Abstinence and safer sex HIV risk-reduction interventions for African American adolescents - A randomized controlled trial
Abstinence and safer sex HIV risk-reduction interventions for African American adolescents - A randomized controlled trial
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DOI：
10.1001/jama.279.19.1529
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发表时间：
1998-05-20
影响因子：
120.7
通讯作者：
Fong, GT
中科院分区：
文献类型：
--
作者：
Jemmott, JB;Jemmott, LS;Fong, GT
背景。-非洲裔美国青少年感染人类免疫缺陷病毒(HIV)的性传播感染的风险很高，但哪种行为干预措施最有效，以及谁应该进行这些干预尚不清楚。目的-评估禁欲和性行为安全的艾滋病毒降低风险干预措施对市中心年轻的非洲裔青少年艾滋病毒性行为的影响，与同行辅助者相比。设计-随机对照试验，随访3个月、6个月和12个月。设置-费城三所为低收入非洲裔美国人社区提供服务的中学，参与者。-总共659名非裔美国青少年被招募参加周六的项目。干预。-基于认知行为理论和启发研究，干预包括由成人促进者或同伴协助者实施的8个1小时的模块。禁欲干预强调推迟或减少性交的频率；安全性行为干预强调使用避孕套；控制干预涉及与性行为无关的健康问题。主要观察指标。-自我报告的性行为、使用避孕套和无保护的性行为。结果：参与者的平均年龄为11.8岁；53%是女性，92.6%在12个月时仍在登记，禁欲干预者在干预后3个月报告发生性行为的可能性低于对照组参与者(12.5%对21.5%，P=.02)，但在6个月或12个月随访时没有(17.2%对22.7%，P=.14；20.0%对23.1%，P=.42)。在3个月时，安全性行为干预参与者报告的安全套使用一致性显著高于对照组参与者(优势比[OR]=3.38；95%可信区间[CI]，1.25-9.16)，并且在所有随访中使用安全套的频率更高。在报告了基线水平的性行为经历的青少年中，在6个月和12个月的随访中，安全性行为干预组报告的前3个月的性行为少于对照组和禁欲干预组(调整后的平均天数分别为1.34比3.77和3.03；在12个月的随访中P<或等于0.01)，并且在所有的随访中都比对照组少(调整后的平均天数分别为0.04和1.85，P
Context.-African American adolescents are at high risk of contracting sexually transmitted infection with human immunodeficiency virus (HIV), but which behavioral interventions to reduce risk are most effective and who should conduct them is not known.Objective.-To evaluate the effects of abstinence and safer-sex HIV risk-reduction interventions on young inner-city African American adolescents' HIV sexual risk behaviors when implemented by adult facilitators as compared with peer cofacilitators.Design.-Randomized controlled trial with 3-, 6-, and 12-month follow-up.Setting.-Three middle schools serving low-income African American communities in Philadelphia, Pa.Participants.-A total of 659 African American adolescents recruited for a Saturday program.Interventions.-Based on cognitive-behavioral theories and elicitation research, interventions involved 8 1-hour modules implemented by adult facilitators or peer cofacilitators. Abstinence intervention stressed delaying sexual intercourse or reducing its frequency; safer-sex intervention stressed condom use; control intervention concerned health issues unrelated to sexual behavior.Main Outcome Measures.-Self-reported sexual intercourse, condom use, and unprotected sexual intercourse.Results.-Mean age of the enrollees was 11.8 years; 53% were female and 92.6% were still enrolled at 12 months, Abstinence intervention participants were less likely to report having sexual intercourse in the 3 months after intervention than were control group participants (12.5% vs 21.5%, P=.02), but not at 6- or 12-month follow-up (17.2% vs 22.7%, P=.14; 20.0% vs 23.1%, P=.42, respectively). Safer sex intervention participants reported significantly more consistent condom use than did control group participants at 3 months (odds ratio [OR]=3.38; 95% confidence interval [CI], 1.25-9.16) and higher frequency of condom use at all follow ups. Among adolescents who reported sexual experience at baseline, the safer-sex intervention group reported less sexual intercourse in the previous 3 months at 6- and 12-month follow-up than did control and abstinence intervention (adjusted mean days over prior 3 months, 1.34 vs 3.77 and 3.03, respectively; P less than or equal to.01 at 12-month follow-up) and less unprotected intercourse at all follow-ups than did control group (adjusted mean days, 0.04 vs 1.85, respectively, P