Clinic-based intervention reduces unprotected sexual behavior among HIV-infected patients in KwaZulu-Natal, South Africa: results of a pilot study.
Clinic-based intervention reduces unprotected sexual behavior among HIV-infected patients in KwaZulu-Natal, South Africa: results of a pilot study.
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DOI：
10.1097/qai.0b013e31817bebd7
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发表时间：
2008-08-15
期刊：
影响因子：
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通讯作者：
Fisher JD
中科院分区：
文献类型：
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作者：
Cornman DH;Kiene SM;Christie S;Fisher WA;Shuper PA;Pillay S;Friedland GH;Thomas CM;Lodge L;Fisher JD
评估南非夸祖鲁-纳塔尔省辅导员在常规临床护理期间向艾滋病毒感染者提供的艾滋病毒预防干预措施的可行性、保真度和有效性。共有 152 名年龄在 18 岁及以上的艾滋病毒感染者在南非一家城市医院接受临床护理，他们被随机分配到干预组或标准护理控制顾问组。干预顾问在每次临床接触时实施简短的风险降低干预，以帮助患者减少无保护的性行为。在基线和 6 个月时进行自我报告调查问卷，以评估前 3 个月内无保护性行为的数量。 99% 的例行患者就诊均实施了干预措施，包括 8 个干预步骤中的 8 个干预步骤。尽管两种情况下的 HIV 感染患者在 6 个月的随访中报告的阴道性交和肛交事件比基线时更多，但接受咨询师提供干预的患者报告，随着时间的推移，无保护性行为的数量显着减少。在标准护理控制条件下，这些事件的发生率略有增加。由咨询师提供的针对艾滋病毒感染者的艾滋病毒预防干预措施似乎可以在南非临床护理环境中忠实地实施，并且可以有效减少无保护的性行为。
Evaluate the feasibility, fidelity, and effectiveness of an HIV prevention intervention delivered to HIV-infected patients by counselors during routine clinical care in KwaZulu-Natal, South Africa. Total of 152 HIV-infected patients, aged 18 years and older, receiving clinical care at an urban hospital in South Africa, were randomly assigned to intervention or standard-of-care control counselors. Intervention counselors implemented a brief risk reduction intervention at each clinical encounter to help patients reduce their unprotected sexual behavior. Self-report questionnaires were administered at baseline and 6 months to assess number of unprotected sex events in previous 3 months. Intervention was delivered in 99% of routine patient visits, and included a modal 8 of 8 intervention steps. Although HIV-infected patients in both conditions reported more vaginal and anal sex events at 6-month follow-up than at baseline, patients who received the counselor-delivered intervention reported a significant decrease over time in number of unprotected sexual events. There was a marginally significant increase in these events among patients in the standard-of-care control condition. A counselor-delivered HIV prevention intervention targeting HIV-infected patients appears to be feasible to implement with fidelity in the South African clinical care setting and effective at reducing unprotected sexual behavior.