Department of Psychology, College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA.
Sex Transm Dis. 2010 Mar;37(3):140-6. doi: 10.1097/OLQ.0b013e3181c18975.
Although several studies have characterized patterns and predictors of continued risky sexual behavior in HIV-infected rural persons, far less research has evaluated interventions to reduce risky sex in this group. This pilot randomized clinical trial compared 2 brief telephone-administered interventions designed to reduce continued risky sexual behaviors in HIV-infected rural persons.
Participants were 79 HIV-infected rural persons who reported 1 or more occasions of unprotected anal, vaginal, or oral sex in the past 2 months. Participants were recruited through AIDS service organizations in rural areas of 27 states and assigned randomly to either a 2-session, motivational interviewing plus skills-building intervention (i.e., integrated intervention; n = 48) or a 2-session, skills-building only comparison intervention (n = 31). Participants completed self-report measures of sexual behaviors and factors related to risky sex at preintervention and 2-month follow-up.
Before enrolling into the intervention, 37% of participants had 2 or more sexual partners in the past 2 months, 29% had sex with 1 or more partners without knowing their partners' HIV serostatus, and almost one-third of participants located sex partners in high-risk environments (e.g., public parks, roadside rest areas). A 2 x 2 repeated measures multivariate analyses of variance found that integrated intervention participants reported greater increases in risk-reduction motivation and greater increases in condom-protected vaginal and oral intercourse occasions at follow-up compared to skills-building only participants.
Brief telephone-administered interventions that integrate motivational interviewing with skills-building show potential to reduce risky sexual behaviors in HIV-infected rural persons. Additional and large-scale evaluations of this intervention approach appear warranted.
尽管有几项研究已经描述了 HIV 感染者继续发生危险性行为的模式和预测因素，但针对该人群减少高危性行为的干预措施的研究却很少。本试验性随机临床试验比较了两种旨在减少 HIV 感染农村人群继续发生高危性行为的简短电话管理干预措施。
参与者为 79 名报告在过去 2 个月内有 1 次或多次无保护肛交、阴道交或口交的 HIV 感染农村居民。通过艾滋病服务组织在 27 个州的农村地区招募参与者，并随机分配到 2 次、以动机访谈为基础的技能培养干预组（即综合干预组，n=48）或 2 次、仅技能培养比较干预组（n=31）。参与者在干预前和 2 个月随访时完成性行为和与高危性行为相关因素的自我报告测量。
在参加干预措施之前，37%的参与者在过去 2 个月内有 2 个或更多性伴侣，29%与 1 个或多个不知道其 HIV 血清学状况的性伴侣发生性行为，近三分之一的参与者在高风险环境中寻找性伴侣（例如，公园、路边休息区）。2×2 重复测量多元方差分析发现，与仅技能培养组相比，综合干预组参与者在随访时报告的减少风险的动机增加更多，并且避孕套保护的阴道和口腔性交次数增加更多。
简短的电话管理干预措施，将动机访谈与技能培养相结合，显示出减少 HIV 感染农村人群高危性行为的潜力。这种干预方法需要进一步的大规模评估。
