在印度南部 22 个地区进行的大规模艾滋病毒预防规划中，性工作者的方案覆盖范围、避孕套使用和性传播感染治疗情况：横断面调查结果。
Programme coverage, condom use and STI treatment among FSWs in a large-scale HIV prevention programme: results from cross-sectional surveys in 22 districts in southern India.
机构信息
Family Health International, New Delhi, India.
出版信息
Sex Transm Infect. 2010 Feb;86 Suppl 1(Suppl_1):i62-8. doi: 10.1136/sti.2009.038760.
OBJECTIVE
This paper evaluates Avahan programme's coverage of female sex workers (FSWs), focus on high-risk FSWs and intermediate outcomes.
METHODS
First round of cross-sectional survey data, Integrated Behavioral and Biological Assessments (IBBA), conducted in 22 districts, were aggregated into district categories: Solo, where Avahan was the sole service provider covering all FSWs and Major or Minor where Avahan was not the sole provider, but intended coverage was >50% or <or= 50% of FSWs respectively. Multivariate logistic regression was applied to compare exposure by district categories, vulnerability factors and intermediate outcomes associated with exposure.
RESULTS
Reported exposure, evaluated on basis of having received any of three core services, was higher in Solo (75%) compared with Minor (66%) districts. Logistic regression showed that FSWs in solo districts were more likely to be exposed (adjusted odds ratio (AOR)=1.5; 95% CI 1.20 to 1.86) compared with FSWs in Minor districts. Multivariate analysis in Solo districts revealed that FSW with >or=15 clients in the past week had a higher chance of being exposed to core services (AOR=1.56; 95% CI 1.03 to 2.35). Exposure to the three services in Solo Avahan districts was significantly associated with correct knowledge on condom use (AOR=1.36; 95% CI 1.05 to 1.78), consistent condom use with occasional clients (AOR=3.17; 95% CI 2.17 to 4.63) and regular clients (AOR=2.47; 95% CI 1.86 to 3.28) and STI treatment-seeking behaviour (AOR=3.00; 95% CI 1.94 to 4.65).
CONCLUSIONS
Higher coverage of FSWs was achieved in districts where Avahan was the only intervention compared with districts having multiple and longstanding non-Avahan programmes. Exposure in Solo districts was associated with intermediate outcomes; this need to be further evaluated in comparison with non Avahan areas and substantiated through data from next IBBA.
目的
本文评估了 Avahan 项目对性工作者（FSWs）的覆盖范围，重点关注高危 FSWs 和中间结果。
方法
对 22 个地区进行了第一轮横断面调查数据的综合行为和生物评估（IBBA），将数据汇总到地区类别中：Solo，Avahan 是唯一提供服务的地区，覆盖所有 FSWs；Major 或 Minor，Avahan 不是唯一的服务提供者，但预期覆盖范围分别为 FSWs 的>50%或<=50%。采用多变量逻辑回归比较按地区类别、脆弱性因素和与暴露相关的中间结果的暴露情况。
结果
根据接受三种核心服务中的任何一种服务，Solo（75%）地区的报告暴露率高于 Minor（66%）地区。逻辑回归显示，Solo 地区的 FSWs 更有可能接触到服务（调整后的优势比（AOR）=1.5；95%置信区间 1.20 至 1.86），而 Minor 地区的 FSWs 则没有。在 Solo 地区的多变量分析中，过去一周有>或=15 名客户的 FSW 更有可能接触到核心服务（AOR=1.56；95%置信区间 1.03 至 2.35）。在 Solo 地区，接触三种服务与正确的 condom 使用知识（AOR=1.36；95%置信区间 1.05 至 1.78）、偶尔客户（AOR=3.17；95%置信区间 2.17 至 4.63）和定期客户（AOR=2.47；95%置信区间 1.86 至 3.28）以及性传播感染（STI）的治疗寻求行为（AOR=3.00；95%置信区间 1.94 至 4.65）显著相关。
结论
与有多种长期非 Avahan 项目的地区相比，在仅有 Avahan 干预的地区，FSWs 的覆盖范围更高。Solo 地区的暴露与中间结果有关；这需要与非 Avahan 地区进行进一步评估，并通过下一次 IBBA 的数据加以证实。
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