Impact of Social and Structural Influence Interventions on Condom Use and Sexually Transmitted Infections Among Establishment-Based Female Bar Workers in the Philippines.
Impact of Social and Structural Influence Interventions on Condom Use and Sexually Transmitted Infections Among Establishment-Based Female Bar Workers in the Philippines.
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DOI：
10.1300/j056v17n01_04
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发表时间：
2005-01-01
期刊：
影响因子：
--
通讯作者：
Malow, Robert
中科院分区：
文献类型：
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作者：
Morisky, Donald E;Chiao, Chi;Malow, Robert
这项准实验性研究评估了结构性干预成分的影响（例如，不断变化的组织和社会影响因素）在减少菲律宾女性酒吧工作者（基线N = 369）的生物性性传播感染（STI）和无保护性行为报告方面的作用。从四个大的菲律宾南部城市招聘，FBW暴露于一个标准的护理，经理的影响，同行的影响，或合并的经理/同行的影响条件。两年的干预期后，在同伴和管理者相结合的干预条件下，FBW显示出更大的减少性传播感染和无保护的性行为相对于那些在标准的护理条件。与标准护理条件相比，在合并和仅管理者条件下的FBW也显示出STI的减少。在标准护理条件下的管理人员报告较低的积极安全套的态度和较低的出席率在艾滋病毒/艾滋病相关的培训课程相比，在合并的条件。与标准护理相比，管理人员和同伴的综合作用对安全套使用行为和STI减少有积极的协同作用。这项研究提供的经验证据表明，规则、条例和增加避孕套的可及性等结构性变化必须与规范性变化（个人的态度、信仰和规范性期望）相结合，才能在避孕套使用行为和减少/预防性传播感染方面取得最大效益。
This quasi-experimental study evaluated the influence of structural intervention components (e.g., changing organizational and social influence factors) in reducing biological sexually transmitted infections (STIs) and reports of unprotected sex among female bar workers (FBWs) in the Philippines (N = 369 at baseline). Recruited from four large southern Philippines cities, FBWs were exposed to a standard care, a manager influence, a peer influence, or a combined manager/peer influence condition. After the two-year intervention period, FBWs in the combined peer and manager intervention condition showed greater reductions in STIs and unprotected sex relative to those in the standard care condition. FBWs in the combined and the manager only conditions also showed a decrease in STIs compared to those in the standard care condition. Managers in the standard care condition reported lower positive condom attitudes and lower attendance at HIV/AIDS related training sessions compared to those in the combined condition. The combined effect of managers and peers had a positive, synergistic effect on condom use behavior and STI reduction compared to the standard care. This research provides empirical evidence that structural changes such as rules, regulations, and increased accessibility of condoms must be in combination with normative changes (individuals' attitudes, beliefs and normative expectancies) in order to achieve the greatest benefit in condom use behavior and STI reduction/prevention.