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Effects of structural intervention on increasing condom availability and reducing risky sexual behaviours in gay bathhouse attendees

机译：结构性干预对同性恋澡堂参加者增加避孕套供应和减少危险性行为的影响

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The study purpose was to evaluate the effectiveness of a structural intervention in reducing unprotected sexual behaviours, increasing condom accessibility and their relationship to the prevalence of HIV infection and sexually transmitted infections (STIs) in gay bathhouse attendees. A quasi-experimental study with a non-equivalent control group for comparison was conducted at nine gay bathhouses in Taiwan from 2004 to 2006. A structural intervention designed to increase condom distribution and accessibility inside the bathhouses was implemented at one bathhouse in each city. Bathhouse attendees were invited to complete a questionnaire and to be screened for HIV infection and STIs. Of 632 study participants, 270 were surveyed six months after the intervention was conducted. At the time of follow-up after controlling for baseline data, patrons attending bathhouses for which intervention was performed were more likely to report accessing condoms inside bathhouses than those attending control bathhouses (92.6% versus 81.3%, P =0.016), and condoms were more likely to be available at the reception desk of the bathhouse entrance (87.5% in intervention bathhouses versus 69.4% in control, P =0.047). In a multivariate analysis adjusted for age, access to condoms inside bathhouses (adjusted odds ratio (AOR): 4.35; 95% confidence interval (CI): 1.48-12.78) and attendance at bathhouses with intervention (AOR: 2.07; 95% CI: 1.07-3.97) were independently associated with consistent condom use during anal intercourse. There were no significant differences in the prevalences of HIV infection and STIs at the six-month follow-up. Bathhouses with structural intervention were associated with consistent condom use during anal intercourse among bathhouse patrons. Our findings highlight the importance of extension of condom distribution inside the bathhouses to increase condom use among bathhouse patrons.
机译：该研究的目的是评估结构干预措施在减少无保护的性行为，增加安全套可及性及其与男同性恋参加者中HIV感染和性传播感染（STIs）患病率之间的关系的有效性。 2004年至2006年，在台湾的9家同志澡堂进行了一项与非同等对照组作比较的准实验研究。在每个城市的一个澡堂中，实施了旨在增加避孕套分布和可及性的结构干预措施。邀请澡堂参与者填写问卷并进行HIV感染和性传播感染筛查。在632个研究参与者中，干预后六个月对270个参与者进行了调查。在控制了基线数据之后的随访时，参加过干预的浴室的患者比参加对照的浴室的患者更有可能报告进入浴室内部的避孕套（92.6％对81.3％，P = 0.016），并且更有可能在浴室入口处的接待处获得（干预浴室的87.5％相对于对照浴室的69.4％，P = 0.047）。在针对年龄进行调整的多变量分析中，可使用浴室内的避孕套（调整后的优势比（AOR）：4.35; 95％置信区间（CI）：1.48-12.78）和参加干预的浴室（AOR：2.07; 95％CI： 1.07-3.97）与肛交期间一致使用安全套独立相关。在六个月的随访中，HIV感染和性传播感染的患病率没有显着差异。在浴室顾客之间进行性交时，经过结构干预的浴室与持续使用避孕套有关。我们的发现凸显了扩大澡堂内部安全套分布对增加澡堂顾客使用避孕套的重要性。

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