Gullette Donna L, Rooker Janet L, Kennedy Robert L
University of Arkansas for Medical Sciences, College of Nursing, 4301 West Markham Street, # 529, Little Rock, AR 72205-7199, USA.
J Community Health Nurs. 2009 Jul;26(3):121-30. doi: 10.1080/07370010903034425.
Sexually transmitted infections (STIs) remains a serious healthcare problem costing approximately 13 billion dollars annually to treat. Men and women who contract STIs have a higher risk for reinfection and for developing human immunodeficiency virus (HIV). Determining the risk factors associated with STIs in a community would be helpful in designing culturally appropriate tailored interventions to reduce spread of STIs.
The purpose of this retrospective chart review was to determine the frequency and type of STIs, as well as to determine the predictor variables associated with STIs among those seeking treatment at a local inner city health unit.
A total of 237 medical records were reviewed from a STI clinic. The sample comprised 119 men and 118 women, of whom 70.9% were African American. The mean age was 27, and 38% had a prior STI. Men used significantly more condoms (chi(2) = 24.28, p = 0.000), had more sexual partners (chi(2) = 18.36, p = 0.003), and had more prior infections of gonorrhea (chi(2) = 10.04, p =0.002) than women. Women had significantly more prior infections of Chlamydia (chi(2) = 11.74, p = 0.001). Using no type of birth control measures (pills, diaphragm, implants) was a significant predictor of number of sexual partners (t = 2.441, p < 0.015), but negatively associated with condom use (t = -12.290, p < 0.000).
Over one-third had a prior STI, indicating that individuals do not perceive themselves to be at risk for another STI, and choose not to use condoms. Reasons why individuals continue to put themselves at risk need to be explored in gender specific focus groups so that tailored sexual risk reduction programs can be designed to meet the needs of different communities.
性传播感染(STIs)仍然是一个严重的医疗保健问题,每年治疗费用约为130亿美元。感染性传播感染的男性和女性再次感染以及感染人类免疫缺陷病毒(HIV)的风险更高。确定社区中性传播感染的相关危险因素将有助于设计适合文化背景的针对性干预措施,以减少性传播感染的传播。
本次回顾性病历审查的目的是确定性传播感染的频率和类型,并确定在当地市中心健康单位寻求治疗的人群中性传播感染的预测变量。
对一家性传播感染诊所的237份病历进行了审查。样本包括119名男性和118名女性,其中70.9%为非裔美国人。平均年龄为27岁,38%的人曾患过性传播感染。男性使用避孕套的比例显著更高(卡方值=24.28,p=0.000),性伴侣更多(卡方值=18.36,p=0.003),淋病既往感染次数更多(卡方值=10.04,p=0.002)。女性衣原体既往感染次数显著更多(卡方值=11.74,p=0.001)。不使用任何类型的避孕措施(避孕药、子宫托、植入物)是性伴侣数量的显著预测因素(t=2.441,p<0.015),但与避孕套使用呈负相关(t=-12.290,p<0.000)。
超过三分之一的人曾患过性传播感染,这表明个体并未意识到自己有再次感染性传播感染的风险,并且选择不使用避孕套。需要在针对性别的焦点小组中探讨个体继续将自己置于风险中的原因,以便设计出适合不同社区需求的针对性降低性风险计划。