Efficacy of peer-led interventions to reduce unprotected anal intercourse among men who have sex with men: a meta-analysis.
Efficacy of peer-led interventions to reduce unprotected anal intercourse among men who have sex with men: a meta-analysis.
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DOI：
10.1371/journal.pone.0090788
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Qian HZ
中科院分区：
文献类型：
--
作者：
Ye S;Yin L;Amico R;Simoni J;Vermund S;Ruan Y;Shao Y;Qian HZ
进行系统回顾和荟萃分析，以评估同伴主导的干预措施在减少男男性行为者（MSM）无保护肛交（UAI）方面的有效性。随机临床试验（RCT），准实验性研究，干预前和干预后的研究，没有对照组，和一系列的横断面评估，涉及同行提供干预措施的男男性接触者和发表截至2012年2月，确定了系统搜索13个电子数据库和交叉引用。以干预前后组间UAI的标准化均数差（SMD）的变化作为效应量（ES）。共有22项研究符合入选标准，包括5项RCT、6项准实验研究、6项干预前后研究和5项连续横断面干预研究。我们使用了15项个体研究，包括17项干预措施来计算总体ES;在荟萃分析中，同伴主导的干预措施降低了与任何性伴侣的UAI（平均ES：-0.27; 95%置信区间[CI]：-0.41，-0.13; P<0.01）。亚组分析表明，在准实验研究（平均ES：−0.30; 95% CI：−0.50，−0.09; P = 0.01）和系列横断面干预研究（平均ES：−0.33; 95% CI：−0.57，−0.09; P = 0.01）中UAI统计学显著降低，但在RCT（平均ES：−0.15; 95% CI：−0.36，0.07; P = 0.18）或干预前后研究（平均ES：−0.29; 95% CI：−0.69，0.11; P = 0.15）中无显著降低。 在这15项研究中，异质性很大（I2 = 77.5%; P<0.01），主要是由于干预前后研究和系列横断面干预研究。 同伴主导的艾滋病毒预防干预措施降低了男男性行为者的总体UAI，但效果因研究设计而异。需要更多的随机对照试验来评估同行领导的干预措施的效果，同时最大限度地减少潜在的偏倚。
To conduct a systematic review and meta-analysis to evaluate the efficacy of peer-led interventions in reducing unprotected anal intercourse (UAI) among men who have sex with men (MSM). Randomized clinical trials (RCTs), quasi-experimental studies, pre- and post-intervention studies without control groups, and serial cross-sectional assessments involving peers delivering interventions among MSM and published as of February 2012 were identified by systematically searching 13 electronic databases and cross-referencing. Effect sizes (ES) were calculated as the changes of standardized mean difference (SMD) in UAI between groups or pre-post intervention. A total of 22 studies met the eligibility criteria, including five RCTs, six quasi-experimental studies, six pre-and-post intervention studies, and five serial cross-sectional intervention studies. We used 15 individual studies including 17 interventions for overall ES calculation; peer-led interventions reduced UAI with any sexual partners in meta-analysis (mean ES: -0.27; 95% confidence interval [CI]: −0.41, −0.13; P<0.01). Subgroup analyses demonstrated a statistically significant reduction on UAI in quasi-experimental studies (mean ES: −0.30; 95% CI: −0.50, −0.09; P = 0.01) and serial cross-sectional intervention studies (mean ES: −0.33; 95% CI: −0.57, −0.09; P = 0.01), but non-significant reduction in RCTs (mean ES: −0.15; 95% CI: −0.36, 0.07; P = 0.18) or pre- and post-intervention studies (mean ES: −0.29; 95% CI: −0.69, 0.11; P = 0.15). Heterogeneity was large across these 15 studies (I 2 = 77.5%; P<0.01), largely due to pre-and-post intervention studies and serial cross-sectional intervention studies. Peer-led HIV prevention interventions reduced the overall UAI among MSM, but the efficacy varied by study design. More RCTs are needed to evaluate the effect of peer-led interventions while minimizing potential bias.
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影响因子：
4.9
作者：
Bradford, Judith B.;Coleman, Sharon;Cunningham, William
通讯作者：
Cunningham, William
影响因子：
1.8
作者：
Kang, Minsoo;Brinthaupt, Thomas M.
通讯作者：
Brinthaupt, Thomas M.
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
DOI：
10.2471/blt.09.068213
发表时间：
2010-08-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
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作者：
Kennedy, Caitlin E;Medley, Amy M;O'Reilly, Kevin R
通讯作者：
O'Reilly, Kevin R
影响因子：
12.7
作者：
Jones, Kenneth T.;Gray, Phyllis;Johnson, Wayne D.
通讯作者：
Johnson, Wayne D.