Feldblum P J, Kuyoh M A, Bwayo J J, Omari M, Wong E L, Tweedy K G, Welsh M J
Family Health International, Research Triangle Park, North Carolina 27709, USA.
AIDS. 2001 May 25;15(8):1037-44. doi: 10.1097/00002030-200105250-00012.
To measure the impact on sexually transmitted infection (STI) prevalence of a female condom introduction and risk-reduction program at Kenyan agricultural sites.
We conducted a cluster-randomized trial to determine whether a replicable, community-level intervention would reduce STI prevalence.
Six matched pairs of tea, coffee and flower plantations were identified. The six intervention sites received an information/motivation program with free distribution of female and male condoms, and six control sites received only male condoms and related information. Participants were tested for cervical gonorrhea and chlamydia by ligase chain reaction on urine specimens, and vaginal trichomoniasis by culture, at baseline, 6 and 12 months.
Participants at intervention (n = 969) and control sites (n = 960) were similar; baseline STI prevalence was 23.9%. Consistent male condom use was more than 20% at 12 months. Consistent female condom use was reported by 11 and 7% of intervention site women at 6 and 12 months. Unadjusted STI prevalence was 16.5 and 17.4% at 6 months, and 18.3 and 18.5% at 12 months, at the intervention and control sites, respectively. Logistic regression models confirmed the null effect of the female condom intervention.
Female condom introduction did not enhance STI prevention at these sites. It is unclear which aspects of the intervention -- STI education, condom promotion, case management -- were associated with decreased STI prevalence from baseline to follow-up.
评估在肯尼亚农业地区引入女用避孕套及开展风险降低项目对性传播感染（STI）患病率的影响。
我们进行了一项整群随机试验，以确定一项可推广的社区层面干预措施是否能降低STI患病率。
确定了六对匹配的茶叶、咖啡和花卉种植园。六个干预地点接受了信息/宣传项目，并免费发放男用和女用避孕套，六个对照地点仅接受男用避孕套及相关信息。在基线、6个月和12个月时，通过对尿液标本进行连接酶链反应检测宫颈淋病和衣原体感染，并通过培养检测阴道毛滴虫感染。
干预组（n = 969）和对照组（n = 960）的参与者情况相似；基线STI患病率为23.9%。在12个月时，持续使用男用避孕套的比例超过20%。在6个月和12个月时，干预地点分别有11%和7%的女性报告持续使用女用避孕套。在6个月时，干预组和对照组的未调整STI患病率分别为16.5%和17.4%；在12个月时，分别为18.3%和18.5%。逻辑回归模型证实了女用避孕套干预无效果。
在这些地点引入女用避孕套并未增强STI预防效果。尚不清楚干预措施的哪些方面——STI教育、避孕套推广、病例管理——与从基线到随访期间STI患病率的降低有关。
