Efficacy of SISTA South Africa on sexual behavior and relationship control among isiXhosa women in South Africa: results of a randomized-controlled trial.
Efficacy of SISTA South Africa on sexual behavior and relationship control among isiXhosa women in South Africa: results of a randomized-controlled trial.
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DOI：
10.1097/qai.0b013e31829202c4
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发表时间：
2013-06-01
期刊：
影响因子：
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通讯作者：
DiClemente RJ
中科院分区：
文献类型：
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作者：
Wingood GM;Reddy P;Lang DL;Saleh-Onoya D;Braxton N;Sifunda S;DiClemente RJ
艾滋病毒流行病对南非妇女造成了毁灭性的影响。目前的研究评估了SISTA南非的疗效，这是一项针对南非isiXhosa妇女的文化一致的艾滋病毒干预，改编自SISTA，一项针对非洲裔美国妇女的艾滋病毒干预。一项随机对照试验招募了342名18 - 35岁的伊西科萨妇女。参与者被随机分配到一般健康比较组或南非SISTA干预组。讲科萨语的同伴健康教育工作者为南非国际互助协会量身定制了课程，同时保留了原来国际互助协会干预措施的核心要素。参与者在基线和6个月随访时完成评估。与比较中的参与者相比，艾滋病毒干预组的参与者减少了无保护阴道性交行为的频率（调整后的平均差异= 1.06;p = 0.02），更有可能报告不渴望干性行为（AOR = 0.229; 95% CI = 0.10, 0.47; p = 0.0001），更有可能认为他们的主要性伴侣不渴望干性行为（AOR = 0.24; 95% CI = 0.11, 0.52; p = 0.0001）。此外，随机分配到干预组的妇女也报告了艾滋病毒知识的增加，更好的关系控制和对艾滋病毒污名的更接受态度。艾滋病毒干预并没有降低性传播感染的发生率。该试验表明，针对农村isiXhosa妇女的艾滋病毒干预措施可以减少自我报告的性风险行为，并增强这一弱势群体中的艾滋病毒调解人。
The HIV epidemic has a devastating impact among South-African women. The current study evaluated the efficacy of SISTA South Africa, a culturally congruent HIV intervention for isiXhosa women in South Africa that was adapted from SISTA, an HIV intervention for African American women. A randomized controlled trial recruited 342 isiXhosa women 18 – 35 years of age. Participants were randomized to the general health comparison or the SISTA South Africa intervention. Xhosa speaking peer health educators tailored the SISTA South Africa curriculum, while maintaining the core elements of the original SiSTA intervention. Participants completed assessments at baseline and 6 months follow-up. Relative to participants in the comparison, participants in the HIV intervention reduced the frequency of unprotected vaginal intercourse acts (adjusted mean difference = 1.06; p = .02), were more likely to report not desiring dry sex (AOR = .229; 95% CI = .10, .47; p = .0001) and, were more likely to perceive that their main sexual partner did not desire dry sex (AOR = .24; 95% CI = .11, .52; p = .0001). Additionally, women randomized to the intervention also reported an increase in HIV knowledge, greater relationship control and had more accepting attitudes towards HIV stigma. The HIV intervention did not reduce STI incidence. This trial demonstrates that an HIV intervention which is adapted to enhance its gender and cultural relevance for rural isiXhosa women can reduce self-reported sexual risk behaviors and enhance mediators of HIV among this vulnerable population.