Couple-based HIV prevention for low-income drug users from New York City: a randomized controlled trial to reduce dual risks.
Couple-based HIV prevention for low-income drug users from New York City: a randomized controlled trial to reduce dual risks.
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DOI：
10.1097/qai.0b013e318229eab1
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发表时间：
2011-10-01
期刊：
影响因子：
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通讯作者：
Remien RH
中科院分区：
文献类型：
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作者：
El-Bassel N;Gilbert L;Wu E;Witte SS;Chang M;Hill J;Remien RH
注射吸毒和危险性行为的双重威胁继续增加美国低收入社区吸毒夫妇中艾滋病毒和其他性传播感染的传播。检验了两个假设：（1）“干预效果”-与注意力控制条件相比，向夫妇或个别伴侣提供的降低艾滋病毒风险干预是否更有效地减少无保护性行为的数量，以及在12个月的随访期内生物学证实的性传播感染的累积发病率是否更低;（2）“方式效应”-艾滋病风险-减少干预更有可能减少无保护性行为的数量，并且与提供给夫妇的相同干预相比，单个.使用随机对照试验，282对艾滋病毒阴性吸毒夫妇（564人）被随机分配接受以下任何一种治疗：（1）以夫妇为基础的风险降低;（2）以个人为基础的艾滋病毒风险降低;或（3）以夫妇为基础的健康促进，作为注意力控制条件。在12个月的随访中，与注意力控制组的参与者相比，与研究伴侣发生无保护性交行为的发生率降低了30%;此外，在12个月的随访中，与个体组相比，夫妻组发生相同结果的发生率降低了29%，在12个月的随访中降低了41%。采取以夫妇为基础的办法，处理毒品和性风险，并以低收入的活跃吸毒者为目标，可能有助于遏制艾滋病毒的流行。
Dual threats of injection drug use and risky sexual practices continue to increase transmission of HIV and other sexually transmitted Infections (STIs) among drug-using couples in low-income communities in the United States. Two hypotheses were tested: (1) “intervention effect”—whether the HIV risk-reduction intervention provided to the couple or individual partners would be more efficacious in decreasing number of unprotected sexual acts and having a lower cumulative incidence of biologically confirmed STIs over the 12-month follow-up period compared with the attention control condition; and (2) “modality effect”—whether the HIV risk-reduction intervention would be more likely to decrease the number of unprotected sexual acts and have a lower cumulative STI incidence when delivered to a couple compared with the same intervention delivered to an individual. Using a randomized controlled trial, 282 HIV-negative drug-using couples (564 individuals) were randomly assigned to receive either of the following: (1) couple-based risk reduction; (2) individual-based HIV risk reduction, or (3) couple-based wellness promotion, which served as an attention control condition. Over 12-month follow-up, there was a 30% reduction in the incidence rate of unprotected acts of intercourse with the study partners compared with participants in the attention control arm. Moreover, over 12-month follow-up there was a 29% reduction in the same outcome in the couple arm compared with the individual arm with a 41% reduction at the 12-month follow-up. A couple-based approach that addresses drug and sexual risks and targets low-income active drug users may help curb the HIV epidemic.