The effects of HIV testing advocacy messages on test acceptance: a randomized clinical trial
The effects of HIV testing advocacy messages on test acceptance: a randomized clinical trial
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DOI：
10.1186/s12916-014-0204-4
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发表时间：
2014-11-06
期刊：
影响因子：
9.3
通讯作者：
Zimet, Gregory D.
中科院分区：
文献类型：
--
作者：
Kasting, Monica L.;Cox, Anthony D.;Zimet, Gregory D.
背景：在美国，近五分之一的艾滋病毒感染者不知道自己被感染。因此，它是重要的是开发和评估的健康传播信息，临床医生可以用来鼓励HIV tests.Methods：其目的是评估健康传播信息，旨在提高妇女的HIV检测率，并评估可能的调节剂的消息效果。我们使用了一项在城市社区门诊健康诊所进行的随机四臂临床试验，涉及1，919名18至64岁的女性患者。四个健康信息干预组是：i）仅信息控制; ii）描述艾滋病毒检测优点的单侧信息; iii）承认对检测的表面反对的双侧信息（即，等待20分钟等待结果），然后描述测试的优点;以及iv）确认严重反对意见的双面消息（即，对艾滋病毒检测呈阳性的恐惧），然后介绍了检测的优点。主要结果是接受的口服快速HIV test.Results：参与者被随机接受控制消息（n = 483），单侧消息（n = 480），双侧消息与表面的反对（n = 481），或双侧消息与严重的反对（n = 475）。艾滋病毒检测的总体接受率为83%。双侧消息组与对照组无显著差异。然而，单侧消息组的测试率（80%）低于对照组（86%）（OR，0.66; 95% CI，0.47 - 0.93; P = 0.018）。"感知到的艾滋病毒检测障碍"缓和了这种影响，表明在艾滋病毒检测接受的单边消息组的下降，只有那些谁报告了高水平的艾滋病毒检测障碍的统计学显着（OR，0.36; 95%CI，0.19 - 0.67; P = 0.001）。片面的信息降低了接受度，这种影响对于那些认为对测试有更大障碍的女性尤其如此，而这正是人们最想说服的群体。这一发现表明，在某些情况下，说服那些不愿接受检测的人的努力可能会产生意想不到的负面影响。应研究其他方法来宣传艾滋病毒检测，特别是针对不同的行为高危人群。
Background: Nearly 1 in 5 people living with HIV in the United States are unaware they are infected. Therefore, it is important to develop and evaluate health communication messages that clinicians can use to encourage HIV testing.Methods: The objective was to evaluate health communication messages designed to increase HIV testing rates among women and evaluate possible moderators of message effect. We used a randomized four-arm clinical trial conducted at urban community outpatient health clinics involving 1,919 female patients, 18 to 64 years old. The four health message intervention groups were: i) information-only control; ii) one-sided message describing the advantages of HIV testing; iii) two-sided message acknowledging a superficial objection to testing (i.e., a 20 minute wait for results) followed by a description of the advantages of testing; and iv) two-sided message acknowledging a serious objection (i.e., fear of testing positive for HIV) followed by a description of the advantages of testing. The main outcome was acceptance of an oral rapid HIV test.Results: Participants were randomized to receive the control message (n = 483), one-sided message (n = 480), two-sided message with a superficial objection (n = 481), or two-sided message with a serious objection (n = 475). The overall rate of HIV test acceptance was 83%. The two-sided message groups were not significantly different from the controls. The one-sided message group, however, had a lower rate of testing (80%) than the controls (86%) (OR, 0.66; 95% CI, 0.47-0.93; P = 0.018). "Perceived obstacles to HIV testing" moderated this effect, indicating that the decrease in HIV test acceptance for the one-sided message group was only statistically significant for those who had reported high levels of obstacles to HIV testing (OR, 0.36; 95% CI, 0.19-0.67; P = 0.001).Conclusions: None of the messages increased test acceptance. The one-sided message decreased acceptance and this effect was particularly true for women with greater perceived obstacles to testing, the very group one would most want to persuade. This finding suggests that efforts to persuade those who are reluctant to get tested, in some circumstances, may have unanticipated negative effects. Other approaches to messaging around HIV testing should be investigated, particularly with diverse, behaviorally high-risk populations.