目的 研究自评HIV感染风险高的青年学生接受HIV检测服务的影响因素。方法 基于Andersen卫生服务利用行为模型及相关文献设计学生HIV检测服务利用行为影响因素的研究框架。采用阶段模型分步骤对2019年3-4月使用青年学生性健康和HIV感染风险评估干预工具("熊探")自评HIV感染风险高的学生进行多因素分析。结果 共526名研究对象,年龄(19.30±1.19)岁,其中96.2%(506/526)知道发生高危行为后应主动寻求HIV检测;发生过插入式性行为比例为56.7%(298/526),HIV检测率为11.0%(58/526);发生过和未发生过插入式性行为的学生HIV检测率分别为13.42%(40/298)和7.89%(18/228)。多因素logistic回归分析结果显示,倾向性特征模块中的性取向为其他(与异性恋相比,OR=7.88,95%CI:3.98~15.61)、艾滋病知识知晓程度较高(与知晓程度较低的相比,OR=2.05,95%CI:1.07~3.93),需要因素模块中的有危险性行为(与未发生过危险性行为的相比,OR=2.66,95%CI:1.41~5.03)、在医院确诊感染过STD (与未感染者相比,OR=6.35,95%CI:2.21~18.27),能力因素模块中的最近1年接受过艾滋病预防知识的宣传(与未接受的相比,OR=0.29,95%CI:0.11~0.76)、最近1年接受过艾滋病自愿咨询检测服务的宣传(与未接受的相比,OR=3.67,95%CI:1.71~7.90)是HIV检测行为的影响因素。结论 学生的检测行动力亟待提高,其知识得分和性取向等倾向因素,以及是否有高危性行为和感染过STD等需要因素对HIV检测服务的利用均有较大的影响。但相比之下,接受过艾滋病预防和咨询检测服务相关知识政策教育等能力因素显得更重要,提示今后要进一步加强自愿咨询检测服务知识政策的教育,尤其是重点关注女生、有危险性行为者的教育。
英文摘要:
      Objective To analyze the influencing factors for HIV testing services utilization in students with self-assessed high risk of HIV infection. Methods The research framework of the influencing factors for HIV testing services utilization in students was developed based on Andersen's health services utilization behavioral model and related literature. A cross-sectional survey was performed in students with self-assessed high risk of HIV infection by an online HIV infection risk assessment tool from March to April 2019. Multiple logistic regressions were applied with hierarchical model. Results A total of 526 students were included in the study (age:19.30±1.19 years old), in whom 96.2% agreed that HIV testing should be received after high-risk behavior. 56.7% (298/526) had sexual behavior and the HIV testing rate was 11.0% (58/526). The HIV testing rates in students who had and had no sex behavior were 13.42%(40/298) and 7.89% (18/228), respectively. According to the results from multivariate logistic regression analysis, non-heterosexual (compared with heterosexual, OR=7.88, 95%CI:3.98-15.61) and higher score of AIDS knowledge awareness (compared with lower score, OR=2.05, 95%CI:1.07-3.93) in propensity factor module, and having risk sexual behavior (compared with having no risk sexual behavior, OR=2.66, 95%CI:1.41-5.03) and having diagnosis of STD infection in hospital (compared with having no such diagnosis, OR=6.35, 95%CI:2.21-18.27) in demand factor module, and receiving health education about AIDS prevention in the past year (compared with receiving no such health education, OR=0.29, 95%CI:0.11-0.76) and receiving health education about AIDS testing service in the past year (compared with receiving no such health education, OR=3.67, 95%CI:1.71-7.90) in ability factor module were the influencing factors for utilization of HIV testing services.Conclusions The acceptance of HIV testing in students needs to be improved urgently. Propensity factors, such as their AIDS knowledge awareness and sexual orientation, and demand factors, such as having risk sexual behavior and STD infection, have obvious impacts on the utilization of HIV testing services. However, health education about AIDS prevention and HIV testing service can play a more important role in facilitating the utilization of HIV testing in students. In the future, we should further strengthen the publicity of voluntary HIV counseling and testing service in students with particular attention to girls and those with risk sexual behaviors.
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