Grinstead O A, Gregorich S E, Choi K H, Coates T
Center for AIDS Prevention Studies, University of California, San Francisco, CA 94105, USA.
AIDS. 2001 May 25;15(8):1045-52. doi: 10.1097/00002030-200105250-00013.
The results of the Voluntary HIV-1 Counselling and Testing Efficacy Study support the efficacy and cost-effectiveness of HIV voluntary counselling and testing (VCT) for reducing risk behaviors in three developing countries.
This report explores the social consequences of HIV VCT by examining the incidence of positive and negative life events at the first follow-up (an average of 7.3 months after recruitment). The incidence of positive and negative life events was compared between: (i) those who were randomly assigned to HIV VCT versus health information (HI); (ii) those who tested seronegative and those who tested seropositive; and (iii) those who disclosed their serostatus and those who did not.
The occurrence of most negative life events was rare (0--4%); positive life events were more common (17--39%). With few exceptions, those assigned to HIV VCT were no more likely to experience negative life events than those who were assigned to HI. For individuals, positive serostatus was associated with increased support from health professionals, the break-up of a marriage and being neglected or disowned by their family. Serodiscordant couples with an HIV-positive woman were most likely to report the break-up of a marriage (20 versus 0--7% for other groups) and the break-up of a sexual relationship (45 versus 22--38% for other groups). Disclosure was associated with strengthening of a sexual relationship except for HIV-seropositive women.
These findings, in combination with findings supporting the efficacy and cost-effectiveness of HIV VCT, support the dissemination of HIV VCT with appropriate support services in developing countries.
自愿性HIV-1咨询与检测效果研究的结果支持了HIV自愿咨询与检测（VCT）在三个发展中国家降低危险行为方面的有效性和成本效益。
本报告通过检查首次随访（招募后平均7.3个月）时积极和消极生活事件的发生率，探讨了HIV VCT的社会后果。比较了以下几组之间积极和消极生活事件的发生率：（i）随机分配接受HIV VCT与健康信息（HI）的人群；（ii）检测结果为血清阴性和血清阳性的人群；（iii）披露血清状态和未披露血清状态的人群。
大多数消极生活事件的发生率很低（0 - 4%）；积极生活事件更为常见（17 - 39%）。除少数例外情况外，被分配接受HIV VCT的人群与被分配接受HI的人群相比，经历消极生活事件的可能性并无差异。对于个人而言，血清阳性状态与来自医疗专业人员的支持增加、婚姻破裂以及被家人忽视或抛弃有关。女方为HIV阳性的血清学不一致夫妻最有可能报告婚姻破裂（20%，而其他组为0 - 7%）和性关系破裂（45%，而其他组为22 - 38%）。除了HIV血清阳性女性外，披露血清状态与性关系的加强有关联。
这些发现，连同支持HIV VCT有效性和成本效益的研究结果，支持在发展中国家推广HIV VCT并提供适当的支持服务。
