Evaluating a two-step approach to sexual risk reduction in a publicly-funded STI clinic: Rationale, design, and baseline data from the Health Improvement Project-Rochester (HIP-R)
Evaluating a two-step approach to sexual risk reduction in a publicly-funded STI clinic: Rationale, design, and baseline data from the Health Improvement Project-Rochester (HIP-R)
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DOI：
10.1016/j.cct.2008.02.001
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发表时间：
2008-07-01
影响因子：
2.2
通讯作者：
Urban, Marguerite A.
中科院分区：
文献类型：
--
作者：
Carey, Michael P.;Vanable, Peter A.;Urban, Marguerite A.
背景：性传播感染 (STI) 诊所为 MV 预防工作提供了有利的环境。这项随机对照试验评估了公共资助的一种独特的、两步降低性风险的方法。性传播感染诊所。方法：在初次就诊期间，患者完成了音频计算机辅助自我访谈（ACASI），被随机分配并接受两项简短干预中的一项，获得医疗护理，并完成后评估。接下来，三分之二的患者被分配参加密集的性风险降低研讨会。在第 3、6 和 12 个月时，患者完成了额外的 ACASIs 并提供尿液样本来评估行为变化和性传播感染事件。结果：在 28 个月的时间间隔内，对 5613 名患者进行了筛查，其中 2691 名患者符合资格，1483 名患者同意参与并被随机分配；拒绝的最常见原因是缺乏时间（82%）。同意的患者包括 688 名女性和 795 名男性； 64% 的参与者是非裔美国人。样本属于低收入群体，其中 57% 的人年收入低于 15,000 美元；大多数参与者 (62%) 受过高中或以下教育，5·1% 失业。性危险行为很常见，表现为多个性伴侣（平均 = 32.8，终生；平均 = 2.8，过去 3 个月）、无保护性行为（平均 = 17.3 次，过去 3 个月）和既往性传播感染（平均 = 3.3，终生；基线时为 23%）。双变量分析证实了我们的预测，即与艾滋病毒相关的动机和行为技能将与当前的性危险行为相关。所有患者均接受了简短的干预；两种干预措施的患者满意度均较高（4 分制的所有平均值 >= 3.7）。百分之五十六的受邀患者参加了强化研讨会，并且出席率并没有因简短干预而有所不同。患者对研讨会干预措施的满意度也一致为积极（所有平均值 >= 3.6）。随访评估的回报率超过 0%。结论：结果表明，在繁忙的公共诊所实施 IHV 预防计划是可行的，并且得到患者的广泛接受。持续的评估将确定干预措施是否可以减少性危险行为并降低性传播感染的发生率。 (c) 2008 Elsevier Inc. 保留所有权利。
Background: Sexually transmitted infection (STI) clinics provide an opportune setting for MV prevention efforts. This randomized controlled trial evaluated a unique, two-step approach to sexual risk reduction at a publicly-funded. STI clinic.Methods: During an initial visit, patients completed an audio-computer assisted self-interview (ACASI), were randomized to and received one of two brief interventions, obtained medical care, and completed a post-assessment. Next, two-thirds of the patients were assigned to attend an intensive sexual risk reduction workshop. At 3, 6, and 12 months, patients completed additional ACASIs and provided urine specimens to assess behavior change and incident STIs.Results: During a 28-month interval, 5613 patients were screened, 2691 were eligible, and 1483 consented to participate and were randomized; the modal reason for declining was lack of time (82%). Consenting patients included 688 women and 795 men; 64% of participants were African-American. The sample was low-income, with 57% reporting an annual income of less than $15,000; most participants (62%) had a high school education or less, and 5 1 % were unemployed. Sexual risk behavior was common, as indicated by multiple sexual partners (mean = 32.8, lifetime; mean= 2.8, past 3 months), unprotected sex (mean = 17.3 episodes, past 3 months), and prior STIs (mean = 3.3, lifetime; 23% at baseline). Bivariate analyses confirmed our prediction that HIV-related motivation and behavioral skills would be related to current sexual risk behavior. All patients received a brief intervention; patient satisfaction ratings were uniformly high for both interventions (all means >= 3.7 on 4-point scales). Fifty-six percent of invited patients attended the intensive workshop, and attendance did not differ as a function of brief intervention. Patient satisfaction ratings were also uniformly positive for the workshop interventions (all means >= 3.6). Return to follow-up assessments exceeded 0%.Conclusions: Results demonstrate that implementing an IHV preventive program in a busy, public clinic is feasible and well accepted by patients. Ongoing evaluation will determine if the interventions reduce sexual risk behavior and lower incident STIs. (c) 2008 Elsevier Inc. All rights reserved.