| Objectives:To understand the sexual behavior characteristics,condom use and related factors of gonorrhea patients in some endemic areas of Yunnan Province,and to provide scientific basis for the prevention and treatment of gonorrhea.Method:From August to October,2018,Yunnan Province selected the top 7 states(cities)(Dehong,Xishuangbanna,Qujing,Yuxi,Honghe,Wenshan and Zhaotong)to conduct cross-sectional surveys for the three consecutive years of increase in the incidence of gonorrhea and the number of reported cases from 2015 to 2017.In each state(city),selected the county(city,district)that reported the largest number of gonorrhea patients in 2017,and selected the two hospitals with the largest number of gonorrhea reports in 2017 in each county(city,district),a total of 14 hospitals,each hospital selected STDs clinic for on-site investigation.A one-to-one questionnaire survey was conducted among patients with gonorrhea who met the inclusion criteria using continuous and convenient sampling.In addition,the purpose sampling was used to carry out qualitative investigation on the patients with gonorrhea,and the individual in-depth interview of the patients with gonorrhea was carried out in the independent space through one-to-one form.Using EpiData3.1 for data double input,SPSS 19.0 statistical software for data analysis,statistical analysis including statistical description,?2 test,non-conditional Logistic regression analysis.The qualitative interview arranges the interview record in time,and carries on the coding,the classification and the analysis summary to the interview content.Results:A total of 180 patients with gonorrhea were investigated,179 valid questionnaires,the effective rate was 99.4%.Qualitative research completed in-depth interviews with 18 patients with gonorrhea.1.General Demographic Characteristics:The average age of the subjects was(29.01 ± 8.93)years,of which 50.2%(90/179)was in the 20-29 age group,with the majority of males,88.3%(158/179)of the sexes;the majority of ethnic groups were Han,with 82.7%(148/179);the lower secondary and lower education levels were 48.1%(86/179);the unmarried were 48.0%(86/179);and the professions were in the service sector,with 34.6%(62/179);the main place of residence is the province,accounting for 96.1%(172/179).2.Types Of Sexual Partners:The most recent one-time behaviors were heterosexual contact,98.3%(176/179),temporary sexual partners,53.1%(95/179),spouse/fixed partners,38.0%(68/179)and commercial partners,8.9%(16/179).A total of 27.9%(50/179)of the last month's sex partners ? 2.Contact with temporary partners is mainly WeChat,QQ and other soCIal software,accounting for 66.3%(63/95),followed by entertainment,accounting for 17.9%(17/95),friends introduction or parties and other activities accounted for 15.8%(15/95).3.Condom Use:The most recent condom use rate was 17.9%(17/95),with 29.5%(23/78)due to "drunken unconsciousness",while 19.1%(13/68)and 30.9%(17/55)were due to" unnecessary use "among spouses/fixed partners,while 18.8%(3/16)were due to the use of commerciall sex condoms and 38.5%(5/13).4.Factors Affecting The Occurrence Of Temporary Acts:Multivariate Logistic regression analysis showed that men(OR=3.76,95%CI=1.259?11.253,P=0.018),single(OR=3.141,95%CI=1.589?6.208,P=0.001),multiple partners in the last month(?2)(OR=4.119,95%CI=1.829?9.278,P=0.001)were risk factors for the occurrence of temporary sexual behavior.5.Factors Affecting Condom Use:Multivariate Logistic regression analysis showed that Women(OR=3.922,95%CI=1.474?10.436,P?0.006)were more likely to use condoms than men.6.Seeking Medical Treatment:91.6%(164/179)of the respondents had one or more clinical symptoms or signs of venereal diseases,of which 59.1%(97/164)chose to visit general hospitals,16.5%(27/164)went to private clinics,13.4%(22/164)chose to buy their own medicine,and 11.0%(18/164)chose to visit specialist STD clinics.There were 17.9%(32/179)of respondents dmedical treatmenthad delaye.7.Health Services:Of those surveyed,40.8%(73/179)received at least one or more STD health services in the last year,of which 17.3%(31/179)received STD awareness campaigns,13.4%(24/179)received STD counselling and testing in the last year,2.2%(4/179)received condom promotion and distribution services,3.4%(6/179)received gynaecological examinations or treatment,12.3%(22/179)received peer education,and 6.7%(12/179)independently accessed the Internet Knowledge of sexually transmitted diseases.8.Qualitative Interview Results:Sexual partner contact is varied or "online ",young people are vulnerable to peer influence into the local" nightclub ","bar "or"hotel ",the occurrence of temporary or commercial sexual behavior;spouse/fixed sexual partners have extramarital sexual behavior ority.The patients' awareness of disease prevention was weak," spend money to buy enjoyment "and" trust "in sexual partners were the main reasons for not using condoms.After the symptoms,the respondents first tend to network inquiry or network "inquiry ",followed by consulting friends around.Most of the interviewees indicated that they had not heard of gonorrhea in the past,and did not know the way of its transmission,and needed to increase the publicity and education about gonorrhea related knowledge to raise their awareness of disease prevention.Conclusions:1.Patients with gonorrhea in STD clinic were mainly temporary,followed by spouse and fixed sex,and less commercial sex and same sex.Condom use was less than 20%for several sexual acts.The results indicated that the infection of Neisseria gonorrhoeae in Yunnan Province was mainly related to unprotected temporary behavior,unprotected spouse/fixed sexual behavior.In addition,there are high-risk extramarital sex and multiple sexual partners between spouses and fixed partners,and the next step in Yunnan Province's prevention and control efforts should focus on,in addition to continuing to strengthen behavioral intervention in the sex of prostitutes,men at equal risk,health promotion and behavioral intervention for temporary behavior(especially for men with single and multiple sexual partners)and inter-spouse sexual behavior,and further strengthen the awareness of the general public,especially women,100%condom use,and promote condom use.2.The majority of STD outpatient gonorrhea patients are male young adults,,suggesting that sex health education for adolescents and schools should be further strengthened.In addition,the gender difference between men and women is also related to the lack of obvious clinical symptoms after female infection with gonococcal,social psychological and other factors leading to fewer women active medical treatment.It is suggested that there are a certain number of hidden gonorrhea patients and infectious sources at the social level,which brings great challenges to the detection and treatment of gonorrhea infectious sources.3.There is a certain proportion of non-standard and delayed seeking medical treatment,lack of awareness of their own risk of sexually transmitted diseases,low awareness of disease prevention.It is suggested that the publicity and education on the harm of STD,safe sex and proper medical treatment should be strengthened,and the coverage and accessibility of STD prevention and treatment services should be improved.4.For patients with gonorrhea,the temporary contact mode is mainly network"APP",which suggests that the relevant departments should strengthen the supervision of social software,at the same time,the social software platform can be used to carry out" online "STD prevention and treatment knowledge publicity,education and service information,and" online "behavior intervention. |
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