Afsar H A, Mahmood M A, Barney N, Ali S, Kadir M M, Bilgrami M
Department of Community Health Sciences, the Aga Khan University, Karachi, Pakistan.
J Pak Med Assoc. 2006 Jan;56(1 Suppl 1):S50-4.
To determine knowledge, attitude and practices regarding sexually transmitted infections in district Khairpur, Sindh, Pakistan.
A needs assessment study employing a community based survey, key informant interviews and focus group discussions was conducted in all seven sub-districts of the district. This paper is based on the results of the key informant interviews and the focus group discussions. Thirty interviews and six group discussions were held with members of the community and with the health care providers.
There was little awareness regarding causes and prevention of sexually transmitted infections in the community. The situation was slightly better among health care providers. While health care providers believed that the prevalence of sexually transmitted infections is high, the community did not consider themselves at risk. The community believed that these diseases are a problem among a sub-population of male adolescents, especially those who have homosexual relations. However, due to social norms, they rarely discussed such health problems with other family members or elders. Adolescents with any sexual health problems visit hakims and quacks. The community was aware about aetiology and some of the risk factors associated with AIDS and hepatitis, most probably due to the recent public health campaigns against both diseases.
Considering the suspected high prevalence of sexually transmitted infections and the relative lack of knowledge, it is imperative that a public health intervention be initiated. This must include educating not only the community but also the health workers. The governments' initiative to train community workers in reproductive health is a step in the right direction (JPMA 52:21, 2002).
确定巴基斯坦信德省海得布尔地区关于性传播感染的知识、态度和行为。
在该地区所有七个分区开展了一项需求评估研究，采用社区调查、关键信息人访谈和焦点小组讨论的方式。本文基于关键信息人访谈和焦点小组讨论的结果。与社区成员和医疗服务提供者进行了30次访谈和6次小组讨论。
社区对性传播感染的病因和预防知之甚少。医疗服务提供者的情况稍好一些。虽然医疗服务提供者认为性传播感染的患病率很高，但社区并不认为自己有风险。社区认为这些疾病是男性青少年亚群体中的问题，尤其是那些有同性恋关系的青少年。然而，由于社会规范，他们很少与其他家庭成员或长辈讨论这类健康问题。有任何性健康问题的青少年会去看哈基姆（传统医学从业者）和江湖郎中。社区了解艾滋病和肝炎的病因及一些相关风险因素，这很可能是由于最近针对这两种疾病开展的公共卫生运动。
鉴于性传播感染疑似高患病率以及相对缺乏知识的情况，必须启动公共卫生干预措施。这不仅要包括对社区进行教育，还要包括对卫生工作者进行教育。政府培训社区工作者开展生殖健康工作的举措是朝着正确方向迈出的一步（《巴基斯坦医学协会杂志》2002年第52卷第21期）。
