J Acquir Immune Defic Syndr. 2010 Jun;54(2):204-14. doi: 10.1097/QAI.0b013e3181d61def.
To determine whether community populations in community popular opinion leader intervention venues showed greater reductions in sexual risk practices and lower HIV/sexually transmitted disease (STD) incidence than those in comparison venues.
A 5-country group-randomized trial, conducted from 2002 to 2007, enrolled cohorts from 20 to 40 venues in each country. Venues, matched within country on sexual risk and other factors, were randomly assigned within matched pairs to the community popular opinion leader intervention or an AIDS education comparison. All participants had access to condoms and were assessed with repeated in-depth sexual behavior interviews, STD/HIV testing and treatment, and HIV/STD risk-reduction counseling. Sexual behavior change and HIV/STD incidence were measured over 2 years.
Both intervention and comparison conditions showed declines of approximately 33% in risk behavior prevalence and had comparable diseases incidence within and across countries.
The community-level intervention did not produce greater behavioral risk and disease incidence reduction than the comparison condition, perhaps due to the intensive prevention services received by all participants during the assessment. Repeated detailed self-review of risk behavior practices coupled with HIV/STD testing, treatment, HIV risk-reduction counseling, and condom access can themselves substantially change behavior and disease acquisition.
确定社区中流行意见领袖干预场所的人群与比较场所的人群相比，其性行为风险行为的减少幅度更大，HIV/性传播疾病（STD）发病率更低。
这是一项在 2002 年至 2007 年进行的 5 国群组随机试验，在每个国家招募了 20 到 40 个场所的队列。在性风险和其他因素方面与国家内的其他场所相匹配的场所，在配对内被随机分配到社区流行意见领袖干预组或艾滋病教育对照组。所有参与者都可以获得避孕套，并接受重复的深入性行为访谈、STD/HIV 检测和治疗以及 HIV/STD 风险降低咨询。在 2 年内测量性行为变化和 HIV/STD 发病率。
干预和对照组的风险行为流行率均下降了约 33%，且在国家内和国家间的疾病发病率相当。
社区层面的干预并没有比对照组产生更大的行为风险和疾病发病率降低，这可能是由于所有参与者在评估期间都接受了密集的预防服务。对风险行为实践的反复详细自我审查，加上 HIV/STD 检测、治疗、HIV 风险降低咨询和避孕套的使用，本身就可以极大地改变行为和疾病的发生。
