Interventions to prevent HIV/AIDS among adolescents in less developed countries: Are they effective?
Interventions to prevent HIV/AIDS among adolescents in less developed countries: Are they effective?
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欠发达国家青少年预防艾滋病毒/艾滋病的干预措施：有效吗？
DOI：
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发表时间：
2004
影响因子：
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通讯作者：
P. Jolly
中科院分区：
文献类型：
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作者：
Lesley Magnussen;J. Ehiri;H. Ejere;P. Jolly
这项研究的目的是总结和批判性地评估在欠发达国家预防青少年艾滋病毒/艾滋病干预措施的效果。评价在11-25岁人群中预防艾滋病毒/艾滋病/性传播疾病的干预措施的研究报告是从网上计算机数据库中获得的，方法是搜索会议记录和相关期刊，并跟踪已发表报告中引用的参考文献。如果他们调查了旨在预防或减少欠发达国家11-25岁人群中艾滋病毒/艾滋病/性传播疾病的任何教育、行为、心理社会或其他干预措施，研究就包括在内。只有包括对照组的研究才包括干预前和干预后评估。结果措施包括：(1)改变安全性行为(禁欲、使用避孕套、限制性伴侣、避免随意性行为)、(2)艾滋病毒/艾滋病传播和预防方法的知识、(3)对艾滋病毒/艾滋病/性传播疾病风险的认知、(4)关于避孕套谈判和拒绝性行为的自我效能、(5)接受自愿咨询和检测(VCT)、(6)减少艾滋病毒/艾滋病/性传播疾病的发生率。根据干预形式(例如，教育、角色扮演、视频)、持续时间和环境(学校或社区)对研究进行评估。对报告的干预组与对照组相比在结果测量方面的改善进行了评估。有16项研究符合纳入标准。其中13项是在非洲进行的，3项是在拉丁美洲进行的。16项研究中有12项是以学校为基础的，4项是以社区为基础的。所审查的干预措施在增加艾滋病毒/艾滋病知识、改变态度、改善谈判和沟通技能、或通过持续使用避孕套、禁欲或减少伴侣数量来影响积极行为方面并未取得明显成功。考虑到在青少年中预防艾滋病毒/艾滋病的重要性，欠发达国家方案评价研究的设计需要改进。建议使用随机对照试验或其他严格的方法来评估基于人群的行为干预措施(例如，所罗门四设计)。
The objective of this study was to summarize and critically assess the effects of interventions to prevent HIV/AIDS among adolescents in less developed countries. Reports of studies that evaluated interventions for preventing HIV/AIDS/STDs among persons aged 11-25 years were obtained from online computer databases, by searching conference proceedings and relevant journals, and by following up references cited in published reports. Studies were included if they investigated any educational, behavioral, psychosocial or other intervention that aimed to prevent or reduce HIV/AIDS/STD among persons aged 11-25 years in a less developed country. Only studies that included a control group, and which involved pre- and post-intervention assessments were included. Outcome measures included: (i) changes in safe sex practices (abstinence, condom use, limitation of sexual partners, avoidance of casual sex), (ii) knowledge about HIV/AIDS transmission and prevention methods, (iii) perception of HIV/AIDS/STD risks, (iv) self-efficacy with regard to condom negotiation and refusal of sex, (v) uptake of voluntary counseling and testing (VCT), and (vi) reduction in incidence of HIV/AIDS/STDs. Studies were assessed in terms of intervention format (e.g., education, role-play, video), duration, and setting (school or community). Reported improvements in outcome measures in intervention versus control groups were assessed. Sixteen studies met the inclusion criteria. Thirteen of these were conducted in Africa and three in Latin America. Twelve of the sixteen studies were school-based, and four were community-based. The interventions reviewed were not resoundingly successful in achieving their goals of increasing knowledge of HIV/AIDS, altering attitudes, improving negotiation and communication skills, or in influencing positive behavior evidenced through consistent condom use, abstinence, or reducing the number of partners. Considering the importance of HIV/AIDS prevention among adolescents, design of evaluation studies of programs in less developed countries need to be improved. The use of randomized controlled trials or other rigorous approaches for evaluating population-based behavioral interventions (e.g., Solomon Four design) is recommended.