Efficacy of a Multi-level Intervention to Reduce Injecting and Sexual Risk Behaviors among HIV-Infected People Who Inject Drugs in Vietnam: A Four-Arm Randomized Controlled Trial.
Efficacy of a Multi-level Intervention to Reduce Injecting and Sexual Risk Behaviors among HIV-Infected People Who Inject Drugs in Vietnam: A Four-Arm Randomized Controlled Trial.
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DOI：
10.1371/journal.pone.0125909
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Quan VM
中科院分区：
文献类型：
--
作者：
Go VF;Frangakis C;Minh NL;Latkin C;Ha TV;Mo TT;Sripaipan T;Davis WW;Zelaya C;Vu PT;Celentano DD;Quan VM
注射吸毒是许多国家艾滋病毒流行的主要原因。注射吸毒者（注射吸毒者）和艾滋病毒感染者常常受到双重耻辱，许多人在减少危险行为方面遇到困难。需要对感染艾滋病毒的吸毒者采取预防干预措施，在个人、家庭和社区层面提供加强支持，以促进降低风险。居住在太原省 32 个街道的 455 名艾滋病毒感染者及其艾滋病毒阴性注射网络成员 355 名被纳入研究。我们进行了两阶段随机化：首先，分区被随机分配到社区视频筛查和挨家挨户访问或标准护理教育小册子。其次，在每个分区内，参与者被随机分配接受增强的个人水平检测后咨询和团体支持课程或标准护理艾滋病毒检测和咨询。这产生了四个方面：1）护理标准； 2）社区层面的干预； 3）个体层面的干预； 4）社区加个人干预。随访时间为 6、12、18 和 24 个月。主要结果是自我报告的艾滋病毒注射和性危险行为。次要结果包括艾滋病毒阴性网络成员中的艾滋病毒发病率。报告从基线到 24 个月期间，所有组中共用注射设备和无保护性行为的参与者较少（分别为 77% 至 4% 和 24% 至 5%）。 24 个月访视时，4 个组之间没有显着差异（Wald = 3.40 (3 df)；p = 0.33；Wald = 6.73 (3 df)；p = 0.08）。 24 个月内共有 4 例 HIV 血清转化，干预组和对照组之间没有显着差异。了解所有类别（尤其是对照组）表现出低风险行为和低艾滋病毒发病率的机制对于政策和预防规划具有重要意义。 ClinicalTrials.gov NCT01689545
Injecting drug use is a primary driver of HIV epidemics in many countries. People who inject drugs (PWID) and are HIV infected are often doubly stigmatized and many encounter difficulties reducing risk behaviors. Prevention interventions for HIV-infected PWID that provide enhanced support at the individual, family, and community level to facilitate risk-reduction are needed. 455 HIV-infected PWID and 355 of their HIV negative injecting network members living in 32 sub-districts in Thai Nguyen Province were enrolled. We conducted a two-stage randomization: First, sub-districts were randomized to either a community video screening and house-to-house visits or standard of care educational pamphlets. Second, within each sub-district, participants were randomized to receive either enhanced individual level post-test counseling and group support sessions or standard of care HIV testing and counseling. This resulted in four arms: 1) standard of care; 2) community level intervention; 3) individual level intervention; and 4) community plus individual intervention. Follow-up was conducted at 6, 12, 18, and 24 months. Primary outcomes were self-reported HIV injecting and sexual risk behaviors. Secondary outcomes included HIV incidence among HIV negative network members. Fewer participants reported sharing injecting equipment and unprotected sex from baseline to 24 months in all arms (77% to 4% and 24% to 5% respectively). There were no significant differences at the 24-month visit among the 4 arms (Wald = 3.40 (3 df); p = 0.33; Wald = 6.73 (3 df); p = 0.08). There were a total of 4 HIV seroconversions over 24 months with no significant difference between intervention and control arms. Understanding the mechanisms through which all arms, particularly the control arm, demonstrated both low risk behaviors and low HIV incidence has important implications for policy and prevention programming. ClinicalTrials.gov NCT01689545
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影响因子：
6
作者：
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通讯作者：
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影响因子：
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