针对社区监管下涉毒女性的基于小组的多媒体HIV预防干预措施的效果：“值得”项目
Efficacy of a group-based multimedia HIV prevention intervention for drug-involved women under community supervision: project WORTH.
作者信息
El-Bassel Nabila, Gilbert Louisa, Goddard-Eckrich Dawn, Chang Mingway, Wu Elwin, Hunt Tim, Epperson Matt, Shaw Stacey A, Rowe Jessica, Almonte Maria, Witte Susan
机构信息
Social Intervention Group, Columbia University, New York, New York, United States of America.
School of Social Service Administration, University of Chicago, Chicago, Illinois, United States of America.
出版信息
PLoS One. 2014 Nov 5;9(11):e111528. doi: 10.1371/journal.pone.0111528. eCollection 2014.
IMPORTANCE
This study is designed to address the need for evidence-based HIV/STI prevention approaches for drug-involved women under criminal justice community supervision.
OBJECTIVE
We tested the efficacy of a group-based traditional and multimedia HIV/STI prevention intervention (Project WORTH: Women on the Road to Health) among drug-involved women under community supervision.
DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION: We randomized 306 women recruited from community supervision settings to receive either: (1) a four-session traditional group-based HIV/STI prevention intervention (traditional WORTH); (2) a four-session multimedia group-based HIV/STI prevention intervention that covered the same content as traditional WORTH but was delivered in a computerized format; or (3) a four-session group-based Wellness Promotion intervention that served as an attention control condition. The study examined whether the traditional or multimedia WORTH intervention was more efficacious in reducing risks when compared to Wellness Promotion; and whether multimedia WORTH was more efficacious in reducing risks when compared to traditional WORTH.
MAIN OUTCOMES AND MEASURES
Primary outcomes were assessed over the 12-month post-intervention period and included the number of unprotected sex acts, the proportion of protected sex acts, and consistent condom use. At baseline, 77% of participants reported unprotected vaginal or anal sex (n = 237) and 63% (n = 194) had multiple sex partners.
RESULTS
Women assigned to traditional or multimedia WORTH were significantly more likely than women assigned to the control condition to report an increase in the proportion of protected sex acts (β = 0.10; 95% CI = 0.02-0.18) and a decrease in the number of unprotected sex acts (IRR = 0.72; 95% CI = 0.57-0.90).
CONCLUSION AND RELEVANCE
The promising effects of traditional and multimedia WORTH on increasing condom use and high participation rates suggest that WORTH may be scaled up to redress the concentrated epidemics of HIV/STIs among drug-involved women in the criminal justice system.
TRIAL REGISTRATION
ClinicalTrials.gov NCT01784809.
重要性
本研究旨在满足为处于刑事司法社区监管下的涉毒女性提供循证 HIV/性传播感染预防方法的需求。
目的
我们在社区监管下的涉毒女性中测试了一种基于小组的传统及多媒体 HIV/性传播感染预防干预措施（“值得项目”：健康之路女性项目）的效果。
设计、地点、参与者及干预措施：我们将从社区监管场所招募的 306 名女性随机分组，使其接受以下干预措施之一：（1）为期四节的基于小组的传统 HIV/性传播感染预防干预（传统“值得项目”）；（2）为期四节的基于小组的多媒体 HIV/性传播感染预防干预，其涵盖与传统“值得项目”相同的内容，但以计算机化形式呈现；或（3）为期四节的基于小组的健康促进干预，作为注意力控制组。该研究考察与健康促进相比，传统或多媒体“值得项目”干预在降低风险方面是否更有效；以及与传统“值得项目”相比，多媒体“值得项目”在降低风险方面是否更有效。
主要结局与测量指标
主要结局在干预后的 12 个月期间进行评估，包括无保护性行为的次数、有保护性行为的比例以及持续使用避孕套的情况。在基线时，77%的参与者报告有过无保护的阴道或肛交（n = 237），63%（n = 194）有多个性伴侣。
结果
被分配到传统或多媒体“值得项目”组的女性比被分配到对照组的女性更有可能报告有保护性行为的比例增加（β = 0.10；95%置信区间 = 0.02 - 0.18）以及无保护性行为的次数减少（发病率比值比 = 0.72；95%置信区间 = 0.57 - 0.90）。
结论与意义
传统和多媒体“值得项目”在增加避孕套使用方面的显著效果以及高参与率表明，“值得项目”可能会扩大规模，以解决刑事司法系统中涉毒女性群体中 HIV/性传播感染的集中流行问题。
试验注册
ClinicalTrials.gov NCT01784809。
Zotero 插件