减少危险关系:一项针对有吸毒史女性减少艾滋病毒性行为风险的监狱干预措施多地点随机试验。

Reducing risky relationships: a multisite randomized trial of a prison-based intervention for reducing HIV sexual risk behaviors among women with a history of drug use.

作者信息

Knudsen Hannah K, Staton-Tindall Michele, Oser Carrie B, Havens Jennifer R, Leukefeld Carl G

机构信息

a Department of Behavioral Science and Center on Drug & Alcohol Research , University of Kentucky , Lexington , KY , USA.

出版信息

AIDS Care. 2014;26(9):1071-9. doi: 10.1080/09540121.2013.878779. Epub 2014 Jan 13.

Abstract

Women involved in the criminal justice system, particularly those with a history of drug use, are at elevated risk of HIV infection, yet few HIV prevention interventions have been tailored for delivery to incarcerated women. Drawing on the Relational Model, the Reducing Risky Relationships for HIV (RRR-HIV) intervention was developed and evaluated in a multisite randomized clinical trial. Women with weekly drug use prior to incarceration (n = 444) who were incarcerated within correctional institutions in four states were randomized to (1) the RRR-HIV intervention consisting of an HIV educational video, five group sessions, and one postrelease booster session or (2) a control condition consisting of the HIV educational video. The RRR-HIV intervention combined didactic and interactive content regarding seven "thinking myths" about intimate relationships that may result in decisions to engage in risky sexual behaviors. Data were collected while women were still incarcerated and approximately 90 days following release from prison by trained interviewers. A negative binomial regression (NBR) model of unprotected sexual behaviors at the 90-day follow-up indicated that RRR-HIV participants reported fewer unprotected sexual behaviors than women in the control condition once the analysis was adjusted for study site. Future studies should examine the sustainability of the RRR-HIV intervention's effect on risk reduction. Implementation research is needed to determine whether delivery of this intervention by correctional staff or peers, rather than research staff, yields similar reductions in unprotected sexual behaviors.

摘要

参与刑事司法系统的女性,尤其是那些有吸毒史的女性,感染艾滋病毒的风险较高,但很少有专门为被监禁女性设计的艾滋病毒预防干预措施。基于关系模型,开发了降低艾滋病毒风险关系(RRR-HIV)干预措施,并在一项多地点随机临床试验中进行了评估。在四个州的惩教机构中被监禁的、入狱前每周吸毒的女性(n = 444)被随机分为两组:(1)RRR-HIV干预组,包括一部艾滋病毒教育视频、五节小组课程和一节出狱后强化课程;(2)对照组,包括这部艾滋病毒教育视频。RRR-HIV干预措施结合了关于亲密关系的七个“思维误区”的教学和互动内容,这些误区可能导致做出从事危险性行为的决定。数据由经过培训的访谈员在女性仍被监禁期间以及出狱后约90天收集。90天随访时对无保护性行为的负二项回归(NBR)模型表明,在对研究地点进行调整分析后,RRR-HIV干预组的参与者报告的无保护性行为比对照组的女性少。未来的研究应检验RRR-HIV干预措施降低风险效果的可持续性。需要进行实施研究,以确定由惩教人员或同伴而非研究人员实施该干预措施是否会在无保护性行为减少方面产生类似效果。

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