HIV/AIDS risk reduction counseling for alcohol using sexually transmitted infections clinic patients in Cape Town, South Africa
HIV/AIDS risk reduction counseling for alcohol using sexually transmitted infections clinic patients in Cape Town, South Africa
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DOI：
10.1097/qai.0b013e3180415e07
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发表时间：
2007-04-15
影响因子：
3.6
通讯作者：
Peltzer, Karl
中科院分区：
文献类型：
--
作者：
Kalichman, Seth C.;Simbayi, Leickness C.;Peltzer, Karl
背景：艾滋病毒正在肆虐南部非洲，在性行为中饮酒促进了艾滋病毒传播危险行为的发生。在非洲，尚无直接针对饮酒者和HIV高危人群中HIV危险行为的干预措施。目的：测试一种行为风险降低咨询干预措施，用于南部非洲的性传播感染(STI)诊所。方法：对南非开普敦的143名STI门诊患者进行随机干预试验。参与者接受了60分钟的实验性艾滋病毒和酒精风险降低行为技能干预，或20分钟的对照艾滋病毒教育条件。结果：总体上，在6个月的随访期中，试验性干预的避孕套使用率增加了25%以上，无保护性行为的发生率减少了65%，在这两个随访期中，试验性行为的风险降低显著高于对照条件。在3个月的随访期中，在性环境中饮酒[F(1，94)=6.2；P<；0.05]和饮酒能提高性体验的期望值[F(1，94)=8.3；P<；0.01]也显著低于实验条件下的[F(1，94)=6.3；P<；0.01]。结论：在该STI门诊人群中，HIV预防咨询干预可降低HIV传播风险长达6个月。可以通过结构性干预来维持效果，以减少性行为中的酒精使用，并支持长期的降低风险的行为改变。
Background: HIV is ravaging southern Africa, and HIV transmission risk behaviors are facilitated by alcohol use in sexual contexts. There are no known interventions that directly target HIV risk behavior among people who drink and are at risk for HIV in Africa.Purpose: To test a behavioral risk reduction counseling intervention for use in sexually transmitted infection (STI) clinics in southern Africa.Methods: A randomized intervention trial was conducted with 143 STI clinic patients in Cape Town, South Africa. Participants received an experimental 60-minute HIV and alcohol risk reduction behavioral skills intervention or a control 20-minute HIV education condition. Participants were followed for 3 and 6 months after the intervention, with 73% retention.Results: Overall, the experimental intervention demonstrated more than a 25% increase in condom use and a 65% reduction in unprotected intercourse over the 6-month follow-up period, with risk reduction significantly greater for the experimental condition than for the control condition at both follow-ups. Alcohol use in sexual contexts [F(1,94) = 6.2; P < 0.05] and expectancies that alcohol enhances sexual experiences [F(1,94) = 8.3; P < 0.01] were also significantly lower for the experimental condition at the 3-month follow-up.Conclusions: An HIV prevention counseling intervention reduced HIV transmission risks for up to 6 months in this STI clinic population. Effects may be sustained with structural interventions to reduce alcohol use in sexual contexts and support risk reduction behavior changes over the long-term.