HIV RISK BEHAVIOR REDUCTION FOLLOWING INTERVENTION WITH KEY OPINION LEADERS OF POPULATION - AN EXPERIMENTAL-ANALYSIS
HIV RISK BEHAVIOR REDUCTION FOLLOWING INTERVENTION WITH KEY OPINION LEADERS OF POPULATION - AN EXPERIMENTAL-ANALYSIS
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DOI：
10.2105/ajph.81.2.168
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发表时间：
1991-02-01
影响因子：
12.7
通讯作者：
ANDREW, ME
中科院分区：
文献类型：
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作者：
KELLY, JA;LAWRENCE, JSS;ANDREW, ME
背景和目的。同伴规范影响采取行为改变，以降低感染艾滋病毒(人类免疫缺陷病毒)的风险。通过在社区一级进行实验性干预来修改危险行为规范，可能会促进在人群中普遍减少艾滋病毒风险做法。我们培训了在一个小城市的男同性恋者中被可靠地识别为流行意见领袖的人，让他们成为同龄人行为改变的代言人。意见领袖获得了进行这些代言的社交技能，并遵守了与朋友和熟人频繁交谈的规定。在干预前后，我们在干预城市和两个匹配的对照城市对光顾同性恋俱乐部的男性进行了调查。在干预城市，在两个月内进行任何无保护肛交的男性比例从36.9%下降到27.5%(比基线下降了25%)，无保护接受性肛交的比例从27.1%下降到19.0%(比基线下降了30%)。与基线水平相比，肛交期间避孕套的使用增加了16%，拥有一个以上性伴侣的男性比例下降了18%。在同一时期，比较城市的男性几乎没有变化。雇佣同行领导支持改变的干预措施可能会产生或加速人口行为的改变，以降低感染艾滋病毒的风险。
Background and Purpose. Peer norms influence the adoption of behavior changes to reduce risk for HIV (human immunodeficiency virus) infection. By experimentally intervening at a community level to modify risk behavior norms, it may be possible to promote generalized reductions in HIV risk practices within a population.Methods. We trained persons reliably identified as popular opinion leaders among gay men in a small city to serve as behavior change endorsers to their peers. The opinion leaders acquired social skills for making these endorsements and complied in talking frequently with friends and acquaintances. Before and after intervention, we conducted surveys of men patronizing gay clubs in the intervention city and in two matched comparison cities.Results. In the intervention city, the proportion of men who engaged in any unprotected anal intercourse in a two-month period decreased from 36.9 percent to 27.5 percent (-25 percent from baseline), with a reduction from 27.1 percent to 19.0 percent (-30 percent from baseline) for unprotected receptive anal intercourse. Relative to baseline levels, there was a 16 percent increase in condom use during anal intercourse and an 18 percent decrease in the proportion of men with more than one sexual partner. Little or no change was observed among men in the comparison cities over the same period of time.Conclusions. Interventions that employ peer leaders to endorse change may produce or accelerate population behavior changes to lessen risk for HIV infection.