Schilling R F, el-Bassel N, Schinke S P, Gordon K, Nichols S
Columbia University School of Social Work, New York, NY 10025.
Public Health Rep. 1991 May-Jun;106(3):297-304.
Although most women infected with HIV are intravenous drug users, some contact the virus through sexual contact with IV drug users. To reach at-risk women, public health officials must develop a range of prevention strategies. One approach, skills training, holds promise as a means of altering risk-related sexual behavior. In this study, 91 women methadone patients were pretested and randomly assigned to an information-only control control group or a skills-building intervention group. Skills-building intervention consisted of five sessions of small groups in which participants identified their own high risk sexual behaviors, discussed their negative associations with condoms, and practiced skills which involved asking partners to use condoms. Compared with members of the control group, respondents in the intervention group reported that they initiated discussion of sexual issues with their partners more frequently, felt more comfortable talking with them about safer sex, and reported using and carrying condoms more frequently. The high rates of attendance and program retention by skills-building participants suggest that such groups may be supportive and useful in the design of risk reduction and drug abuse treatment programs. The modest outcomes of this study underscore the difficulty of altering risk behavior but also serve as a basis for future AIDS prevention studies.
虽然大多数感染艾滋病毒的女性是静脉注射吸毒者,但有些女性是通过与静脉注射吸毒者发生性接触而感染该病毒的。为了接触到有感染风险的女性,公共卫生官员必须制定一系列预防策略。其中一种方法,即技能培训,有望成为改变与风险相关的性行为的一种手段。在这项研究中,91名接受美沙酮治疗的女性患者在进行预测试后被随机分配到仅接受信息的对照组或技能培养干预组。技能培养干预包括五节小组课程,参与者在课程中识别自己的高风险性行为,讨论她们对避孕套的负面看法,并练习向性伴侣提出使用避孕套要求等技能。与对照组成员相比,干预组的受访者报告称,她们更频繁地与伴侣开始讨论性问题,在与伴侣谈论安全性行为时感觉更自在,并且报告更频繁地使用和携带避孕套。参与技能培养的人员出席率和课程留存率很高,这表明此类小组在降低风险和药物滥用治疗项目的设计中可能会起到支持作用且很有用。这项研究的有限成果凸显了改变风险行为的难度,但也为未来的艾滋病预防研究奠定了基础。