Sikkema K J, Kelly J A, Winett R A, Solomon L J, Cargill V A, Roffman R A, McAuliffe T L, Heckman T G, Anderson E A, Wagstaff D A, Norman A D, Perry M J, Crumble D A, Mercer M B
Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, USA.
Am J Public Health. 2000 Jan;90(1):57-63. doi: 10.2105/ajph.90.1.57.
Women in impoverished inner-city neighborhoods are at high risk for contracting HIV. A randomized, multisite community-level HIV prevention trial was undertaken with women living in 18 low-income housing developments in 5 US cities.
Baseline and 12-month follow-up population risk characteristics were assessed by surveying 690 women at both time points. In the 9 intervention condition housing developments, a community-level intervention was undertaken that included HIV risk reduction workshops and community HIV prevention events implemented by women who were popular opinion leaders among their peers.
The proportion of women in the intervention developments who had any unprotected intercourse in the past 2 months declined from 50% to 37.6%, and the percentage of women's acts of intercourse protected by condoms increased from 30.2% to 47.2%. Among women exposed to intervention activities, the mean frequency of unprotected acts of intercourse in the past 2 months tended to be lower at follow-up (mean = 4.0) than at baseline (mean = 6.0). These changes were corroborated by changes in other risk indicators.
Community-level interventions that involve and engage women in neighborhood-based HIV prevention activities can bring about reductions in high-risk sexual behaviors.
生活在贫困市中心社区的女性感染艾滋病毒的风险很高。在美国5个城市的18个低收入住房开发区,对居住在那里的女性进行了一项随机、多地点的社区层面艾滋病毒预防试验。
通过在两个时间点对690名女性进行调查,评估基线和12个月随访时的人群风险特征。在9个干预条件住房开发区,开展了社区层面的干预措施,包括减少艾滋病毒风险研讨会以及由在同龄人中具有广泛影响力的女性实施的社区艾滋病毒预防活动。
在干预开发区中,过去2个月内有过任何无保护性行为的女性比例从50%降至37.6%,女性性行为中使用避孕套保护的比例从30.2%增至47.2%。在接受干预活动的女性中,过去2个月无保护性行为的平均频率在随访时(平均=4.0)往往低于基线时(平均=6.0)。其他风险指标的变化也证实了这些改变。
让女性参与基于社区的艾滋病毒预防活动的社区层面干预措施,可以减少高危性行为。