Shain Rochelle N, Piper Jeanna M, Holden Alan E C, Champion Jane Dimmitt, Perdue Sondra T, Korte Jeffrey E, Guerra Fernando A
Department of Obstetrics & Gynecology, Microbiology, and School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio Metropolitan Health District, San Antonio, Texas 78229, USA.
Sex Transm Dis. 2004 Jul;31(7):401-8. doi: 10.1097/01.olq.0000135301.97350.84.
Sexually transmitted disease (STD), including AIDS, disproportionately affects African-American and Hispanic women.
To evaluate efficacy of standard and enhanced (addition of optional support groups) gender- and culture-specific, small-group behavioral interventions, compared to interactive STD counseling, in high risk minority women for two years.
Women with a non-viral STD were treated and enrolled in a randomized trial. Follow-up screens and interviews occurred at 6 months, 1 year, 18 months (short interview, optional exam) and 2 years. The primary outcome was subsequent infection with chlamydia and/or gonorrhea. Secondary outcomes included risky sexual behaviors. We employed logistic regression based on intention-to-treat.
Data from 775 women were included; the retention rate was 91%. Adjusted infection rates were higher in the controls in Year 1 (26.8%), Year 2 (23.1%), and cumulatively (39.8%) than in the enhanced (15.4%, P = 0.004; 14.8%, P < 0.03; 23.7%, P < 0.001, respectively) and standard (15.7%, P = 0.006; 14.7%, P = 0.03; 26.2%, P < 0.008, respectively) intervention arms at these time points. Enhanced-intervention women who opted to attend support groups (attendees) had the lowest adjusted infection rates in Year 1 (12.0%) and cumulatively (21.8%). Intervention women in general, but particularly attendees, were significantly less likely than controls to have repeat infections. Multiple partners and unprotected sex with an untreated or incompletely treated partner helped explain group differences in infection.
Risk-reduction interventions significantly decreased both single and multiple infective episodes with chlamydia and/or gonorrhea and risky sexual behaviors in the two-year study period. Support-group attendance appeared to contribute additional risk reduction in Year 1.
包括艾滋病在内的性传播疾病（STD）对非裔美国女性和西班牙裔女性的影响尤为严重。
在高危少数族裔女性中，对比标准的和强化的（增加可选的支持小组）针对性别和文化的小组行为干预措施与交互式STD咨询，评估这两种干预措施在两年内的效果。
对患有非病毒性STD的女性进行治疗并纳入一项随机试验。在6个月、1年、18个月（简短访谈，可选检查）和2年时进行随访筛查和访谈。主要结局是随后感染衣原体和/或淋病。次要结局包括危险性行为。我们采用基于意向性分析的逻辑回归。
纳入了775名女性的数据；保留率为91%。在第1年（26.8%）、第2年（23.1%）以及累计（39.8%）时，对照组的调整感染率高于强化干预组（分别为15.4%，P = 0.004；14.8%，P < 0.03；23.7%，P < 0.001）和标准干预组（分别为15.7%，P = 0.006；14.7%，P = 0.03；26.2%，P < 0.008）。选择参加支持小组的强化干预组女性在第1年（12.0%）和累计（21.8%）时调整感染率最低。总体而言，干预组女性，尤其是参加支持小组的女性，重复感染的可能性显著低于对照组。有多个性伴侣以及与未治疗或未完全治疗的伴侣进行无保护性行为有助于解释感染方面的组间差异。
在为期两年的研究期间，降低风险的干预措施显著减少了衣原体和/或淋病的单次和多次感染发作以及危险性行为。参加支持小组在第1年似乎有助于进一步降低风险。
