DiClemente Ralph J, Wingood Gina M, Rose Eve S, Sales Jessica M, Lang Delia L, Caliendo Angela M, Hardin James W, Crosby Richard A
Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA 30322, USA.
Arch Pediatr Adolesc Med. 2009 Dec;163(12):1112-21. doi: 10.1001/archpediatrics.2009.205.
OBJECTIVES: To evaluate the efficacy of an intervention to reduce incident sexually transmitted disease (STD) and enhance STD/human immunodeficiency virus (HIV)-preventive behaviors and psychosocial mediators. DESIGN: A randomized controlled trial of an HIV prevention program. SETTING: Clinic-based sample in Atlanta, Georgia. PARTICIPANTS: African American adolescent females (N = 715), aged 15 to 21 years, seeking sexual health services. Participants completed an audio computer-assisted self-interview and provided self-collected vaginal specimens for STD testing. Intervention Intervention participants received two 4-hour group sessions and 4 telephone contacts over a 12-month period, targeting personal, relational, sociocultural, and structural factors associated with adolescents' STD/HIV risk, and were given vouchers facilitating male partners' STD testing/treatment. Main Outcome Measure Incident chlamydial infections. RESULTS: Over the 12-month follow-up, fewer adolescents in the intervention had a chlamydial infection (42 vs 67; risk ratio [RR], 0.65; 95% confidence interval [CI], 0.42 to 0.98; P = .04) or recurrent chlamydial infection (4 vs 14; RR, 0.25; 95% CI, 0.08 to 0.83; P = .02). Adolescents in the intervention also reported a higher proportion of condom-protected sex acts in the 60 days preceding follow-up assessments (mean difference, 10.84; 95% CI, 5.27 to 16.42; P < .001) and less frequent douching (mean difference, -0.76; 95% CI, -1.15 to -0.37; P = .001). Adolescents in the intervention were also more likely to report consistent condom use in the 60 days preceding follow-up assessments (RR, 1. 41; 95% CI, 1.09 to 1.80; P = .01) and condom use at last intercourse (RR, 1.30; 95% CI, 1.09 to 1.54; P = .005). Intervention effects were observed for psychosocial mediators of STD/HIV-preventive behaviors. CONCLUSION: Interventions for African American adolescent females can reduce chlamydial infections and enhance STD/HIV-preventive behaviors and psychosocial mediators of STD/HIV-preventive behaviors. Trial Registration clinicaltrials.gov Identifier: NCT00633906.
目的：评估一项干预措施在降低性传播疾病（STD）发病率、增强STD/人类免疫缺陷病毒（HIV）预防行为及心理社会调节因素方面的效果。 设计：一项HIV预防项目的随机对照试验。 地点：佐治亚州亚特兰大市的诊所样本。 参与者：年龄在15至21岁之间、寻求性健康服务的非裔美国青少年女性（N = 715）。参与者完成了一次音频计算机辅助自我访谈，并提供了自行采集的阴道样本用于STD检测。干预措施干预组参与者在12个月内接受了两次为期4小时的小组培训课程以及4次电话随访，内容针对与青少年STD/HIV风险相关的个人、人际关系、社会文化和结构因素，并获得了有助于男性伴侣进行STD检测/治疗的代金券。主要结局指标衣原体感染发病率。 结果：在12个月的随访期内，干预组衣原体感染的青少年较少（42例对67例；风险比[RR]，0.65；95%置信区间[CI]，0.42至0.98；P = 0.04）或衣原体复发感染较少（4例对14例；RR，0.25；95%CI，0.08至0.83；P = 0.02）。干预组青少年在随访评估前60天内报告的使用避孕套性行为比例也更高（平均差异，10.84；95%CI，5.27至16.42；P < 0.001），且冲洗频率较低（平均差异，-0.76；95%CI，-1.15至-0.37；P = 0.001）。干预组青少年在随访评估前60天内报告始终坚持使用避孕套的可能性也更高（RR，1.41；95%CI，1.09至1.80；P = 0.01）以及在最后一次性交时使用避孕套的比例更高（RR，1.30；95%CI，1.09至1.54；P = 0.005）。观察到干预措施对STD/HIV预防行为的心理社会调节因素产生了影响。 结论：针对非裔美国青少年女性的干预措施可降低衣原体感染率，增强STD/HIV预防行为以及STD/HIV预防行为的心理社会调节因素。试验注册clinicaltrials.gov标识符：NCT00633906。
Arch Pediatr Adolesc Med. 2009-12
Arch Pediatr Adolesc Med. 2010-10
Nat Rev Psychol. 2022-2
J Soc Social Work Res. 2020
Int J Environ Res Public Health. 2022-3-8
J Assoc Nurses AIDS Care.
Zotero 插件