Brief cognitive counseling with HIV testing to reduce sexual risk among men who have sex with men - Results from a randomized controlled trial using paraprofessional counselors
Brief cognitive counseling with HIV testing to reduce sexual risk among men who have sex with men - Results from a randomized controlled trial using paraprofessional counselors
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DOI：
10.1097/qai.0b013e318033ffbd
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发表时间：
2007-04-15
影响因子：
3.6
通讯作者：
McFarland, Willi
中科院分区：
文献类型：
--
作者：
Dilley, James W.;Woods, William J.;McFarland, Willi
目的：测试的有效性和可接受性的单届个性化的认知咨询（PCC）干预提供的辅助人员在HIV自愿咨询和testing.Methods：HIV阴性的男性与男性发生性关系（MSM; n = 336）被随机分配到PCC或常规咨询（UC）2002年10月至2004年9月。主要结局是在基线、6个月和12个月时测量的过去90天内与任何HIV血清状态不一致的非主要伴侣进行无保护肛交（UAI）的次数。通过随机截距泊松回归分析将影响评估为“意向治疗”。可接受性进行了评估，通过标准化的客户满意度survey.Results：男性接受PCC和UC报告艾滋病毒不一致的UAI在基线水平相当（平均发作：4.2与4.8，分别为P = 0.151）。PCC组6个月时UAI下降超过60%，为1.9次（与基线相比P < 0.001），但UC组为4.3次（与基线相比P = 0.069）。在6个月时，接受PCC的男性报告的风险显著低于接受UC的男性（与PCC的差异P = 0.029）。PCC组的风险降低持续6至12个月，为1.9（P = 0.181），而UC组的风险在此期间显著降低至2.2（P < 0.001 vs. 6个月; P = 0.756 vs. PCC 12个月）。PCC参与者对咨询体验的“非常满意”（78.2%）显著高于UC参与者（59.2%）（P = 0.002）。MSM重复测试。PCC参与者表现出显着的行为变化更迅速，并报告了更满意的咨询经验比UC参与者。
Objectives: To test the efficacy and acceptability of a single-session personalized cognitive counseling (PCC) intervention delivered by paraprofessionals during HIV voluntary counseling and testing.Methods: HIV negative men who have sex with men (MSM; n = 336) were randomly allocated to PCC or usual counseling (UC) between October 2002 and September 2004. The primary outcome was the number of episodes of unprotected anal intercourse (UAI) with any nonprimary partner of nonconcordant HIV serostatus in the preceding 90 days, measured at baseline, 6 months, and 12 months. Impact was assessed as "intent to treat" by random-intercept Poisson regression analysis. Acceptability was assessed by a standardized client satisfaction survey.Results: Men receiving PCC and UC reported comparable levels of HIV nonconcordant UAI at baseline (mean episodes: 4.2 vs. 4.8, respectively; P = 0.151). UAI decreased by more than 60% to 1.9 episodes at 6 months in the PCC arm (P < 0.001 vs. baseline) but was unchanged at 4.3 episodes for the UC arm (P = 0.069 vs. baseline). At 6 months, men receiving PCC reported significantly less risk than those receiving UC (P = 0.029 for difference to PCC). Risk reduction in the PCC arm was sustained from 6 to 12 months at 1.9 (P = 0.181), whereas risk significantly decreased in the UC arm to 2.2 during this interval (P < 0.001 vs. 6 months; P = 0.756 vs. PCC at 12 months). Significantly more PCC participants were "very satisfied" with the counseling experience (78.2%) versus UC participants (59.2%) (P = 0.002).Conclusions: Both interventions were effective in reducing high-risk sexual behavior among. MSM repeat testers. PCC participants demonstrated significant behavioral change more swiftly and reported a more satisfying counseling experience than UC participants.