Fisher Jeffrey D, Fisher William A, Cornman Deborah H, Amico Rivet K, Bryan Angela, Friedland Gerald H
Department of Psychology, Center for Health/HIV Intervention and Prevention, University of Connecticut, Storrs, CT 06269-1248, USA.
J Acquir Immune Defic Syndr. 2006 Jan 1;41(1):44-52. doi: 10.1097/01.qai.0000192000.15777.5c.
To evaluate the effectiveness of a clinician-delivered intervention, implemented during routine clinical care, in reducing unprotected sexual behavior of HIV-infected patients.
A prospective clinical trial comparing the impact of a clinician-delivered intervention arm vs. a standard-of-care control arm on unprotected sexual behavior of HIV-infected patients.
The 2 largest HIV clinics in Connecticut.
A total of 497 HIV-infected patients, aged > or =18 years, receiving HIV clinical care.
HIV clinical care providers conducted brief client-centered interventions at each clinical encounter that were designed to help HIV-infected patients reduce unprotected sexual behavior.
Unprotected insertive and receptive vaginal and anal intercourse and unprotected insertive oral sex; unprotected insertive and receptive vaginal and anal intercourse only.
HIV-infected patients who received the clinician-delivered intervention showed significantly reduced unprotected insertive and receptive vaginal and anal intercourse and insertive oral sex over a follow-up interval of 18 months (P < 0.05). These behaviors increased across the study interval for patients in the standard-of-care control arm (P < 0.01). For the measure of unprotected insertive and receptive vaginal and anal sex only, there was a trend toward a reduction in unprotected sex among intervention arm participants over time (P < 0.09), and a significant increase in unprotected sex in the standard-of-care control arm (P < 0.01).
A clinician-delivered HIV prevention intervention targeting HIV-infected patients resulted in reductions in unprotected sex. Interventions of this kind should be integrated into routine HIV clinical care.
评估在常规临床护理期间实施的由临床医生提供的干预措施对减少HIV感染患者无保护性行为的有效性。
一项前瞻性临床试验，比较由临床医生提供的干预组与标准护理对照组对HIV感染患者无保护性行为的影响。
康涅狄格州最大的两家HIV诊所。
共有497名年龄≥18岁、接受HIV临床护理的HIV感染患者。
HIV临床护理提供者在每次临床诊疗时进行以患者为中心的简短干预，旨在帮助HIV感染患者减少无保护性行为。
无保护的插入式和接受式阴道及肛交以及无保护的插入式口交；仅无保护的插入式和接受式阴道及肛交。
接受临床医生提供干预措施的HIV感染患者在18个月的随访期内，无保护的插入式和接受式阴道及肛交以及插入式口交显著减少（P<0.05）。在标准护理对照组中，这些行为在研究期间有所增加（P<0.01）。对于仅无保护的插入式和接受式阴道及肛交这一指标，干预组参与者随着时间推移无保护性行为有减少趋势（P<0.09），而标准护理对照组中无保护性行为显著增加（P<0.01）。
针对HIV感染患者的由临床医生提供的HIV预防干预措施可减少无保护性行为。此类干预措施应纳入常规HIV临床护理中。
