COMMUNITY AIDS HIV RISK REDUCTION - THE EFFECTS OF ENDORSEMENTS BY POPULAR PEOPLE IN 3 CITIES
COMMUNITY AIDS HIV RISK REDUCTION - THE EFFECTS OF ENDORSEMENTS BY POPULAR PEOPLE IN 3 CITIES
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DOI：
10.2105/ajph.82.11.1483
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发表时间：
1992-11-01
影响因子：
12.7
通讯作者：
MORGAN, MG
中科院分区：
文献类型：
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作者：
KELLY, JA;STLAWRENCE, JS;MORGAN, MG
目标。关键是扩大社区层面的获得性免疫缺陷综合征(艾滋病)预防努力，而不仅仅是教育，并开发更好地鼓励行为改变的模式。由于危险行为的持续高发率，小城市的男同性恋者很容易感染人类免疫缺陷病毒(HIV)。这项研究介绍了一种干预措施，培训受欢迎的人作为行为改变的代言人，依次在三个不同的城市担任同龄人的代言人。对每个城市所有光顾同性恋俱乐部的男性进行了全民调查，以确定危险行为的基本比率。在确定了一小批受欢迎的“潮流引领者”之后，他们接受了同伴教育方法的培训，然后签约与朋友们交流降低风险的建议和支持。在所有城市定期重复调查，在每个社区以滞后的方式引入相同的干预措施。干预始终使人群的高危行为(无保护肛交)比基线水平系统性降低15%至29%，相同的影响模式在所有三个城市顺序复制。这构成了针对社区的艾滋病毒预防模式的第一次受控、多城市测试。这一结果支持了改变规范方法的效用，以减少艾滋病毒危险行为。
Objectives. It is critical to extend community-level acquired immunodeficiency syndrome (AIDS) prevention efforts beyond education alone and to develop models that better encourage behavioral changes. Gay men in small cities are vulnerable to human immunodeficiency virus (HIV) infection due to continued high rates of risk behavior. This research introduced an intervention that trained popular people to serve as behavioral change endorsers to peers sequentially across three different cities.Methods. Populationwide surveys were conducted of all men patronizing gay clubs in each city to establish risk behavior base rates. After a small cadre of popular "trendsetters" were identified, they received training in approaches for peer education and then contracted to communicate risk reduction recommendations and endorsements to friends. Surveys were repeated at regular intervals in all cities, with the same intervention introduced in lagged fashion across each community.Results. Intervention consistently produced systematic reductions in the population's high-risk behavior (unprotected anal intercourse) of 15% to 29% from baseline levels, with the same pattern of effects sequentially replicated in all three cities.Conclusions. This constitutes the first controlled, multiple-city test of an HIV prevention model targeting communities. The results support the utility of norm-changing approaches to reduce HIV risk behavior.