Weinhardt L S, Carey M P, Johnson B T, Bickham N L
Department of Psychology, Syracuse University, NY 13244-2340, USA.
Am J Public Health. 1999 Sep;89(9):1397-405. doi: 10.2105/ajph.89.9.1397.
This study examined whether HIV counseling and testing leads to reductions in sexual risk behavior.
The meta-analysis included 27 published studies that provided sexual behavior outcome data, assessed behavior before and after counseling and testing, and provided details sufficient for the calculation of effect sizes. The studies involved 19,597 participants.
After counseling and testing, HIV-positive participants and HIV-serodiscordant couples reduced unprotected intercourse and increased condom use more than HIV-negative and untested participants. HIV-negative participants did not modify their behavior more than untested participants. Participants' age, volition for testing, and injection drug use treatment status, as well as the sample seroprevalence and length of the follow-up, explained the variance in results.
HIV counseling and testing appears to provide an effective means of secondary prevention for HIV-positive individuals but, as conducted in the reviewed studies, is not an effective primary prevention strategy for uninfected participants. Theory-driven research with attention given to the context of testing is needed to further explicate the determinants of behavior change resulting from HIV counseling and testing, and the effectiveness of specific counseling approaches.
本研究探讨了艾滋病病毒咨询与检测是否能降低性风险行为。
该荟萃分析纳入了27项已发表的研究，这些研究提供了性行为结果数据，评估了咨询与检测前后的行为，并提供了足以计算效应量的详细信息。这些研究涉及19597名参与者。
咨询与检测后，艾滋病病毒呈阳性的参与者以及血清学结果不一致的伴侣比艾滋病病毒呈阴性且未接受检测的参与者更多地减少了无保护性行为并增加了避孕套的使用。艾滋病病毒呈阴性的参与者与未接受检测的参与者相比，行为改变并不明显。参与者的年龄、检测意愿、注射吸毒治疗状况，以及样本血清阳性率和随访时间，解释了结果的差异。
艾滋病病毒咨询与检测似乎为艾滋病病毒呈阳性的个体提供了一种有效的二级预防手段，但就所审查的研究而言，对未感染的参与者来说并不是一种有效的一级预防策略。需要开展理论驱动的研究，并关注检测背景，以进一步阐明艾滋病病毒咨询与检测导致行为改变的决定因素，以及特定咨询方法的有效性。
