Korte Jeffrey E, Shain Rochelle N, Holden Alan E C, Piper Jeanna M, Perdue Sondra T, Champion Jane D, Sterneckert Kyle
Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, Texas 78229-3900, USA.
Sex Transm Dis. 2004 Mar;31(3):166-73. doi: 10.1097/01.olq.0000115461.50698.55.
Project SAFE, a gender- and culture-specific cognitive-behavioral intervention, was one of the few interventions to have demonstrated a significant reduction in sexually transmitted infections in a randomized, controlled trial.
We evaluated intervention efficacy in 379 Mexican Americans and 170 African Americans; and in a subset of 477 women, explored ethnic differences in the relationships over time between attitudes/beliefs about relationships, reported sexual behavior, and infection.
Women were questioned intensively at baseline, 6, and 12 months. We used stratified analyses and multivariate regression to evaluate ethnic differences and the role of behavior in explaining ethnic differences in infection.
African Americans had higher overall infection rates (29.0% vs. 18.3%) than Mexican Americans, but the intervention efficacy was similar (odds ratios, 0.58 and 0.54, respectively). African Americans reported more douching after sex, less mutual monogamy, and more rapid partner turnover. However, Mexican Americans appeared slightly more likely to have sex with an untreated partner, and there was no difference in risky sex. African Americans reported greater difficulty finding partners and reported attitudes more compatible with nonmonogamy.
Despite substantial ethnic differences in attitudes/beliefs, behaviors, and infection rates, the intervention had a comparable impact on both Mexican American and African American.
“安全计划”（Project SAFE）是一种针对性别和文化的认知行为干预措施，是少数在随机对照试验中证明能显著降低性传播感染率的干预措施之一。
我们评估了该干预措施对379名墨西哥裔美国人和170名非裔美国人的疗效；并在477名女性的子集中，探讨了随着时间推移，在恋爱态度/观念、报告的性行为和感染之间的关系上的种族差异。
在基线、6个月和12个月时对女性进行深入询问。我们使用分层分析和多元回归来评估种族差异以及行为在解释感染方面种族差异的作用。
非裔美国人的总体感染率（29.0%对18.3%）高于墨西哥裔美国人，但干预效果相似（优势比分别为0.58和0.54）。非裔美国人报告性行为后冲洗更多、相互一夫一妻制更少且性伴侣更换更快。然而，墨西哥裔美国人似乎与未接受治疗的性伴侣发生性行为的可能性略高，且在危险性行为方面没有差异。非裔美国人报告在寻找性伴侣方面困难更大，且报告的态度与非一夫一妻制更相符。
尽管在态度/观念、行为和感染率方面存在显著的种族差异，但该干预措施对墨西哥裔美国人和非裔美国人的影响相当。
