Zhang Hong-bo, Zhu Jun-li, Wu Zun-you, Pang Lin, Zhang Ling-lin, Li Tian, Yu Fei, Yang Hong-wu, Zhang Ren-jie, Wang Jun
Department of Maternal and Child Health, School of Public Health, Anhui Medical University, Hefei 230032, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2009 Nov;43(11):970-6.
To determine feasibility and effectiveness of the intervention on HIV/AIDS among MSM based on venues and peer network.
The intervention trial was conducted in Mianyang and Yibin in Sichuan province, where the cultural and social environment were similar. These two cities have no HIV/AIDS intervention conducted yet before this study. The intervention was conducted in Mianyang, while Yibin was regarded as control, in which education materials related HIV/AIDS and VCT service were available. Intervention in Mianyang included MSM venue intervention distributing the education materials, condom and promoting HIV-test and STIs clinic referral by 40 MSM as Popular Opinion Leaders who received the knowledge and intervention skill training.Meanwhile, Popular Opinion Leader intervention was implemented in MSM peer network to advocate safe sex. After 6-month intervention the survey was conducted to assess the effectiveness of intervention.
The scores of knowledge related HIV/STDs and self-efficacy of condom use was 1.293 (95%CI: 0.657 - 1.292, P < 0.05) and 1.556 (95%CI: 0.656 - 2.456, P < 0.05) higher in post-intervention than in pre-intervention which was (12.42 +/- 0.232) and (10.25 +/- 0.327) respectively in Mianyang, while no significant changing in Yibin during the time. Score of knowledge related HIV/STDs increase 0.577 (95%CI: -0.173 - 1.327, P > 0.05) in post-intervention compared with (10.40 +/- 0.412) in pre-intervention and score of self-efficacy of condom use decreased 0.362 from 9.86 +/- 0.547 in pre-intervention (95%CI: -1.458 - 0.534, P > 0.05). In the six months prior to survey, the rate of unprotected sexual intercourse with male casual sexual partners in last 3 times decreased to 11.0% (22/200) (OR(adjusted) = 0.472, 95%CI: 0.265 - 0.841, P < 0.05) from 19.5% (39/200) baseline in Manyang, while in Yibin that increased to 19.0% (38/200) from 17.5% (35/200) in baseline (OR(adjusted) = 1.153, 95%CI: 0.660 - 2.014, P > 0.05). The rate of HIV-test increased significantly from 9.0% (18/200) to 22.0% (44/200) (OR = 2.852, 95%CI: 1.583 - 5.138, P < 0.05) in intervention city and Accordingly in the control, that was 24.5% (29/200) in baseline and 24.0% (28/200) in post-intervention (OR = 0.960, 95%CI: 0.548 - 1.682, P > 0.05). No difference was found in number of male sexual partner pre- and post-intervention both in intervention and control city.
The intervention based on MSM venues and peer network among MSM is feasible and can increase knowledge related HIV/STDs and self-efficacy and as well as condom use and HIV testing.
基于场所和同伴网络确定针对男男性行为者（MSM）的艾滋病病毒/艾滋病干预措施的可行性和有效性。
干预试验在四川省绵阳和宜宾进行，这两个城市文化和社会环境相似，且在本研究之前均未开展过艾滋病病毒/艾滋病干预。干预在绵阳进行，宜宾作为对照，提供与艾滋病病毒/艾滋病及自愿咨询检测服务相关的教育材料。绵阳的干预包括在MSM场所进行干预，分发教育材料、避孕套，并由40名接受过知识和干预技能培训的MSM作为意见领袖促进艾滋病检测及性传播感染门诊转诊。同时，在MSM同伴网络中实施意见领袖干预以倡导安全性行为。干预6个月后进行调查以评估干预效果。
在绵阳，干预后艾滋病病毒/性传播疾病相关知识得分及使用避孕套的自我效能得分分别比干预前高1.293（95%可信区间：0.657 - 1.292，P < 0.05）和1.556（95%可信区间：0.656 - 2.456，P < 0.05），干预前分别为(12.42 ± 0.232)和(10.25 ± 0.327)，而在此期间宜宾无显著变化。与干预前(10.40 ± 0.412)相比，干预后艾滋病病毒/性传播疾病相关知识得分增加0.577（95%可信区间： - 0.173 - 1.327，P > 0.05），使用避孕套的自我效能得分从干预前的9.86 ± 0.547下降0.362（95%可信区间： - 1.458 - 0.534，P > 0.05）。在调查前的六个月中，绵阳与男性临时性伴最近3次无保护性行为的比例从基线的19.5%（39/200）降至11.0%（22/200）（校正OR = 0.472，95%可信区间：0.265 - 0.841，P < 0.05），而在宜宾，该比例从基线的17.5%（35/200）升至19.0%（38/200）（校正OR = 1.153，95%可信区间：0.660 - 2.014，P > 0.05）。干预城市艾滋病检测率从9.0%（18/200）显著升至22.0%（44/200）（OR = 2.852，95%可信区间：1.583 - 5.138，P < 0.05），相应地，对照城市基线时为24.5%（29/200），干预后为24.0%（28/200）（OR = 0.960，95%可信区间：0.548 - 1.682，P > 0.05）。干预城市和对照城市干预前后男性性伴数量均无差异。
基于MSM场所和同伴网络对MSM进行的干预是可行的，可增加艾滋病病毒/性传播疾病相关知识、自我效能以及避孕套使用和艾滋病检测。
