梅毒患者性伴通知意愿及其影响因素分析

摘要/Abstract

摘要：

目的了解梅毒患者性伴通知意愿，探讨影响因素。方法 2011年4月至2014年6月，对深圳市南山区慢性病防治院归口管理的594例梅毒患者进行信息采集并建立病历，对可能影响其性伴通知意愿的社会人口学、临床特征等变量进行单因素和多因素logistic回归分析。结果单因素分析显示，梅毒患者的性别、婚姻、文化程度、工作状态、疾病发现方式、有无男男性行为、是否合并HIV感染、自诉感染源和是否有临时性伴与性伴通知意愿有关。多因素分析结果进一步证实，梅毒患者性别（AOR = 2.579，P = 0.005）和婚姻状态（已婚AOR = 4.864，P ＜ 0.05；离异/丧偶AOR = 0.360，P = 0.016）、发现方式（因病就诊AOR = 0.316，P = 0.003；被动筛查AOR = 0.358，P = 0.013）、同性性行为（AOR = 7.952，P = 0.024）、是否有临时性伴（AOR = 0.303，P ＜ 0.001）与是否愿意通知性伴相关。结论女性、已婚、主动检测、无男男性行为史以及无临时性伴的梅毒患者通知性伴的意愿程度更高，规范化的梅毒诊疗服务有助于提高患者性伴通知意愿。

Abstract:

Luo Zhenzhou, Lin Jia, Li Zhen, Tian Lishan, Yuan Jun, Zhou Guomao, Chen Sihan, Yang Tubao, Feng Tiejian, Chen Xiangsheng Department of Skin Disease and STD Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China （Luo ZZ, Lin J, Li Z, Tian LS, Yuan J, Zhou GM, Chen SH）; Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha 410078, China （Yang TB）; Shenzhen Center for Chronic Disease Control, Shenzhen 518019, China （Feng TJ）; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College; Reference Laboratory， National Center for Sexually Transmitted Disease Control, China Center for Disease Control and Prevention, Nanjing 210042, China （Chen XS） Corresponding author: Zhou Guomao, Email: 453351637@qq.com 【Abstract】 Objective To evaluate willingness to notify sexual partners in syphilitic patients, and to explore its influencing factors. Methods Social-demographic and clinical data were collected from 594 patients with syphilis administrated by Shenzhen Nanshan Center for Chronic Disease Control between April 2011 and June 2014, and medical records were established for them. Univariate and multivariate logistic regression analyses were performed to identify factors influencing willingness to notify sexual partners. Results Univariate analysis showed that many factors affected willingness to notify sexual partners in syphilitic patients, including gender, marital status, educational levels, working status, ways to learn of the illness, absence or presence of male homosexual behavior, having or not having HIV co-infection, self-reported sources of infection, having or not having casual sexual partners. Multivariate analysis further confirmed that gender （female: adjusted odds ratio ［AOR］ = 2.579, P = 0.005）, marital status （married: AOR = 4.864, P < 0.05; divorced/widowed: AOR = 0.360, P = 0.016）, ways to learn of the illness （seeking medical care for disorders: AOR = 0.316, P = 0.003; passive screening: AOR = 0.358, P = 0.013）, absence or presence of male homosexual behavior （AOR = 7.952, P = 0.024）, having or not having casual sexual partners （AOR = 0.303, P < 0.001） were significantly associated with willingness to notify sexual partners. Conclusion Female, being married, actively seeking medical care, absence of male homosexual behavior, and not having casual sexual partners are associated with stronger willingness to notify sexual partners in syphilitic patients, and standardized medical care services are helpful to improve willingness to notify sexual partners in syphilitic patients.

罗珍胄林嘉李真田丽闪袁军周国茂陈思韩杨土保冯铁建陈祥生. 梅毒患者性伴通知意愿及其影响因素分析[J]. 中华皮肤科杂志, 2016, 49(5): 324-328.

参考文献 14

［1］	Chen ZQ, Zhang GC, Gong XD, et al. Syphilis in China: results of a national surveillance programme［J］. Lancet, 2007, 369（9556）: 132⁃138. DOI: 10.1016/S0140⁃6736（07）60074⁃9.
［2］	中华人民共和国卫生部. 中国预防与控制梅毒规划（2010⁃2020年）［EB/OL］. （2010⁃06⁃21）［2015⁃09⁃08］. http://www.gov.cn/gzdt/2010⁃06/21.
	Ministry of Health, People′s Republic of China. Syphilis prevention and control program in China from 2010 to 2020［EB/OL］. （2010⁃06⁃21）［2015⁃09⁃08］. http://www.gov.cn/gzdt/2010⁃06/21.
［3］	Cowan FM, French R, Johnson AM. The role and effectiveness of partner notification in STD control: a review ［J］. Genitourin Med, 1996, 72（4）: 247⁃252. DOI: 10.1136/sti.72.4.247.
［4］	Kohl KS, Farley TA, Ewell J, et al. Usefulness of partner notifi⁃cation for syphilis control［J］. Sex Transm Dis,1999, 26（4）: 201⁃207. DOI: 10.1097/00007435⁃199904000⁃00003.
［5］	李真, 周国茂, 袁军, 等. 梅毒归口管治全程服务模式探讨［J］. 中国热带医学, 2013, 13（1）: 59⁃62. DOI: 10.13604/j.cnki.46⁃1064/r.2013.01.024.
	Li Z, Zhou GM, Yuan J, et al. Results of convergence syphilis⁃patient management whole process service in Nanshan district of Shenzhen［J］. China Trop Med, 2013, 13（1）: 59⁃62. DOI: 10.13604/ j.cnki.46⁃1064/r.2013.01.024
［6］	卫生部传染病标准委员会. WS273⁃2007,梅毒诊断标准［S］. 北京: 人民卫生出版社, 2007.
	Committee on Standards for Infectious Diseases, Ministry of Health of China. Diagnostic criteria for syphilis, WS273⁃2007［S］. Beijing: People′s Health Publishing House, 2007.
［7］	周露, 李贞贞, 王红红. HIV 感染者/AIDS 病人性伴告知影响因素的研究进展［J］. 护理研究, 2014, 28（33）: 4106⁃4108. DOI:10.3969/j.issn.10096493.2014.33.004.
	Zhou L, Li ZZ, Wang HH. Research progress on influencing factors of partner notification in HIV infection/AIDS patients［J］. Chin Nurs Res, 2014, 28（11）: 4106⁃4108. DOI: 10.3969/j.issn.10096493.2014.33.004.
［8］	Wang AL, Peng RR, Tucker JD, et al. Partner notification uptake for sexually transmitted infections in China: a systematic literature review［J］. Sex Transm Infect, 2012, 88（5）: 386⁃393. DOI: 10.1136/sextrans⁃2011⁃050275.
［9］	Liu H, Detels R, Li X, et al. Stigma, delayed treatment, and spousal notification among male patients with sexually transmitted disease in China［J］. Sex Transm Dis, 2002, 29（6）: 335⁃343. DOI: 10.1097/00007435⁃200206000⁃00005.
［10］	梁霁, 钱序, 程华, 等. 上海市某中心城区生殖道感染“性伴通知”的可接受性研究［J］. 中国妇幼保健, 2004, 19（9）: 29⁃31. DOI: 10.3969/j.issn.1001⁃4411.2004.09.014.
	Liang J, Qian X, Cheng H, et al. Acceptability study on "partner notification" in reproductive tract infections patients in one of centered districts of Shanghai［J］. Matern Child Health Care China, 2004, 19（5）: 29⁃31. DOI: 10.3969/j.issn.1001⁃4411.2004.09. 014.
［11］	Wang B, Li X, Stanton B, et al. Gender differences in HIV⁃related perceptions, sexual risk behaviors, and history of sexually transmitted diseases among Chinese migrants visiting public sexually transmitted disease clinics［J］. AIDS Patient Care STDS, 2007, 21（1）: 57⁃68. DOI: 10.1089/apc.2006.0031.
［12］	李玉艳, 武俊青, 黄伟栋, 等. 上海市性病门诊顾客性伴通知态度的影响因素［J］. 生殖医学杂志, 2006, 15（4）: 248⁃251. DOI:10.3969/j.issn.1004⁃3845.2006.04.008.
	Li YY, Wu JQ, Huang WD, et al. Analysis of influential factors of client′s attitude to partner notification in Shanghai STD clinics［J］. J Reprod Med, 2006, 15（4）: 248⁃251. DOI: 10.3969/j.issn.1004⁃3845.2006.04.008.
［13］	殷方兰, 戴依群, 石国政, 等. 上海市嘉定区性病门诊患者402例性伴告知意愿及影响因素分析［J］. 中国皮肤性病学杂志, 2011, 25（10）: 780⁃782.
	Yin FL, Dai YQ, Shi GZ, et al. Partner notification and its determinants among 402 STD clinic attendants in Jiading District,Shanghai［J］. Chin J Dermatovenereol, 2011, 25（10）: 780⁃782.
［14］	许珊丹, 朱长才, 曾婧, 等. 公众对HIV感染的性伴通知意愿调查及影响因素分析［J］. 疾病控制杂志, 2007, 11（4）: 436⁃437. DOI: 10.3969/j.issn.1674⁃3679.2007.04.040.
	Xu SD, Zhu CC, Zeng J, et al. Intention to notify sexual partners about HIV infection among the public: a survey and analysis of influencing factors［J］. Chin J Dis Control Prev, 2007, 11（4）: 436⁃437. DOI: 10.3969/j.issn.1674⁃3679.2007.04.040.