Randomized Trial of a Community-based Alcohol-related HIV Risk-reduction Intervention for Men and Women in Cape Town South Africa
Randomized Trial of a Community-based Alcohol-related HIV Risk-reduction Intervention for Men and Women in Cape Town South Africa
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DOI：
10.1007/s12160-008-9067-2
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发表时间：
2008-12-01
影响因子：
3.8
通讯作者：
Jooste, Sean
中科院分区：
文献类型：
--
作者：
Kalichman, Seth C.;Simbayi, Leickness C.;Jooste, Sean
艾滋病毒对南部非洲造成了毁灭性的破坏，饮酒与艾滋病毒传播风险密切相关。当前的研究测试了针对在非正规酒精服务机构饮酒的男性和女性进行简短的单次艾滋病毒酒精风险降低干预的有效性（即，一项随机社区实地试验通过外展和连锁转诊招募了男性（N = 117）和女性（N = 236）。与会者收到：（a）3 h基于理论的行为HIV-酒精风险降低干预，重点是性谈判和安全套使用的技能培训或（B）1 h HIV-酒精信息/教育对照组。参与者在干预后随访3个月和6个月，保持率为89%。与对照组相比，降低风险干预组的无保护性交、性行为前饮酒、性伴侣数量、在饮酒场所见面的性伴侣数量和安全套使用率显著降低。然而，干预效果受到酒精使用的调节;在风险降低条件下，轻度饮酒者比重度饮酒者表现出更多的干预收益。干预效果在3个月随访时出现，6个月后消失。在南非，一项简短的降低艾滋病毒风险的干预措施减少了饮酒者的性风险行为。然而，对于那些喝得最多的人来说，干预效果最弱。我们的研究结果提供了一个基础，在南非的酒精服务机构建立艾滋病毒预防。需要进行研究，以确定多层次的干预模式，可以降低酗酒者的风险，并随着时间的推移维持行为变化。
HIV is devastating southern Africa and alcohol use is closely related to HIV transmission risks.The current study tested the efficacy of a brief single-session HIV-alcohol risk-reduction intervention for men and women who drink at informal alcohol serving establishments (i.e., shebeens) in South Africa.A randomized community field trial recruited men (N = 117) and women (N = 236) through outreach and chain referrals. Participants received either: (a) 3-h theory-based behavioral HIV-alcohol risk-reduction intervention that focused on skills training for sexual negotiation and condom use or (b) 1-h HIV-alcohol information/education control group. Participants were followed up for 3 and 6 months post-intervention with 89% retention.The risk-reduction intervention demonstrated significantly less unprotected intercourse, alcohol use before sex, numbers of sex partners, partners met at drinking establishments and greater condom use relative to the control group. However, intervention effects were moderated by alcohol use; lighter drinkers demonstrated significantly more intervention gains than heavier drinkers in the risk-reduction condition. Intervention effects occurred at 3 months follow-up and dissipated by 6 months.A brief HIV risk-reduction intervention reduced sexual-risk behaviors among drinkers in South Africa. However, intervention effects were weakest for those who drink heaviest. Our results provide a basis for establishing HIV prevention in alcohol serving establishments in South Africa. Research is needed to identify multi-level intervention models that can reduce risks among heavier drinkers and sustain behavior changes over time.