Who goes to sexually transmitted disease clinics? Results from a national population survey.
Who goes to sexually transmitted disease clinics? Results from a national population survey.
复制标题
谁去性传播疾病诊所？
DOI：
--
复制
发表时间：
1996
期刊：
影响因子：
--
通讯作者：
J. Field
中科院分区：
文献类型：
--
作者：
Am Johnson;J. Wadsworth;K. Wellings;J. Field
目的：研究英国性传播疾病（STD）诊所的就诊模式。比较性传播疾病门诊就诊者与非性传播疾病门诊就诊者的人口学特征、行为和态度，并评估高危性生活方式人群使用性传播疾病门诊的程度。设计：随机抽样调查一般人群的性态度和生活方式。研究对象：随机选择的18876名年龄在16-59岁之间的英国居民。主要观察指标：512名调查对象近5年曾到性病门诊就诊者与未到性病门诊就诊者的人口学特征、近5年同性伴侣关系、异性伴侣关系模式、性支付、堕胎、药物注射、性行为态度。结果：8.3%的男性和5.6%的女性在其一生中曾到过诊所，在过去五年中分别为3.4%和2.6%。出勤率因居住地区的不同而有很大差异。11%的内伦敦居民在过去五年里上过学。在多变量分析中，男性性病就诊人数与异性伴侣数量增加(OR = 6.01（4.44-8.15）和同性恋伴侣数量增加（OR = 9.59(5.83-15.8)）的相关性最强，与性交易报酬、非体力劳动社会阶层、25-44岁、未婚状态和吸烟的相关性较弱。女性就诊与异性伴侣数量(OR = 3.74（2.76-5.08）和注射毒品使用（OR = 4.39(1.73-11.1)）相关性最强。流产史、肛交史、非体力劳动社会阶层、未婚状态和16-24岁之间存在较弱的独立关联。从总人口来看，在异性恋伴侣数量分布的前5%中，六分之一的男性和七分之一的女性，五分之一的男性和四分之一的有同性恋伴侣的人在过去五年中去过诊所。多种危险行为增加了出勤率。在就诊的女性和男性中，64.2%和69.7%报告了性病传播的主要危险标志。结论：性病诊所在英国被广泛的人口使用。参与者的行为（而非态度）与非参与者明显不同。诊所相对有效地只吸引那些生活方式高风险的人，但是，在人口水平上，报告有性病传播危险标志的少数人到诊所就诊。这些发现表明性病诊所是促进性健康的重要焦点，但社区项目对于接触非参与者也很重要。
OBJECTIVES: To examine the pattern of attendance at sexually transmitted disease (STD) clinics in Britain. To compare the demographic characteristics, behaviours and attitudes of STD clinic attenders with those of non-attenders, and to assess the extent to which STD clinics are used by those with high-risk sexual lifestyles. DESIGN: Random sample general population survey of sexual attitudes and lifestyle. SUBJECTS: 18,876 randomly selected men and women resident in Britain aged 16-59 years. MAIN OUTCOME MEASURES: Demographic characteristics, pattern of homosexual partnerships, heterosexual partnerships, payment for sex, abortion, drug injection in the last five years, and attitudes to sexual behaviours amongst 512 respondents who had attended STD clinic in the last five years compared with those who had not. RESULTS: 8.3% of men and 5.6% of women had attended a clinic in their lifetime and 3.4% and 2.6% respectively in the last five years. Attendance rates varied substantially with area of residence. 11% of Inner London residents had attended in the last five years. In multivariate analysis, STD clinic attendance for men was most strongly associated with increased numbers of heterosexual partners, (OR = 6.01 (4.44-8.15) and homosexual partnerships (OR = 9.59 (5.83-15.8)) and more weakly associated with payment for sex, non-manual social class, age 25-44, unmarried status and smoking. Clinic attendance for women was most strongly associated with numbers of heterosexual partners (OR = 3.74 (2.76-5.08) and injecting drug use (OR = 4.39 (1.73-11.1)). A weaker independent association was found with a history of abortion, anal sex, non-manual social class, non-married status and age 16-24. From the total population, 1 in 6 men and 1 in 7 women in the top 5% of the distribution for numbers of heterosexual partners and 1 in 5 men paying for sex and 1 in 4 of those with a homosexual partner had attended a clinic in the last five years. The probability of attendance increased with multiple risk behaviours. Of women 64.2% and of men 69.7% attending clinics reported major risk markers for STD transmission. CONCLUSIONS: STD clinics in Britain are used by a wide demographic spectrum of the population. The behaviours, but not the attitudes, of attenders differed markedly from those of non-attenders. Clinics are relatively efficient in attracting only those with high-risk lifestyles, but, at a population level, the minority of those reporting risk-markers for STD transmission attend clinics. These findings suggest that STD clinics are an important focus for sexual health promotion, but that community programmes are also important for reaching non-attenders.