Melendez Rita M, Hoffman Susie, Exner Theresa, Leu Cheng-Shiun, Ehrhardt Anke A
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York and Columbia University, New York, New York 10032-2695, USA.
Arch Sex Behav. 2003 Dec;32(6):499-511. doi: 10.1023/a:1026081309709.
This study examined the effects of a gender-specific HIV/STD prevention intervention with two dosage levels (four-session, eight-session) among women reporting physical abuse by a current or recent (past year) intimate partner. From 360 women included in the full randomized trial, we conducted subgroup analyses among 152 women who experienced partner physical abuse within the past year. Unprotected vaginal and anal sex occasions and negotiation skills were examined as outcomes. We also assessed whether the intervention increased previously abused women's subsequent risk of physical abuse. Among abused women, those in the eight-session, but not the four-session, intervention decreased their unprotected sex occasions or maintained consistent safer sex at both 1-month (OR = 3.63, 95% CI = 1.50-8.80) and 1-year (OR = 2.88, 95% CI = 1.17-7.10) postintervention. In the short-term, abused women in both the four- and eight-session groups had a greater odds of using an alternative strategy (e.g., refusal, "outercourse," or mutual testing) and of having a safer sex discussion with their partners relative to their controls, and they scored higher on intention to negotiate safer sex. The intervention did not increase or decrease the incidence of subsequent abuse during the 1-year follow-up period. A gender-specific intervention that focuses on negotiation skills in the context of potentially abusive partners benefits, and does not appear to harm, recently abused women.
本研究考察了针对曾遭受现任或近期（过去一年）亲密伴侣身体虐待的女性开展的特定性别艾滋病毒/性传播感染预防干预措施（有四个疗程和八个疗程两个剂量水平）的效果。在纳入完整随机试验的360名女性中，我们对过去一年中遭受伴侣身体虐待的152名女性进行了亚组分析。将无保护的阴道和肛交情况及协商技巧作为结果进行考察。我们还评估了该干预措施是否会增加曾受虐待女性随后遭受身体虐待的风险。在受虐待女性中，接受八个疗程干预的女性（而非接受四个疗程干预的女性）在干预后1个月（比值比=3.63，95%置信区间=1.50 - 8.80）和1年（比值比=2.88，95%置信区间=1.17 - 7.10）时减少了无保护性行为的情况，或保持了持续的更安全性行为。短期内，四个疗程组和八个疗程组中受虐待女性与对照组相比，采用替代策略（如拒绝、“边缘性行为”或相互检测）以及与伴侣进行更安全性行为讨论的几率更高，并且她们在协商更安全性行为的意愿方面得分更高。在1年的随访期内，该干预措施未增加或减少随后虐待事件的发生率。一项针对特定性别的干预措施，在潜在虐待性伴侣的背景下注重协商技巧，对近期受虐待的女性有益且似乎无害。
