A randomized control trial of personalized cognitive counseling to reduce sexual risk among HIV-infected men who have sex with men.
A randomized control trial of personalized cognitive counseling to reduce sexual risk among HIV-infected men who have sex with men.
复制标题
一项个性化认知咨询的随机对照试验，旨在降低男男性行为者中艾滋病毒感染者的性风险。
DOI：
10.1080/09540121.2012.674095
复制
发表时间：
2013
期刊：
影响因子：
1.7
通讯作者：
Dilley,JamesW
中科院分区：
文献类型：
--
作者：
Schwarcz,SandraK;Chen,Yea-Hung;Murphy,JessieL;Paul,JayP;Skinta,MatthewD;Scheer,Susan;Vittinghoff,Eric;Dilley,JamesW
艾滋病毒感染者的预期寿命和福祉的增加表明，需要在这一人群中采取有效的预防方法。个性化的认知咨询（PCC）已被证明可以减少无保护的肛交（UAI）与未知的或不同的血清状态的合作伙伴之间的艾滋病毒未感染的男性与男性发生性关系（MSM）。我们在旧金山弗朗西斯科的一项随机临床试验中，将PCC应用于HIV感染的MSM，并测试其对标准风险降低咨询的有效性。在2006年11月至2010年4月期间，共有374名HIV感染的MSM在过去6个月内报告了UAI，其中有两名或两名以上HIV血清状态阴性或未知的男性被随机分配到两次PCC或标准咨询，间隔6个月。主要结局是在基线、6个月和12个月时测量的过去90天内与血清状态不同或未知的非主要男性伴侣发生UAI的次数。调查评估参与者对咨询的满意度。PCC组和对照组基线时UAI发作的平均次数无差异（分别为2.97和3.14;p=0.82）。两组的平均UAI发作次数在6个月时下降，PCC组在12个月时进一步下降，而对照组则增加到基线水平;这些差异无统计学意义。6个月和12个月时的发作平均比值分别为0.76（95%置信区间[CI] 0.25- 2.19，p =0.71）和0.48（95% CI 0.12- 1.84，p =0.34）。两组的参与者都对咨询工作表示高度满意。这项随机试验的结果不支持两次PCC干预在减少HIV感染的MSM中UAI方面的疗效，并表明继续需要在这一人群中确定和实施有效的预防方法。
The increased life expectancy and well-being of HIV-infected persons presents the need for effective prevention methods in this population. Personalized cognitive counseling (PCC) has been shown to reduce unprotected anal intercourse (UAI) with a partner of unknown or different serostatus among HIV-uninfected men who have sex with men (MSM). We adapted PCC for use among HIV-infected MSM and tested its efficacy against standard risk-reduction counseling in a randomized clinical trial in San Francisco. Between November 2006 and April 2010, a total of 374 HIV-infected MSM who reported UAI with two or more men of negative or unknown HIV serostatus in the previous 6 months were randomized to two sessions of PCC or standard counseling 6 months apart. The primary outcome was the number of episodes of UAI with a non-primary male partner of different or unknown serostatus in the past 90 days, measured at baseline, 6, and 12 months. Surveys assessed participant satisfaction with the counseling. The mean number of episodes of UAI at baseline did not differ between PCC and control groups (2.97 and 3.14, respectively;p=0.82). The mean number of UAI episodes declined in both groups at 6 months, declined further in the PCC group at 12 months, while increasing to baseline levels among controls; these differences were not statistically significant. Episode mean ratios were 0.76 (95% confidence interval [CI] 0.25–2.19,p=0.71) at 6 months and 0.48 (95% CI 0.12–1.84,p=0.34) at 12 months. Participants in both groups reported a high degree of satisfaction with the counseling. The findings from this randomized trial do not support the efficacy of a two-session PCC intervention at reducing UAI among HIV-infected MSM and indicate the continued need to identify and implement effective prevention methods in this population.