艾滋病是啥病？中国人还是不太懂

报告类别：调查报告
行业分类：调查
调查地点：京沪穗等7个大中城市、河北与浙江等7省的小城镇及农村地区
调查时间：2003年8月—9月
样本数量：3968名
样本情况：16岁以上的当地居民
调查机构：零点指标数据
报告来源：零点指标数据网

报告内容：

　　第十五届国际艾滋病大会于七月十一日至十六日在曼谷举行，全球政治领导人、科学家、社会活动家以及艾滋病患者将在为期六天的会议中一起探讨迄今为止全世界范围内所掌握的艾滋病的防治、治疗和咨询问题。欧洲前景集团与零点研究集团在英国国际发展部（DFID）资助下合作的《中国居民对待艾滋病的态度与行为》的主题调查结果也在此次全球艾滋病大会上展出，研究结果表明：目前中国居民对艾滋病的基本常识的认知水平偏低，亟待提高；在人们掌握的艾滋病预防知识有限的情况下，中国居民对艾滋病患者表现出的关怀和接纳程度有限；而中国居民在总体上对安全套防艾功能的认知水平较低，目前还未将积极使用安全套作为预防艾滋病经性传播的首选途径。

　　该项调查是2003年8月—9月间使用多阶段随机抽样方式（城镇地区）和整群抽样方式（农村地区），在全国京沪穗等7个大中城市、河北与浙江等7省的小城镇及农村地区中对3968名16岁以上的当地居民进行的入户访问，其中城市居民为1866人，县内的小城镇及农村居民为2102人。数据结果已根据各地实际人口规模进行加权处理，在95%的置信度下本次调查的抽样误差为＋1.75%。此次调查是继2002年4月－6月间《中国城市和小城镇居民对待艾滋病态度和行为研究》之后，又一次大规模的连续性调查。

艾滋基本常识总体了解水平偏低，全部正确认知人群不到一成

　　城市居民对艾滋病的知晓率最高，几乎全部城市居民（96.2%）都听说过艾滋病，其比例明显高于小城镇（82.6%）和农村(75.1%)居民。与2002年针对城镇居民进行的调查结果相比，2003年城镇居民对艾滋病的知晓率与2002年基本持平，2002年有89.9%的城镇居民知道艾滋病，这一比例在2003年为91.2%。

　　然而中国居民对艾滋病基本常识的了解深度却不尽如人意。此次调查向居民提出了4个有关艾滋病传播途径的问题――“艾滋病是否可以通过母婴传播”，“艾滋病是否可以通过母乳传播”，“艾滋病病毒是否可以通过血液传播”，“与已经感染艾滋病的人一起就餐是否会感染艾滋病病毒”；对于性行为领域能够降低艾滋病病毒感染几率的有效措施提出了3个问题――“与单一且没有感染艾滋病的性伙伴保持性关系是否可以降低艾滋病病毒感染几率”，“没有性行为是否可以降低艾滋病病毒感染几率”和“每次性行为时使用安全套是否可以降低艾滋病病毒感染几率”，这些行为举措都是防范艾滋病通过性传播的基础措施。

　　受访居民对以上各题的单题应答的正确率都在40%以上，且对艾滋病病毒经血液传播和母婴垂直传播的知识的掌握程度要明显好于有关性行为领域有效预防艾滋病病毒措施方面的知识。在与艾滋病相关的7个问题中，只有半数居民知道“没有性行为可以降低艾滋病病毒感染几率”；四成居民知道“每次性行为时使用安全套可以降低艾滋病病毒感染几率”，这一问题是所有艾滋病常识题目中应答正确率最低的一个。无论是城市、小城镇还是农村居民，对使用安全套防范艾滋病的正确认知率都最低。

　　进一步分析显示，只有25.6%的居民能对艾滋病传播途径的4个问题全部作出正确回答；对性行为领域有效预防艾滋病措施的3个问题全部作出正确判断的居民仅为21.4%；能答对以上所有7个问题的居民比例仅占所有受访者的8.7%。这表明中国居民对基本的艾滋病知识缺乏全面了解，仍处于低认知水平。

　　通过比较研究可以发现，城市居民对艾滋病基本常识的认知水平要明显高于小城镇和农村居民。城市居民对艾滋病传播途径的正确应答率分别比小城镇和农村居民高出15.5%和16.8%；而对性行为领域能有效预防艾滋病措施的相关知识，城市居民的正确应答率要分别比小城镇和农村居民高5.5%和10.3%。

“艾滋”期待更多关怀

　　与中国人对艾滋病基本常识认知率水平较低的情况相一致的是，人们在日常生活中对艾滋病患者表现出的接纳和开放程度亦不高，且与2002年相比呈现出明显的下降趋势。

　　研究结果表明，只有33.9%的城市居民和19%的小城镇居民表示可以在工作环境中与艾滋病患者平等相处，分别比2002年下降了7.1%和12%；在对待患艾滋病的亲属的态度上，分别有57.2%的城市居民和45%的小城镇居民明确表示愿意照顾患艾滋病的亲属，分别比2002年下降了10.8%和18%，而同时有57.2%的城市居民和63%的小城镇居民表示希望能够保守家人患艾滋病的秘密，比2002年略有上升。

　　欧洲前景集团与零点研究集团合作的另外一项针对性工作者和高危男性人群进行的研究结果表明，受访者预期家人对因不同途径感染了艾滋病的患者所持的态度会存在明显差异：人们会照顾由于输血而感染艾滋病的家人，但对由于性行为而感染艾滋病的家人感到生气和耻辱。

防“艾”作用鲜为人知，安全套不是公众目前防止艾滋病经性传播的首选途径

　　艾滋病的传播途径主要有三种：经性传播、经血液传播和母婴传播，安全套是一种在性传播领域可以阻隔艾滋病病毒传播的有效工具。对中国居民来说，人们更习惯将安全套叫做避孕套。调查结果显示，当提到“安全套”时，中国居民中有35.9%的人把它和“避孕”联系起来，28.8% 的人联想到“性”，只有9.2%的人由它联想到“预防性病或HIV病毒感染”。可见，更多人意识到的是安全套的“避孕”功用，而对于它的防艾功用认知程度并不高。进一步分析表明，城市、小城镇和农村居民中认识到安全套可以预防艾滋病感染的人分别占17.0%、11.4%和5.8%。农村居民中对安全套的防艾功用意识最弱。

　　中国居民对国内艾滋病传播情况的认知并没有对他们的行为产生较大影响。五成居民在得知中国存在艾滋病的情况下表示自己的行为不会发生任何改变。在行为发生改变的居民中，他们的转变更多的体现为“在输血时十分小心”（20.2%）、“不共用针头”（19.6%）和“坚持只有一个性伙伴”（17.3%），只有少数人的行为改变会涉及到安全套的使用，表示会“更经常地使用安全套”和“任何情况下都一直使用安全套”的居民比例分别仅为5.8%和4.8%。进一步分析显示，农村中倾向于各项防艾行为改变的居民比例均低于城市和小城镇。这种行为的转变从一个侧面反映出目前居民对艾滋病病毒由血液途径传播的预防更为重视，而对艾滋病病毒经性途传播和安全套所起作用的重视程度有限。

　　在问到预防艾滋病由性接触传播的具体措施时，安全套并不是目前中国居民的首要选择。调查数据表明，在居民得知艾滋病病毒会通过性行为传播后，表示会将“只保持一名性伙伴”（22%）作为有效防艾措施的居民最多，其次是“不去有感染性病或者艾滋病的危险场所，比如有三陪的地方”（19.8%），而提及“在有性关系时坚持使用安全套”（10%）和“在与配偶或男女朋友以外的人有性关系时坚持使用安全套”（7.2%）这两个与安全套使用相关的措施的居民比例较低。从地域来看，农村居民中选择各项防艾措施的人数比例均低于城市和小城镇。可见，农村居民将安全套作为防止性病和艾滋病由性行为传播的保护措施的意识最弱。

　　艾滋病从发现至今，人类尚未找到一种能彻底治愈的方法，国际上公认的最有效的方法就是从传播渠道上杜绝感染，因此公众的自我保护和防范意识就显得尤为重要。对大多数普通居民而言，系统全面地掌握对艾滋病传播途径和有效预防措施等方面的基本常识就是使自己免受这一疾病侵害最有效的知识工具。正确的认知不仅能使公众更加准确地了解应该如何保护自己，更是人们进行有效沟通的根本前提。目前大多数中国居民不仅在知识层面上对艾滋病的认知存在误区，在公共沟通领域中关于艾滋病的交流同样存在较大的心理障碍。研究人员认为，如何将艾滋病知识的宣传和教育做到有的放矢，尤其是如何以生动有效的形式引起公众学习艾滋病知识的兴趣，并解决大量处于信息传播末端的农村边远地区居民的教育问题，是政府和公共组织亟待解决的问题。在第十五届艾滋病大会开幕当天举行的第二届亚太地区艾滋病问题部长会议上，安南更是呼吁亚太各国政府积极行动起来，制定防止艾滋病传播的全国战略，投入足够的财政和人力资源及早控制疾病蔓延。

　　Bangkok hosted XV International AIDS Conference from July 11 - 16, 2004. World political leaders, scientists, social movement organizers held discussions during this six-day conference. Topics involve problems that have emerged till today concerning the prevention, treatment and consultation of AIDS around the world. Survey results from a research collaboration (Chinese Residents’ Attitudes and Behavior towards AIDS) by Futures Group and Horizon Research Group has been released in this conference. This survey was conducted under the sponsorship of DFID. Research findings show that Chinese residents now have poor knowledge regarding AIDS. People’s care and acceptance for AIDS patients or people living with AIDS has been circumscribed by lack of knowledge. Generally speaking, Chinese residents also lack the knowledge about the function of condoms in AIDS prevention. Few people have actively used condoms as a preventive measure against the spread of AIDS or HIV virus.

　　This survey was carried out among 3968 Chinese residents ages16-60. 1866 were from cities and 2102 were from small towns and rural areas. From August to September of 2003, respondents from seven big cities including Beijing and Shanghai and small towns and rural areas in seven provinces were interviewed on a number of topics, including some questions on HIV/AIDS. This national omnibus study used multi-phase random sampling, and have a margin error of minus and plus 1.75 percentage points within a confidence interval of 95%. The results have been weighted in accordance with population sizes of different regions. This is another large-scale consecutive study following Chinese Residents’ Knowledge, Attitudes and Behaviors Related to HIV/AIDS from April to June of 2002.

Less than 10% of Correct Answer Rate on Knowledge of AIDS

　　City residents are the most knowledgeable about HIV/AIDS. Nearly all (96.2%) of city residents have heard of HIV/AIDS, compared to 82.6% of town residents and 75.1% of rural residents. Compared with a similar study conducted in 2002 among city and town residents, knowledge of AIDS in urban areas is about the same (89.9 percent in 2002 and 91.2 percent in 2003).

　　The depth of knowledge about HIV/AIDS among Chinese residents is not sufficient to prevent its spread in the country. In this survey, respondents were asked to answer four questions on the transmission routes of AIDS, which are ‘Can a pregnant woman infected with HIV or AIDS transmit the virus to her unborn child?’ ‘Can a woman with HIV or AIDS transmit the virus to her newborn child through breastfeeding?’, ‘Can HIV be spread through blood?’, ‘Can a person get HIV by sharing a meal with someone who is infected?’. Another three questions specifically focus on transmission of HIV through sex. People were asked, ‘Can people reduce their chance of getting HIV, the virus that causes AIDS by having just one partner who is not infected and who has no other partners?’ ‘Can people reduce their chance of getting the virus that causes AIDS by not having sex at all?’ ‘Can people protect themselves from HIV the virus that causes AIDS by using a condom correctly every time they have sex?’ These behaviors represent the ‘ABCs’ of prevention of HIV through sexual transmission.
 
　　To each of these seven questions, more than 40% of all residents gave correct answers. People have a better idea about mother to child transmission of HIV and the importance of not sharing needles than about the role of sex in transmission of HIV and the role of condoms in preventing HIV. Only half of all Chinese residents know that not having sex at all will reduce the chance of HIV transmission and 40 percent know that correct and consistent condom use can protect against HIV transmission. Of the seven questions on AIDS-related knowledge, the question on condom use was answered correctly by the lowest percentage of respondents in cities, towns and rural areas.

　　Further analysis reveals that only 25.6% of all respondents answered all the four questions concerning the transmission routes of AIDS correctly. And only 21.4% of all respondents answered the three questions concerning preventive measures against HIV/AIDS transmission through sex correctly. The correct answer rate for all seven questions is 8.7%. Chinese residents have a lot more to learn about HIV/AIDS.

　　City residents clearly have better knowledge about HIV/AIDS, compared to town and rural residents. Their correct answer rate to questions concerning transmission routes of HIV/AIDS is 15.5 percentage points higher than that of town residents, and 16.8 percentage points higher than that of rural residents. To questions concerning preventive measures against sex transmissions, city residents’ correct answer rate is 5.5 percentage points higher than that of town residents, and 10.3 percentage points higher than that of rural residents.

More care for AIDS

　　People in China have poor knowledge about AIDS and few people express caring attitudes and acceptance for those infected by or living with AIDS. Comparing with 2002, the percentage of people showing a caring attitude and acceptance for those infected by or living with AIDS has dropped.

　　Research results show that only 33.9% of urban residents and 19% of town residents think that they could work harmoniously with AIDS patients, with 7.1 percentage point and 12 percentage point decreases respectively comparing with year 2002. When asked about respondents’ attitudes towards relatives with AIDS, 57.2% of urban residents and 45% of town residents are willing to take care of their HIV+ relatives, with 10.8 percentage point and 18 percentage point decreases respectively comparing with year 2002. And 57.2% of urban residents and 63% of town residents hope to keep it secret, and these percentages have increased comparing with year 2002.

　　Another research project targeting at sex workers and high-risk male populations conducted under the combined efforts of Futures Group Europe and Horizon Research Group has shown that there are marked differences among respondents’ on their expectation of how their family members will treat them if their family members were told about the different routes of transmission. That is, people tend to care for those who have been infected by AIDS through blood transfusion, while they feel angry and humiliated towards those who have been infected by AIDS through sexual behaviors.

Few People Know That Condoms Can Protect Against STIS and AIDS，Condom Use Is Not First Choice Against AIDS spreading by sex

　　AIDS could be transmitted through sex, blood transfusion and mother-child transmission. Condoms could be very effective tools in preventing AIDS from been transmitted through sex. The Chinese has two words for condoms – one refers to ‘contraceptive sheath’ and other to ‘protection sheath against disease.’ Research findings show that, in China, condoms are more usually called as ‘contraceptive sheath’. Yet, when asked what they associated with word ‘condom’, 35.9 percent of respondents still associated it with ‘contraception’, 28.8 percent with ‘sex’, and only 9.2 percent for protection against STI/AIDS. Further analysis shows that among city, town and rural residents, the percentages of people who mentioned condoms as ‘protective sheath against AIDS’ are respectively 17.0 percent, 11.4 percent and 5.8 percent; only a small percent of rural residents mentioned the protective function of condoms.

　　Knowing that there is AIDS in China has not changed people’s behaviors much. Around half of the people in the study said they have not changed their behaviour at all. Among all the protective behaviour changes, the most frequently mentioned were ‘be very careful about blood transfusions’ (20.2 percent), ‘not sharing needles with others’ (19.6 percent), and ‘stick with one partner’ (17.3 percent). Only a small number of people mentioned changes concerning the use of condoms. 5.8 percent of them mentioned that they ‘use condoms more frequently’, and 4.8 percent of them said they ‘always use condoms when having sex’. Rural residents were the least likely to say they had made any changes to their behaviour as a result of knowing about AIDS in China. These changes in behaviour suggest that messages about HIV transmission through blood have spread faster in China than have messages about the role of sex in HIV transmission – and the role of condoms in preventing the transmission of HIV during sex.

　　Asked specifically about how they would change their behaviour with the knowledge that HIV can be spread through sex, condom use was not the first choice – 22.0 percent of residents said the would ‘stick with one partner’ and 19.8 percent said they would ‘avoid going to high risk places, like places where sex workers work.’ Only 10.0 percent of Chinese residents said they would ‘always use condoms when having sex’, and 7.2 percent said that they would ‘always use condoms when having sex with non-regular partners.’ Rural residents are less likely to say they would use condoms as a protective measure against STI/AIDS compared to city and town residents.

　　Having the correct knowledge about AIDS is of importance for the public to take precautions against AIDS. It is also a premise on which effective communication is based. Currently in China, most residents have insufficient and often incorrect understanding about AIDS, and apart from this, communication about HIV/AIDS in the public domain has been hindered because of psychological obstacles. It is of great importance for the public campaigns of HIV/AIDS knowledge to be more targeted, especially on rural residents who have limited resources in attaining information. How to present AIDS-related knowledge to the public in a more interesting way is also another question to think about. On the Asia-Pacific AIDS Minister Conference which was held on the opening day of XV International AIDS Conference, Annan called for collective action of all governments in Asia-Pacific region to work out national plans against AIDS, to make enough financial and human resource investment in battling against AIDS, in the effort to extinguish its spread at an earlier stage.

　　Source: 2002 survey was conducted by Futures Group Europe and Horizon Research Group from April to May of 2002, among 4213 adult residents in 10 cities such as Beijing, Shanghai, Guangzhou, Wuhan and Chengdu, and 2622 adult residents in towns of 7 provinces, such as Hebei and Jiangsu. using multi-phasal random sampling method. In 2003, Futures Group Europe and Horizon Research Group carried out a survey among 3968 Chinese residents aged more than 16, using multi-phasal random sampling method. Among them there are 1866 city residents and 2102 town and rural residents. It was conducted from August to September of 2003, and covered 7 cities including Beijing, Shanghai, and Guangzhou, and towns and rural areas in 7 provinces. For further information, please visit www.Horizonkey.com or contact Tim Manchester at Futures Europe Beijing (TManchester@51condom.com) or Karen Hardee, Futures Group Washington DC (K.Hardee@TFGI.COM).

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