Effect of Text Messaging to Deter Early Resumption of Sexual Activity After Male Circumcision for HIV Prevention: A Randomized Controlled Trial
Effect of Text Messaging to Deter Early Resumption of Sexual Activity After Male Circumcision for HIV Prevention: A Randomized Controlled Trial
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DOI：
10.1097/qai.0b013e3182a0a050
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发表时间：
2014-02-01
影响因子：
3.6
通讯作者：
McClelland, R. Scott
中科院分区：
文献类型：
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作者：
Odeny, Thomas A.;Bailey, Robert C.;McClelland, R. Scott
背景资料：在男性包皮环切术后伤口完全愈合之前恢复性生活可能会增加术后手术并发症的风险，以及HIV感染和传播的风险。我们的目的是确定短信对包皮环切术后42天内阻止恢复性生活的影响。研究方法：我们进行了一项随机试验，年龄在18岁以上的男性，拥有移动的手机，刚刚接受包皮环切术，随机接受一系列短信（n = 600）或常规护理（n = 600）。主要结局是42天前自我报告的性生活恢复。结果如下：干预组491例男性中有139例（28.3%）报告了42天前的性别，对照组493例男性中有124例（25.2%）报告了42天前的性别[相对风险= 1.13，95%置信区间（CI）：0.91至1.38，P = 0.3]。已婚或有同居性伴侣的男性更容易早期恢复[校正相对危险度（aRR）1.57，95%CI：1.18 - 2.08，P < 0.01];包皮环切术前一个月有1（aRR：1.50，95% CI：1.07 - 2.12，P = 0.02）或大于1（aRR：1.81，95%CI：1.24 ~ 2.66，P < 0.01）性伴侣;小学及以下文化程度（aRR：1.62，95%CI：1.33 ~ 1.97，P< 0.001）;（aRR：1.35，95%CI：1.05 ~ 1.72，P = 0.02）;或年龄21-30岁（aRR：1.58，95% CI：1.01 - 2.47，P = 0.05），31-40岁（aRR：1.91，95% CI：1.18 ~ 3.09，P < 0.01）或40岁以上（aRR：1.76，95% CI：1.04 ~ 2.97，P = 0.03）与21岁以下相比。结论：本试验中使用的短信并没有减少包皮环切术后早期恢复性生活的人数。我们确定了包皮环切术中需要考虑的早期恢复的关键风险因素。
Background: Resumption of sex before complete wound healing after male circumcision may increase risk of postoperative surgical complications, and HIV acquisition and transmission. We aimed to determine the effect of text messaging to deter resumption of sex before 42 days postcircumcision. Methods: We conducted a randomized trial where men older than18 years who owned mobile phones and had just undergone circumcision were randomized to receive a series of text messages (n = 600) or usual care (n = 600). The primary outcome was self-reported resumption of sex before 42 days. Results: Sex before 42 days was reported by 139 of 491 (28.3%) men in the intervention group and 124 of 493 (25.2%) men in the control group [relative risk = 1.13, 95% confidence interval (CI): 0.91 to 1.38, P = 0.3]. Men were more likely to resume early if they were married or had a live-in sexual partner [adjusted relative risk (aRR) 1.57, 95% CI: 1.18 to 2.08, P < 0.01]; in the month before circumcision had 1 (aRR: 1.50, 95% CI: 1.07 to 2.12, P = 0.02) or more than 1 (aRR: 1.81, 95% CI: 1.24 to 2.66, P < 0.01) sexual partner(s); had primary school or lower education (aRR: 1.62, 95% CI: 1.33 to 1.97, P< 0.001); were employed (aRR: 1.35, 95% CI: 1.05 to 1.72, P = 0.02); or were 21-30 years old (aRR: 1.58, 95% CI: 1.01 to 2.47, P = 0.05), 31-40 years old (aRR: 1.91, 95% CI: 1.18 to 3.09, P < 0.01), or older than 40 years (aRR: 1.76, 95% CI: 1.04 to 2.97, P = 0.03) compared with younger than 21 years. Conclusions: Text messaging as used in this trial did not reduce early resumption of sex after circumcision. We identified key risk factors for early resumption that need to be considered in circumcision programs.