Effects of a couple-based intervention to reduce risks for HIV, HCV, and STIs among drug-involved heterosexual couples in Kazakhstan: a randomized controlled trial.
Effects of a couple-based intervention to reduce risks for HIV, HCV, and STIs among drug-involved heterosexual couples in Kazakhstan: a randomized controlled trial.
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DOI：
10.1097/qai.0000000000000277
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发表时间：
2014-10-01
期刊：
影响因子：
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通讯作者：
Tukeyev M
中科院分区：
文献类型：
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作者：
El-Bassel N;Gilbert L;Terlikbayeva A;Beyrer C;Wu E;Chang M;Hunt T;Ismayilova L;Shaw SA;Primbetova S;Rozental Y;Zhussupov B;Tukeyev M
Project Renaissance是一项在哈萨克斯坦阿拉木图进行的HIV/HCV/STI预防干预的随机对照试验。我们假设，分配到感兴趣的干预措施的夫妇将有较低的艾滋病毒，丙型肝炎病毒，性传播感染（STI）的发病率，无保护性行为的比率，在12个月的随访期内，与那些被分配到注意力控制组的人相比，（600名参与者），其中一方或双方在过去90天内报告注射毒品，被随机分为两组之一：（1）五次HIV/HCV/STI预防干预（风险降低：RR），或（2）五次健康促进（WP）干预。在12个月的随访期内，与WP相比，RR组的HCV感染发生率显著降低了69%（IRR=0.31，95% CI=0.10 - 0.90，p=0.031）。尽管差异无统计学意义，但RR参与者的HIV感染率比WP参与者低51%（IRR=0.49，95% CI=0.16 - 1.48，p=0.204），任何STI的发生率比WP参与者低37%（IRR=0.63，95%=0.21 - 1.93，p=0.418）。与WP参与者相比，RR参与者在整个随访期间与其研究伴侣进行无保护阴道性行为的次数显著减少（IRR=0.58，95% CI=0.36 - 0.93，p=0.024），并更一致地使用避孕套（OR=2.30，95% CI=1.33 - 4.00，p=0.003）。文艺复兴项目证明了对生物学和行为终点的显著影响。调查结果提请注意艾滋病毒/丙型肝炎病毒/性传播感染预防干预战略，可以扩大毒品参与的夫妇在减少伤害的计划，药物治疗和刑事司法设置。
Project Renaissance is a randomized controlled trial of an HIV/HCV/STI prevention intervention conducted in Almaty, Kazakhstan. We hypothesized that couples assigned to the intervention of interest will have lower incidence of HIV, HCV, sexually transmitted infections (STI), rates of unprotected sex, and unsafe injection over the 12-month follow up period compared to those assigned to an attention control arm. A total of 300 couples (600 participants) where one or both partners reported injecting drugs in the past 90 days were randomized to one of two arms: (1) a five-session HIV/HCV/STI prevention intervention (Risk Reduction: RR), or (2) a five-session Wellness Promotion (WP) intervention. Over the 12-month follow up period, assignment to RR compared to WP significantly lowered the incidence of HCV infection by 69% (IRR=0.31, 95% CI=0.10 – 0.90, p=0.031). Although differences were not statistically significant, RR participants had a lower incidence of HIV infection by 51% (IRR=0.49, 95% CI=0.16 – 1.48, p=0.204) and any STI by 37% (IRR=0.63, 95%=0.21 – 1.93, p=0.418) than WP participants. RR participants reported significantly fewer numbers of unprotected vaginal sex acts with their study partners (IRR=0.58, 95% CI=0.36 – 0.93, p=0.024) and more consistent condom use (OR=2.30, 95% CI=1.33 – 4.00, p=0.003) over the entire follow-up period compared to WP participants. Project Renaissance demonstrated a significant effect for biological and behavioral endpoints. Findings draw attention to an HIV/HCV/STI prevention intervention strategy that can be scaled up for drug-involved couples in harm reduction programs, drug treatment, and criminal justice settings.