Interactive "Video Doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings.
Interactive "Video Doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings.
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DOI：
10.1371/journal.pone.0001988
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发表时间：
2008-04-23
期刊：
影响因子：
3.7
通讯作者：
Gerbert, Barbara
中科院分区：
文献类型：
--
作者：
Gilbert, Paul;Ciccarone, Daniel;Gansky, Stuart A.;Bangsberg, David R.;Clanon, Kathleen;McPhee, Stephen J.;Calderon, Sophia H.;Bogetz, Alyssa;Gerbert, Barbara
减少艾滋病毒阳性者的药物使用和无保护的性行为改善了个人健康状况，同时降低了艾滋病毒传播的风险。尽管建议卫生保健提供者对HIV阳性患者进行筛查和咨询，以了解持续的行为风险，但在临床环境中如何最好地提供“阳性预防”尚不清楚。积极选择是一种互动的、为患者量身定做的计算机程序，它是在美国开发的，目的是改善基于诊所的危险行为评估和咨询。我们在旧金山地区的5家HIV门诊诊所进行了一项平行分组随机对照试验(2003年12月至2006年9月)。符合条件的患者(艾滋病毒阳性的讲英语的成年人)完成了深入的计算机化风险评估。报告药物使用或性风险的参与者(n = 476)被随机分成分层区组。干预组通过笔记本电脑和一份打印的教育工作表，从一名“视频医生”那里得到了量身定做的降低风险咨询；提供者收到了一份关于报告风险的提示表。与对照组相比，3个月时RR0.81，95%CI：0.689，0.957，p = 0.014；6个月时RR0.65，95%CI：0.540，0.785，p<；0.001；3个月时RR0.88，95%CI：0.773，0.993，p = 0.039；6个月RR0.80，95%CI：0.686，0.941，p = 0.007。与对照组相比，干预参与者报告的持续使用非法药物的平均天数更少(在3个月时，-4.0d比-1.3d，p = 0.346；在6个月时，-4.7d比-0.7d，p = 0.130)，并且有更少的临时性伴侣(在3个月时，−2.3vs.−1.4p = 0.461；在6个月时，−2.7vs.−0.6p = 0.042)。与对照组相比，积极的选择干预措施在群体一级显著停止了非法药物使用和无保护的性行为，并在个人一级适度减少了持续使用药物的天数和随意性伴侣的数量。积极选择，包括视频医生咨询，是门诊环境中降低风险努力的有效和适当的补充，并有望成为一种公共卫生艾滋病毒干预措施。临床试验.gov NCT00447707
Reducing substance use and unprotected sex by HIV-positive persons improves individual health status while decreasing the risk of HIV transmission. Despite recommendations that health care providers screen and counsel their HIV-positive patients for ongoing behavioral risks, it is unknown how to best provide “prevention with positives” in clinical settings. Positive Choice, an interactive, patient-tailored computer program, was developed in the United States to improve clinic-based assessment and counseling for risky behaviors. We conducted a parallel groups randomized controlled trial (December 2003–September 2006) at 5 San Francisco area outpatient HIV clinics. Eligible patients (HIV-positive English-speaking adults) completed an in-depth computerized risk assessment. Participants reporting substance use or sexual risks (n = 476) were randomized in stratified blocks. The intervention group received tailored risk-reduction counseling from a “Video Doctor” via laptop computer and a printed Educational Worksheet; providers received a Cueing Sheet on reported risks. Compared with control, fewer intervention participants reported continuing illicit drug use (RR 0.81, 95% CI: 0.689, 0.957, p = 0.014 at 3 months; and RR 0.65, 95% CI: 0.540, 0.785, p<0.001 at 6 months) and unprotected sex (RR 0.88, 95% CI: 0.773, 0.993, p = 0.039 at 3 months; and RR 0.80, 95% CI: 0.686, 0.941, p = 0.007 at 6 months). Intervention participants reported fewer mean days of ongoing illicit drug use (-4.0 days vs. -1.3 days, p = 0.346, at 3 months; and -4.7 days vs. -0.7 days, p = 0.130, at 6 months) than did controls, and had fewer casual sex partners at (−2.3 vs. −1.4, p = 0.461, at 3 months; and −2.7 vs. −0.6, p = 0.042, at 6 months). The Positive Choice intervention achieved significant cessation of illicit drug use and unprotected sex at the group-level, and modest individual-level reductions in days of ongoing drug use and number of casual sex partners compared with the control group. Positive Choice, including Video Doctor counseling, is an efficacious and appropriate adjunct to risk-reduction efforts in outpatient settings, and holds promise as a public health HIV intervention. Clinicaltrials.gov NCT00447707
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DOI：
10.1097/00042560-200205010-00014
发表时间：
2002-05-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
de Olalla, PG;Knobel, H;Caylà, JA
通讯作者：
Caylà, JA
影响因子：
3.8
作者：
Hays, RB;Paul, J;Coates, TJ
通讯作者：
Coates, TJ
影响因子：
3.8
作者：
Bangsberg, DR;Perry, S;Moss, A
通讯作者：
Moss, A
DOI：
10.1080/09540120500264134
发表时间：
2006-08-01
影响因子：
1.7
作者：
Aharonovich, E.;Hatzenbuehler, M. L.;Hasin, D. S.
通讯作者：
Hasin, D. S.
DOI：
10.1097/01.qai.0000194495.15309.47
发表时间：
2006-04-15
影响因子：
3.6
作者：
Johnson, BT;Carey, MP;Reid, AE
通讯作者：
Reid, AE