Amirkhanian Yuri A, Kelly Jeffrey A, Takacs Judit, McAuliffe Timothy L, Kuznetsova Anna V, Toth Tamas P, Mocsonaki Laszlo, DiFranceisco Wayne J, Meylakhs Anastasia
aCenter for AIDS Intervention Research (CAIR), Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA bBotkin Hospital for Infectious Diseases, St. Petersburg, Russia cCentre for Social Sciences, Hungarian Academy of Sciences dHatter Society for LGBT People, Budapest, Hungary.
AIDS. 2015 Mar 13;29(5):583-93. doi: 10.1097/QAD.0000000000000558.
To test a novel social network HIV risk-reduction intervention for MSM in Russia and Hungary, where same-sex behavior is stigmatized and men may best be reached through their social network connections.
A two-arm trial with 18 sociocentric networks of MSM randomized to the social network intervention or standard HIV/STD testing/counseling.
St. Petersburg, Russia and Budapest, Hungary.
Eighteen 'seeds' from community venues invited the participation of their MSM friends who, in turn, invited their own MSM friends into the study, a process that continued outward until eighteen three-ring sociocentric networks (mean size = 35 members, n = 626) were recruited.
Empirically identified network leaders were trained and guided to convey HIV prevention advice to other network members.
Changes in sexual behavior from baseline to 3-month and 12-month follow-up, with composite HIV/STD incidence, measured at 12 months to corroborate behavior changes.
There were significant reductions between baseline, first follow-up, and second follow-up in the intervention versus comparison arm for proportion of men engaging in any unprotected anal intercourse (UAI) (P = 0.04); UAI with a nonmain partner (P = 0.04); and UAI with multiple partners (P = 0.002). The mean percentage of unprotected anal intercourse acts significantly declined (P = 0.001), as well as the mean number of UAI acts among men who initially had multiple partners (P = 0.05). Biological HIV/STD incidence was 15% in comparison condition networks and 9% in intervention condition networks.
Even where same-sex behavior is stigmatized, it is possible to reach MSM and deliver HIV prevention through their social networks.
在俄罗斯和匈牙利对男男性行为者（MSM）测试一种新型社交网络降低HIV风险干预措施，在这些国家，同性行为受到污名化，通过社交网络联系可能最易接触到男性。
双臂试验，将18个以社会为中心的男男性行为者网络随机分为社交网络干预组或标准HIV/性传播感染检测/咨询组。
俄罗斯圣彼得堡和匈牙利布达佩斯。
来自社区场所的18名“种子”邀请其男男性行为者朋友参与，这些朋友又邀请自己的男男性行为者朋友加入研究，这一过程向外持续，直到招募到18个三环以社会为中心的网络（平均规模 = 35名成员，n = 626）。
对经实证确定的网络领导者进行培训和指导，以便向其他网络成员传达HIV预防建议。
从基线到3个月和12个月随访期间性行为的变化，以及12个月时测量的HIV/性传播感染综合发病率，以证实行为变化。
干预组与对照组相比，在基线、首次随访和第二次随访之间，进行任何无保护肛交（UAI）的男性比例（P = 0.04）；与非主要性伴进行UAI的比例（P = 0.04）；以及与多个性伴进行UAI的比例（P = 0.002）均有显著下降。无保护肛交行为的平均百分比显著下降（P = 0.001），最初有多个性伴的男性中UAI行为的平均次数也显著下降（P = 0.05）。在对照条件网络中，HIV/性传播感染的生物学发病率为15%，在干预条件网络中为9%。
即使在同性行为受到污名化的地方，也有可能接触到男男性行为者并通过其社交网络开展HIV预防工作。
