Hoffman J A, Klein H, Crosby H, Clark D C
Friends Research Institute--DC, Washington, USA.
J Urban Health. 1999 Dec;76(4):419-34. doi: 10.1007/BF02351500.
Project Neighborhoods in Action was a human immunodeficiency virus (HIV) outreach and intervention program that was conducted with injection drug users and crack users in several inner-city neighborhoods in the District of Columbia. Study participants were placed randomly in either a standard intervention or an enhanced intervention condition, with more than 800 persons being assigned to each group. Drug use frequency dropped from 15.2 days to 12.4 for alcohol (P<.0001), 2.1 days to 1.6 for marijuana (P<.003), 13.0 days to 8.8 days for crack (P<.0001), 2.4 days to 1.5 days for cocaine (P<.0001), 19.7 days to 15.6 for heroin (P<.0001), and 5.2 days to 3.4 for speedball (P<.0001). Drug injecting decreased from an average of 90.8 times to 66.9 (P<.0001), with both direct sharing and indirect sharing rates decreasing significantly as well (from 2.4 to 1.1 times for the former [P<.002] and from 12.0 to 8.1 times for the latter [P<.0004]). The number of sexual partners dropped from a mean of 1.6 to 1.1 (P<.0001). The number of drug-injecting sexual partners went from 0.3 to 0.2 (P<.01). Having sex while high decreased from 11.2 times to 7.9 (P<.0001). Trading sex for drugs and/or money declined from 1.9 times to 1.3 (P<.001). Protected sex increased from 29.5% to 63.7% (P<.0001), and the number of unprotected sexual acts dropped from 9.6 to 7.2 (P<.0001). Only a few differences were observed for standard versus enhanced intervention respondents, with no particular pattern formed. We were left with the impression that the standard intervention and enhanced intervention used in this program were about equally effective at reducing the involvement of drug abusers in HIV-related risky behaviors.
“行动中的社区项目”是一项针对哥伦比亚特区几个市中心社区的注射吸毒者和快克可卡因吸食者开展的人类免疫缺陷病毒（HIV）外展和干预项目。研究参与者被随机分为标准干预组或强化干预组，每组分配了800多人。酒精使用频率从15.2天降至12.4天（P<0.0001），大麻从2.1天降至1.6天（P<0.003），快克可卡因从13.0天降至8.8天（P<0.0001），可卡因从2.4天降至1.5天（P<0.0001），海洛因从19.7天降至15.6天（P<0.0001），速球从5.2天降至3.4天（P<0.0001）。注射毒品的次数从平均90.8次降至66.9次（P<0.000），直接共用和间接共用率也显著下降（前者从2.4次降至1.1次[P<0.002]，后者从12.0次降至8.1次[P<0.0004]）。性伴侣数量从平均1.6人降至1.1人（P<0.0001）。注射毒品的性伴侣数量从0.3人降至0.2人（P<0.01）。吸毒后发生性行为的次数从11.2次降至7.9次（P<0.0001）。以性交易换取毒品和/或金钱的行为从1.9次降至1.3次（P<0.001）。安全性行为从29.5%增至63.7%（P<0.0001），无保护性行为的次数从9.6次降至7.2次（P<0.0001）。标准干预组和强化干预组的受访者之间仅观察到少数差异，未形成特定模式。我们的印象是，该项目中使用的标准干预和强化干预在减少吸毒者参与与HIV相关的危险行为方面效果大致相同。
