Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98105, USA.
Addiction. 2010 Jan;105(1):100-8. doi: 10.1111/j.1360-0443.2009.02812.x.
In a previous report, the effectiveness of the Real Men Are Safe (REMAS) intervention in reducing the number of unprotected sexual occasions among male drug abuse treatment patients was demonstrated. A secondary aim of REMAS was to reduce the frequency with which men engage in sex under the influence (SUI) of drugs or alcohol.
Men in methadone maintenance (n = 173) or out-patient psychosocial treatment (n = 104) completed assessments at baseline, 3 and 6 months post-intervention.
The participants were assigned randomly to attend either REMAS (five sessions containing information, motivational exercises and skills training, including one session specifically targeting reducing SUI) or human immunodeficiency virus (HIV) education (HIV-Ed; one session containing HIV prevention information). SUI during the most recent sexual event served as the primary outcome in a repeated measures logistic regression model.
Men assigned to the REMAS condition reporting SUI at the most recent sexual event decreased from 36.8% at baseline to 25.7% at 3 months compared to a increase from 36.9% to 38.3% in the HIV-Ed condition (t(intervention) = -2.16, P = 0.032). No difference between the treatment groups was evident at 6-month follow-up. At each assessment time-point, sex with a casual partner versus a regular partner, and being in methadone maintenance versus psychosocial out-patient treatment, were associated with engaging in SUI.
Overall, a motivational and skills training HIV prevention intervention designed for men was associated with greater reduction in SUI than standard HIV education at the 3-month follow-up.
在之前的报告中，已经证明了 Real Men Are Safe（REMAS）干预措施在减少男性药物滥用治疗患者无保护性行为次数方面的有效性。REMAS 的次要目标是减少男性在药物或酒精影响下发生性行为的频率。
接受美沙酮维持治疗的男性（n = 173）或门诊心理社会治疗的男性（n = 104）在干预前、干预后 3 个月和 6 个月进行评估。
参与者被随机分配参加 REMAS（五节包含信息、动机练习和技能培训的课程，其中一节专门针对减少 SUI）或人类免疫缺陷病毒（HIV）教育（HIV-Ed；一节包含 HIV 预防信息的课程）。最近一次性行为中的 SUI 作为重复测量逻辑回归模型的主要结局。
在最近一次性行为中报告 SUI 的 REMAS 组男性从基线时的 36.8%下降到 3 个月时的 25.7%，而 HIV-Ed 组从 36.9%增加到 38.3%（干预 t 值= -2.16，P = 0.032）。在 6 个月随访时，两组之间没有差异。在每个评估时间点，与随意伴侣发生性行为而不是与固定伴侣发生性行为，以及接受美沙酮维持治疗而不是接受门诊心理社会治疗，与发生 SUI 有关。
总体而言，针对男性设计的动机和技能培训 HIV 预防干预措施与标准 HIV 教育相比，在 3 个月随访时与 SUI 减少更相关。
