Chen Y C, Xu H F, Luo Y F, Gu Y Z, Fan L R, Han Z G, Cai Y S, He W Y, Yao Z L, Liang Q E, Du Y Y, Gu J
Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China Guangdong Association of STD & AIDS Prevention and Control, Guangzhou 511430, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Nov 10;42(11):1930-1936. doi: 10.3760/cma.j.cn112338-20210317-00214.
To analyze the influencing factors for HIV testing services utilization in students with self-assessed high risk of HIV infection. 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. 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, =7.88, 95%: 3.98-15.61) and higher score of AIDS knowledge awareness (compared with lower score, =2.05, 95%: 1.07-3.93) in propensity factor module, and having risk sexual behavior (compared with having no risk sexual behavior, =2.66, 95%: 1.41-5.03) and having diagnosis of STD infection in hospital (compared with having no such diagnosis, =6.35, 95%: 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, =0.29, 95%: 0.11-0.76) and receiving health education about AIDS testing service in the past year (compared with receiving no such health education, =3.67, 95%: 1.71-7.90) in ability factor module were the influencing factors for utilization of HIV testing services. 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.
分析自我评估为感染艾滋病毒高风险的学生中艾滋病毒检测服务利用情况的影响因素。基于安德森的卫生服务利用行为模型及相关文献，构建了学生艾滋病毒检测服务利用影响因素的研究框架。2019年3月至4月，通过在线艾滋病毒感染风险评估工具，对自我评估为感染艾滋病毒高风险的学生进行了横断面调查。采用分层模型进行多因素logistic回归分析。本研究共纳入526名学生（年龄：19.30±1.19岁），其中96.2%的学生认为高危行为后应接受艾滋病毒检测。56.7%（298/526）的学生有性行为，艾滋病毒检测率为11.0%（58/526）。有性行为和无性行为的学生艾滋病毒检测率分别为13.42%（40/298）和7.89%（18/228）。多因素logistic回归分析结果显示，倾向因素模块中的非异性恋（与异性恋相比，比值比=7.88，95%置信区间：3.98-15.61）和较高的艾滋病知识知晓得分（与较低得分相比，比值比=2.05，95%置信区间：1.07-3.93），需求因素模块中的有危险性行为（与无危险性行为相比，比值比=2.66，95%置信区间：1.41-5.03）和在医院诊断为性传播疾病感染（与无此诊断相比，比值比=6.35，95%置信区间：2.21-18.27），能力因素模块中的过去一年接受过艾滋病预防健康教育（与未接受此类健康教育相比，比值比=0.29，95%置信区间：0.11-0.76）和过去一年接受过艾滋病检测服务健康教育（与未接受此类健康教育相比，比值比=3.67，95%置信区间：1.71-7.90）是艾滋病毒检测服务利用的影响因素。学生对艾滋病毒检测的接受度亟待提高。倾向因素，如他们的艾滋病知识知晓情况和性取向，以及需求因素，如有危险性行为和性传播疾病感染，对艾滋病毒检测服务的利用有明显影响。然而，艾滋病预防和艾滋病毒检测服务健康教育在促进学生利用艾滋病毒检测方面可发挥更重要作用。未来，应进一步加强对学生自愿艾滋病毒咨询检测服务的宣传，尤其要关注女生和有危险性行为的学生。
