The efficacy of a network intervention to reduce HIV risk behaviors among drug users and risk partners in Chiang Mai, Thailand and Philadelphia, USA.
The efficacy of a network intervention to reduce HIV risk behaviors among drug users and risk partners in Chiang Mai, Thailand and Philadelphia, USA.
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DOI：
10.1016/j.socscimed.2008.11.019
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发表时间：
2009-02
影响因子：
5.4
通讯作者：
Celentano, David D.
中科院分区：
文献类型：
--
作者：
Latkin, Carl A.;Donnell, Deborah;Metzger, David;Sherman, Susan;Aramrattna, Apinun;Davis-Vogel, Annet;Quan, Vu Minh;Gandham, Sharavi;Vongchak, Tasanai;Perdue, Tom;Celentano, David D.
关键词：
这项HIV预防试验网络（HPTN）研究评估了网络为导向的同伴教育干预在泰国清迈和美国费城的注射吸毒者及其毒品和性网络成员中促进降低HIV风险的效果。我们招募了414个网络，共1123名参与者，其中204个网络随机分配到治疗组，210个网络随机分配到对照组。实验干预包括6个2小时的小组同伴教育者会议和2个促进会议。随访每6个月进行一次，持续30个月。在基线和随访期间，报告注射危险行为的参与者人数在两个地点和两个手臂都显著下降。费城实验条件下的网络在统计上显著减少了高风险注射行为：共用棉花减少了46%，共用炊具减少了44%，前后装载减少了47%与不熟悉的人一起注射减少了51%。在泰国，干预对风险行为没有显著影响。研究结果表明，注射吸毒者不仅可以减少自己的注射风险行为，而且还可以发挥关键的社区作用，帮助其注射网络成员减少HIV注射风险行为。这项艾滋病毒预防试验网络研究评估了以网络为导向的同伴教育干预在泰国清迈和美国费城的注射吸毒者及其毒品和性网络成员中促进降低艾滋病毒风险的效果。该研究旨在测试对HIV感染的影响，但感染率低，研究提前终止。本文报道了自我报告的艾滋病毒风险行为的疗效。我们招募了414个网络，1123名参与者。实验干预包括六个小组同伴教育者培训课程和两个仅针对网络索引的辅助课程。两组的所有参与者都接受了单独的艾滋病毒咨询和检测。随访每6个月进行一次，持续30个月。10例HIV血清转化，每组5例。报告注射危险行为的参与者人数在基线和随访期间显著下降。与对照组相比，干预组的指数成员在干预后参与了更多关于艾滋病毒风险的对话（OR = 1.42, p = 0.004）。没有证据表明干预措施改变了性风险。观察到注射风险行为的减少：共用棉花、漂洗水和炊具的几率分别减少37%、20%和26%，在别人之后使用注射器的几率减少24%。对各个站点的分析表明，费城站点的注射风险行为有所减少。在这两个地点，干预导致注射吸毒者参与讨论减少艾滋病毒注射风险行为的社区角色。干预并未导致自我报告的性风险行为的总体减少，尽管观察到注射风险行为的减少，但降低风险的总体效果尚未确定。
This HIV Prevention Trials Network (HPTN) study assessed the efficacy of a network oriented peer education intervention to promote HIV risk reduction among injection drug users and their drug and sexual network members in Chiang Mai, Thailand and Philadelphia, US. We enrolled 414 networks with 1123 participants, with 204 networks randomized to the treatment condition and 210 to the control. The experimental intervention consisted of six 2-hour small group peer-educator sessions and two booster sessions. Follow-up visits occurred every six months for up to 30 months. The number of participants reporting injection risk behaviors dropped dramatically between baseline and follow-up in both sites and both arms. The networks in the experimental condition in Philadelphia sustained statistically significant reductions in high risk injection behaviors: a 46% reduction in sharing cottons, 44% reduction in sharing cookers, 47% reduction in front and back loading and 51% reduction in injecting with people not known very well. There were no significant effects associated with the intervention on risk behaviors in Thailand. The study results demonstrates that not only can IDUs reduce their own injection risk behaviors, but they can also engage in the critical community role of assisting their injection network members to reduce HIV injection risk behaviors. This HIV Prevention Trials Network study assessed the efficacy of a network-oriented peer education intervention promoting HIV risk reduction among injection drug users and their drug and sexual network members in Chiang Mai, Thailand and Philadelphia, USA. The study was designed to test impact on HIV infection, but the infection rate was low and study was terminated early. This paper reports efficacy on outcomes of self-reported HIV risk behaviors. We enrolled 414 networks with 1123 participants. The experimental intervention consisted of six small group peer-educator training sessions and two booster sessions delivered to the network index only. All participants in both arms received individual HIV counseling and testing. Follow-up visits occurred every six months for up to 30 months. There were 10 HIV seroconversions, 5 in each arm. The number of participants reporting injection risk behaviors dropped dramatically between baseline and follow-up in both arms at both sites. Index members in the intervention arm engaged in more conversations about HIV risk following the intervention compared to control indexes (OR = 1.42, p = 0.004). There was no evidence of change in sexual risk as a result of the intervention. Reductions in injection risk behaviors were observed: 37%, 20%, and 26% reduction in odds of sharing cottons, rinse water and cookers respectively, and 24% reduction in using a syringe after someone else. Analysis of the individual sites suggested a pattern of reductions in injection risk behaviors in the Philadelphia site. In both sites, the intervention resulted in index IDUs engaging in the community role of discussing reduction in HIV injection risk behaviors. The intervention did not result in overall reductions in self reported sexual risk behaviors, and although reductions in injection risk behaviors were observed, the overall efficacy in reducing risk was not established.
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影响因子：
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作者：
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通讯作者：
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影响因子：
120.7
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DOI：
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影响因子：
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DOI：
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发表时间：
2002-10-01
影响因子：
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作者：
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通讯作者：
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DOI：
10.1097/01.qai.0000179431.42284.3e
发表时间：
2006-02-01
影响因子：
3.6
作者：
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