Jemmott John B, Jemmott Loretta S, O'Leary Ann, Ngwane Zolani, Lewis David A, Bellamy Scarlett L, Icard Larry D, Carty Craig, Heeren G Anita, Tyler Joanne C, Makiwane Monde B, Teitelman Anne
Annenberg School for Communication, University of Pennsylvania.
School of Nursing, University of Pennsylvania.
Health Psychol. 2015 Jun;34(6):610-21. doi: 10.1037/hea0000140. Epub 2014 Aug 11.
Little research has tested HIV/sexually transmitted infection (STI) risk-reduction interventions' effects on early adolescents as they age into middle and late adolescence. This study tested whether intervention-induced reductions in unprotected intercourse during a 12-month period endured over a 54-month period and whether the intervention reduced the prevalence of STIs, which increase risk for HIV.
Grade 6 learners (mean age = 12.4 years) participated in a 12-month trial in Eastern Cape Province, South Africa, in which 9 matched pairs of schools were randomly selected and within pairs randomized to a theory-based HIV/STI risk-reduction intervention or an attention-control intervention. They completed 42- and 54-month postintervention measures of unprotected intercourse (the primary outcome), other sexual behaviors, theoretical constructs, and, at 42- and 54-month follow-up only, biologically confirmed curable STIs (chlamydial infection, gonorrhea, and trichomoniasis) and herpes simplex virus 2.
The HIV/STI risk-reduction intervention reduced unprotected intercourse averaged over the entire follow-up period (OR = 0.42, 95% CI [0.22, 0.84]), an effect not significantly reduced at 42- and 54-month follow-up compared with 3-, 6-, and 12-month follow-ups. The intervention caused positive changes on theoretical constructs averaged over the 5 follow-ups, although most effects weakened at long-term follow-up. Although the intervention's main effect on STIs was nonsignificant, an Intervention Condition × Time interaction revealed that it significantly reduced curable STIs at 42-month follow-up in adolescents who reported sexual experience.
These results suggest that theory-based behavioral interventions with early adolescents can have long-lived effects in the context of a generalized severe HIV epidemic.
很少有研究测试降低艾滋病毒/性传播感染（STI）风险的干预措施对进入青少年中期和晚期的早期青少年的影响。本研究测试了干预措施在12个月期间引起的无保护性行为减少在54个月期间是否持续存在，以及该干预措施是否降低了性传播感染的患病率，性传播感染会增加感染艾滋病毒的风险。
六年级学生（平均年龄 = 12.4岁）参与了南非东开普省的一项为期12个月的试验，从9对匹配的学校中随机选择，每对学校内再随机分为基于理论的艾滋病毒/性传播感染风险降低干预组或注意力控制干预组。他们在干预后42个月和54个月完成了无保护性行为（主要结果）、其他性行为、理论结构的测量，并且仅在42个月和54个月随访时，进行了经生物学确认的可治愈性传播感染（衣原体感染、淋病和滴虫病）和单纯疱疹病毒2的测量。
艾滋病毒/性传播感染风险降低干预措施降低了整个随访期内的平均无保护性行为（比值比 = 0.42，95%可信区间[0.22, 0.84]），与3个月、6个月和12个月随访相比，在42个月和54个月随访时该效果没有显著降低。干预措施在五轮随访的理论结构上引起了积极变化，尽管大多数效果在长期随访中减弱。虽然干预措施对性传播感染的主要影响不显著，但干预条件×时间的交互作用显示，在报告有性经历的青少年中，干预措施在42个月随访时显著降低了可治愈性传播感染。
这些结果表明，在广泛严重的艾滋病毒流行背景下，针对早期青少年的基于理论的行为干预措施可能具有长期效果。
