The Efficacy of HIV/STI Behavioral Interventions for African American Females in the United States: A Meta-Analysis
The Efficacy of HIV/STI Behavioral Interventions for African American Females in the United States: A Meta-Analysis
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DOI：
10.2105/ajph.2008.139519
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发表时间：
2009-11-01
影响因子：
12.7
通讯作者：
O'Leary, Ann
中科院分区：
文献类型：
--
作者：
Crepaz, Nicole;Marshall, Khiya J.;O'Leary, Ann
目标。我们评估了美国非裔美国女性艾滋病行为干预的效果，并确定了与干预效果相关的因素。我们对1988年1月至2007年6月发表的研究进行了全面的文献综述，共获得37项相关研究。数据分析采用混合效应模型和元回归。总体而言，行为干预对降低hiv风险性行为有显著影响(优势比[OR]= 0.63； 95%可信区间[CI] = 0.54, 0.75; n = 11239；P < 0.001)和性传播感染（STIs）； OR = 0.81; 95% CI = 0.67, 0.98; n = 8760；P = .12)。在专门针对非裔美国女性的研究中观察到更大的干预效果，使用特定性别或文化的材料，使用女性交付者，解决赋权问题，提供避孕套使用和安全性行为谈判的技能培训，并使用角色扮演来教授谈判技巧。行为干预在预防非裔美国女性感染艾滋病毒和性传播感染方面是有效的。需要更多的研究来检查预防战略的潜在贡献，这些战略关注影响这一人群中艾滋病毒感染和传播的社区一级和结构一级因素。[J] .公共卫生，2009;99:2069-2078。doi: 10.2105 / AJPH.2008.139519)
Objectives. We evaluated the efficacy of HIV behavioral interventions for African American females in the United States, and we identified factors associated with intervention efficacy.Methods. We conducted a comprehensive literature review covering studies published from January 1988 to June 2007, which yielded 37 relevant studies. Data were analyzed using mixed-effects models and meta-regression.Results. Overall, behavioral interventions had a significant impact on reductions in HIV-risk sex behaviors (odds ratio [OR]= 0.63; 95% confidence interval [CI] = 0.54, 0.75; n = 11239; Cochrane Q(32) = 84.73; P < .001) and sexually transmitted infections (STIs; OR = 0.81; 95% CI = 0.67, 0.98; n = 8760; Cochrane Q(16) = 22.77; P = .12). Greater intervention efficacy was observed in studies that specifically targeted African American females used gender- or culture-specific materials, used female deliverers, addressed empowerment issues, provided skills training in condom use and negotiation of safer sex, and used role-playing to teach negotiation skills.Conclusions. Behavioral interventions are efficacious at preventing HIV and STIs among African American females. More research is needed to examine the potential contribution of prevention strategies that attend to community-level and structural-level factors affecting HIV infection and transmission in this population. (Am J Public Health. 2009;99:2069-2078. doi:10.2105/AJPH.2008.139519)