National Institute of Mental Health Multisite Eban HIV/STD Prevention Intervention for African American HIV Serodiscordant Couples: a cluster randomized trial.
National Institute of Mental Health Multisite Eban HIV/STD Prevention Intervention for African American HIV Serodiscordant Couples: a cluster randomized trial.
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美国国家心理健康研究所多站点EBAN HIV/STD预防措施针对非裔美国人艾滋病毒血清探索夫妇：一项群集随机试验。
DOI：
10.1001/archinternmed.2010.261
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发表时间：
2010-09-27
影响因子：
--
通讯作者：
Bellamy, Scarlett L.
中科院分区：
文献类型：
--
作者：
El-Bassel, Nabila;Jemmott, John B.;Landis, J. Richard;Pequegnat, Willo;Wingood, Gina M.;Wyatt, Gail E.;Bellamy, Scarlett L.
人类免疫缺陷病毒（HIV）对非裔美国人的影响不成比例。夫妇层面的干预可能是一个有前途的干预策略。为了确定行为干预是否可以减少非裔美国人HIV血清不一致夫妇中的HIV/性传播疾病（STD）风险行为，在格鲁吉亚的亚特兰大、加州的洛杉矶、纽约的纽约和宾夕法尼亚州的费城进行了一项群集随机对照试验（Eban）。非裔美国人HIV血清不一致的异性恋夫妇，如果双方至少18岁，并且在过去90天内报告了无保护性交，了解彼此的血清状况。1070名参与者入组（平均年龄43岁; 40%的男性参与者为HIV阳性）。夫妇被随机分配到两种干预措施中的一种：以夫妇为中心的Eban HIV/STD风险降低干预措施或注意力匹配的以个人为中心的健康促进比较。主要结果是避孕套保护性交行为的比例和性病（衣原体、淋病或滴虫）的累积发病率。在干预前和干预后以及6个月和12个月的随访中收集数据。对535对随机夫妇的数据进行了分析：干预组260对，对照组275对; 81.9%的夫妇在12个月随访时保留。广义估计方程分析显示，当对基线标准测量进行调整时，干预组夫妇中避孕套保护性行为的比例（0.77）大于对照组（0.47;风险比，1.24; 95%置信区间[CI]，1.09至1.41; P= 0.006）。干预组中持续使用避孕套的夫妇比例（63%）高于对照组（48%;风险比，1.45; 95%CI，1.24 - 1.70; P<0.001）。干预组调整后的无保护性交行为的平均数（log）低于对照组（平均差异，-1.52; 95%CI，-2.07至-0.98; P<0.001）。在12个月的随访中，干预组和对照组的夫妇之间的累积性病发病率没有差异。在12个月的随访中，535人中有5人（干预组2人，对照组3人）发生了艾滋病毒血清转换，即每10万人中有935人。据我们所知，这是第一个随机对照干预试验，报告显着减少艾滋病毒/性病的危险行为之间的非洲裔美国人艾滋病毒血清不一致的夫妇。
Human immunodeficiency virus (HIV) has disproportionately affected African Americans. Couple-level interventions may be a promising intervention strategy. To determine if a behavioral intervention can reduce HIV/sexually transmitted disease (STD) risk behaviors among African American HIV serodiscordant couples, a cluster randomized controlled trial (Eban) was conducted in Atlanta, Georgia; Los Angeles, California; New York, New York; and Philadelphia, Pennsylvania; with African American HIV serodiscordant heterosexual couples who were eligible if both partners were at least 18 years old and reported unprotected intercourse in the previous 90 days and awareness of each other's serostatus. One thousand seventy participants were enrolled (mean age, 43 years; 40% of male participants were HIV positive). Couples were randomized to 1 of 2 interventions: couple-focused Eban HIV/STD risk-reduction intervention or attention-matched individual-focused health promotion comparison. The primary outcomes were the proportion of condom-protected intercourse acts and cumulative incidence of STDs (chlamydia, gonorrhea, or trichomonas). Data were collected preintervention and postintervention, and at 6- and 12-month follow-ups. Data were analyzed for 535 randomized couples: 260 in the intervention group and 275 in the comparison group; 81.9% were retained at the 12-month follow-up. Generalized estimating equation analyses revealed that the proportion of condom-protected intercourse acts was larger among couples in the intervention group (0.77) than in the comparison group (0.47; risk ratio, 1.24; 95% confidence interval [CI], 1.09 to 1.41; P=.006) when adjusted for the baseline criterion measure. The adjusted percentage of couples using condoms consistently was higher in the intervention group (63%) than in the comparison group (48%; risk ratio, 1.45; 95% CI, 1.24 to 1.70; P<.001). The adjusted mean number of (log)unprotected intercourse acts was lower in the intervention group than in the comparison group (mean difference, –1.52; 95% CI, –2.07 to –0.98; P<.001). The cumulative STD incidence over the 12-month follow-up did not differ between couples in the intervention and comparison groups. The overall HIV sero-conversion at the 12-month follow-up was 5 (2 in the intervention group, 3 in the comparison group) of 535 individuals, which translates to 935 per 100 000 population. To our knowledge, this is the first randomized controlled intervention trial to report significant reductions in HIV/STD risk behaviors among African American HIV serodiscordant couples.
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影响因子：
12.7
作者：
Jemmott, Loretta Sweet;Jemmott, John B., III;O'Leary, Ann
通讯作者：
O'Leary, Ann
影响因子：
12.7
作者：
El-Bassel, N;Witte, SS;Steinglass, P
通讯作者：
Steinglass, P
影响因子：
4.4
作者：
Myers, HF;Wyatt, GE;Liu, HH
通讯作者：
Liu, HH
影响因子：
120.7
作者：
ALLEN, S;SERUFILIRA, A;HULLEY, S
通讯作者：
HULLEY, S
DOI：
10.1111/j.1552-6909.2008.00221.x
发表时间：
2008-03-01
影响因子：
1.8
作者：
Jemmott, Loretta Sweet;Jemmott, John B.;O'Leary, Ann
通讯作者：
O'Leary, Ann