Sexual risk reduction for persons living with HIV - Research synthesis of randomized controlled trials, 1993 to 2004
Sexual risk reduction for persons living with HIV - Research synthesis of randomized controlled trials, 1993 to 2004
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DOI：
10.1097/01.qai.0000194495.15309.47
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发表时间：
2006-04-15
影响因子：
3.6
通讯作者：
Reid, AE
中科院分区：
文献类型：
--
作者：
Johnson, BT;Carey, MP;Reid, AE
目的：对降低HIV+个体性风险的干预措施进行荟萃分析。设计：如果研究在包括HIV阳性参与者在内的样本中检查了故意降低性风险的策略，使用随机对照试验设计，测量了干预后避孕套的使用或性伴侣的数量，并提供了足够的信息来计算效应量（ES）估计，则纳入研究。方法：从计算机数据库中收集报告，通过联系个别研究人员，检索相关期刊和会议记录，以及查阅已获得论文的参考部分。纳入了截至2004年11月30日的15项研究（N = 3234名参与者）的数据。ES估计是标准化的平均差异。结果：在所有研究中，与对照组相比，干预组在使用避孕套方面表现出较低的性风险（平均ES = 0.16, 95%可信区间[Cl]: 0.08至0.25），但在性伴侣数量方面则无此差异（平均ES = -0.0 1, 95%可信区间[Cl]: -0.16至0.14）。如果样本包括较少的男男性行为者（MSM）或更年轻的参与者，并且当干预包括动机和技能成分时，干预在增加避孕套使用方面更成功。结论：行为干预降低了性风险，特别是如果他们包括动机和技能成分。这些干预措施对较老的样本效果较差，这表明需要进一步改进以提高其功效。以动机和技能为基础的干预措施尚未在艾滋病毒阳性男男性行为者中进行测试，总的来说，他们似乎从现有的降低风险干预措施中获益较少。
Objective: To conduct a meta-analytic review of interventions to reduce HIV+ individuals' sexual risk.Design: Studies were included if they examined a deliberate sexual risk-reduction strategy in a sample that included HIV+ participants, used a randomized controlled trial design, measured condom use or number of sexual partners after the intervention, and provided sufficient information to calculate effect size (ES) estimates.Method: Reports were gathered from computerized databases, by contacting individual researchers, by searching relevant journals and conference proceedings, and by reviewing reference sections of obtained papers. Data from 15 studies (N = 3234 participants) available as of November 30, 2004 were included. ES estimates were standardized mean differences.Results: Across the Studies, intervention participants exhibited lowered sexual risk relative to control participants on condom use (mean ES = 0.16, 95% confidence interval [Cl]: 0.08 to 0.25) but not for number of sexual partners (mean ES = -0.0 1, 95% Cl: -0.16 to 0.14). Interventions were more successful at increasing condom use if the sample included fewer men who have sex with men (MSM) or younger participants and when interventions included motivational and skills components.Conclusions: Behavioral interventions reduced sexual risk especially if they included motivational and skills components. Such interventions have been less effective for older samples, Suggesting the need for further refinement to enhance their efficacy. Motivation-and skill-based interventions have not yet been tested with HIV+ MSM who, in general, seem to have benefited less from extant risk-reduction interventions.