Champion Jane Dimmitt
Department of Family Nursing Care, School of Nursing, The University of Texas Health Science Center at San Antonio, 7703 Floyd C Drive, San Antonio, TX 78230-3900, USA.
Int J STD AIDS. 2007 Nov;18(11):748-53. doi: 10.1258/095646207782212180.
Sexually transmitted infection (STI), including AIDS disproportionately affects minority women with a history of physical or sexual abuse. The objective of this study was to evaluate the efficacy of gender- and culture-specific behavioural interventions and interactive STI counselling for high-risk minority women with a history of physical or sexual abuse over two years. African- and Mexican-American women with a non-viral STI were enrolled in a randomized trial. Follow-up screens and interviews occurred at six months and one and two years. The primary outcome was subsequent infection with chlamydia and/or gonorrhoea. Secondary analysis of primary outcomes was made by self-reported physical or sexual abuse. Logistic regression was utilized on an intention-to-treat basis. Baseline data from 853 women were included; the retention rate was 91%. Infection rates were higher in abused women in Year 1 (29% vs. 23.8%, P=0.12), Year 2 (23.4% vs.17.6%, P=0.03) and cumulatively (43.8% vs. 33.0%, P=0.003). Unadjusted association between abuse and reinfection was stronger for adolescents (<19 years) than adults in Year 1 (42.7% vs. 30.8%, P=0.03), Year 2 (32.7% vs. 22.0%, P=0.03) and cumulatively (59.4% vs. 43.3%, P=0.004). Corresponding rates for adults were Year 1 (17.8% vs. 17.0%, P=0.84), Year 2 (17.4% vs. 12.7%, P=0.23) and cumulatively (30.7% vs. 22.3%, P=0.08). Reinfection rates were further stratified by adolescence and substance use. Abused adolescents had consistently higher reinfection than non-abused adolescents and abused adults. In conclusion, risk-reduction interventions decreased infective episodes with chlamydia and/or gonorrhoea in the two-year study period for non-abused women. Abused women, particularly adolescents and substance users, had increased episodes in these study periods.
性传播感染（STI），包括艾滋病，对有身体或性虐待史的少数族裔女性影响尤为严重。本研究的目的是评估针对有身体或性虐待史的高危少数族裔女性，为期两年的针对性别和文化的行为干预及互动性性传播感染咨询的效果。患有非病毒性性传播感染的非裔和墨西哥裔美国女性被纳入一项随机试验。随访筛查和访谈在六个月以及一年和两年时进行。主要结局是随后感染衣原体和/或淋病。对主要结局的二次分析根据自我报告的身体或性虐待情况进行。在意向性分析的基础上采用逻辑回归。纳入了853名女性的基线数据；保留率为91%。在第1年（29%对23.8%，P = 0.12）、第2年（23.4%对17.6%，P = 0.03）以及累计（43.8%对33.0%，P = 0.003）时，受虐女性的感染率更高。在第1年（42.7%对30.8%，P = 0.03）、第2年（32.7%对22.0%，P = 0.03）以及累计（59.4%对43.3%，P = 0.004）时，青少年（<19岁）受虐与再感染之间未经调整的关联比成年人更强。成年人相应的比率在第1年（17.8%对17.0%，P = 0.84）、第2年（17.4%对12.7%，P = 0.23）以及累计（30.7%对22.3%，P = 0.08）时。再感染率根据青少年和物质使用情况进一步分层。受虐青少年的再感染率始终高于未受虐青少年和受虐成年人。总之，在为期两年的研究期间，降低风险干预措施减少了未受虐女性衣原体和/或淋病的感染发作。在这些研究期间，受虐女性，尤其是青少年和物质使用者，感染发作有所增加。
