The efficacy of behavioral interventions in reducing HIV risk behaviors and incident sexually transmitted diseases in heterosexual African Americans
The efficacy of behavioral interventions in reducing HIV risk behaviors and incident sexually transmitted diseases in heterosexual African Americans
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DOI：
10.1097/qad.0b013e3282ff624e
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发表时间：
2008-06-19
期刊：
影响因子：
3.8
通讯作者：
Rutherford, George
中科院分区：
文献类型：
--
作者：
Darbes, Lynae;Crepaz, Nicole;Rutherford, George
目的：对非裔美国异性恋者的HIV干预措施进行荟萃分析，以确定其在减少HIV危险性行为和性传播疾病发生率方面的总体效果，并确定与效果相关的干预特征。方法：综合检索1988~2005年的电子数据库、手工检索期刊、参考文献列表和与研究人员的接触。38个随机对照试验符合选择标准。结果：干预显著减少了无保护性行为(优势比=0.75；95%可信区间=0.67，0.84；35次试验；N=14682)，并略微减少了性传播疾病的发生(优势比=0.88；95%可信区间=0.72，1.07；10次试验；N=10944)。与有效性相关的干预特征包括：文化定制，旨在影响社会规范，促进安全性行为，利用同伴教育，提供正确使用避孕套的技能培训和协商安全性行为所需的沟通技能，以及多次会议和练习所学技能的机会。结论：针对非裔美国异性恋者的干预措施在减少HIV高危性行为方面是有效的。这项研究中确定的有效干预成分应纳入未来干预措施的发展中，并进一步评估其有效性。(C)2008年沃尔特斯-克鲁沃健康垂直酒吧Lippincott Williams&Wilkins。
Objective: To conduct a meta-analytic review of HIV interventions for heterosexual African Americans to determine the overall efficacy in reducing HIV-risk sex behaviors and incident sexually transmitted diseases and identify intervention characteristics associated with efficacy.Methods: Comprehensive searches included electronic databases from 1988 to 2005, handsearches of journals, reference lists of articles, and contacts with researchers. Thirty-eight randomized controlled trials met the selection criteria. Random-effects models were used to aggregate data.Results: Interventions significantly reduced unprotected sex (odds ratio = 0.75; 95% confidence interval = 0.67, 0.84; 35 trials; N = 14682) and marginally significantly decreased incident sexually transmitted diseases (odds ratio = 0.88; 95% confidence interval = 0.72, 1.07; 10 trials;N = 10944). Intervention characteristics associated with efficacy include cultural tailoring, aiming to influence social norms in promoting safe sex behavior, utilizing peer education, providing skills training on correct use of condoms and communication skills needed for negotiating safer sex, and multiple sessions and opportunities to practice learned skills.Conclusion: Interventions targeting heterosexual African Americans are efficacious in reducing HIV-risk sex behaviors. Efficacious intervention components identified in this study should be incorporated into the development of future interventions and further evaluated for effectiveness. (c) 2008 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.