Behavioural interventions and abuse: secondary analysis of reinfection in minority women
Behavioural interventions and abuse: secondary analysis of reinfection in minority women
复制标题
DOI：
10.1258/095646207782212180
复制
发表时间：
2007-11-01
影响因子：
1.4
通讯作者：
Guerra, Fernando A.
中科院分区：
文献类型：
--
作者：
Champion, Jane Dimmitt;Shain, Rochelle N.;Guerra, Fernando A.
包括艾滋病在内的性传播感染对有身体虐待或性虐待史的少数群体妇女的影响特别大。本研究的目的是评估针对特定性别和文化的行为干预措施和互动性传播感染咨询对有两年以上身体虐待或性虐待史的高危少数民族妇女的有效性。患有非病毒性STI的非洲裔和墨西哥裔美国妇女参加了一项随机试验。在6个月、1年和2年时进行了随访筛查和访谈。主要转归是随后的衣原体和/或淋病感染。主要结果的次要分析由自我报告的身体或性虐待进行。在意向治疗的基础上使用逻辑回归。纳入了853名妇女的基线数据;留存率为91%。受虐待妇女的感染率在第1年（29% vs. 23.8%，P = 0.12）、第2年（23.4% vs. 17.6%，P = 0.03）和累积（43.8% vs. 33.0%，P = 0.003）更高。在第1年（42.7% vs. 30.8%，P = 0.03）、第2年（32.7% vs. 22.0%，P = 0.03）和累积（59.4% vs. 43.3%，P = 0.004），青少年（< 19岁）滥用和再感染之间的未校正相关性强于成人。成人的相应发生率为第1年（17.8% vs. 17.0%，P = 0.84）、第2年（17.4% vs. 12.7%，P = 0.23）和累积（30.7% vs. 22.3%，P = 0.08）。再感染率进一步分层的青少年和物质使用。受虐青少年的再感染率一直高于非受虐青少年和受虐成人。总之，在为期两年的研究期间，降低风险的干预措施减少了非受虐待妇女的衣原体和/或淋病感染事件。在这些研究期间，受虐待妇女，特别是青少年和药物使用者的发病率增加。
Sexually transmitted infection (STI), including AIDS disproportionately affects minority women with a history of physical or sexual abuse. The objective of this study was to evaluate the efficacy, of gender- and culture-specific behavioural interventions and interactive STI counselling for high-risk minority women with a history of physical or sexual abuse over two years. African- and Mexican-American women with a non-viral STI were enrolled in a randomized trial. Follow-up screens and interviews occurred at six months and one and two years. The primary outcome was subsequent infection with chlamydia and/or gonorrhoea. Secondary analysis of primary outcomes was made by self-reported physical or sexual abuse. Logistic regression was utilized on an intention-to-treat basis. Baseline data from 853 women were included; the retention rate was 91%. Infection rates were higher in abused women in Year 1 (29% vs. 23.8%, P = 0.12), Year 2 (23.4% vs. 17.6%, P = 0.03) and cumulatively (43.8% vs. 33.0%, P = 0.003). Unadjusted association between abuse and reinfection was stronger for adolescents (< 19 years) than adults in Year 1 (42.7% vs. 30.8%, P = 0.03), Year 2 (32.7% vs. 22.0%, P = 0.03) and cumulatively (59.4% vs. 43.3%, P = 0.004). Corresponding rates for adults were Year 1 (17.8% vs. 17.0%, P = 0.84), Year 2 (17.4% vs. 12.7%, P = 0.23) and cumulatively (30.7% vs. 22.3%, P = 0.08). Reinfection rates were further stratified by adolescence and substance use. Abused adolescents had consistently higher reinfection than non-abused adolescents and abused adults. In conclusion, risk-reduction interventions decreased infective episodes with chlamydia and/or gonorrhoea in the two-year study period for non-abused women. Abused women, particularly adolescents and substance users, had increased episodes in these study periods.