Himmich Hakima, Ouarsas Lahoucine, Hajouji Fatima Zahra, Lions Caroline, Roux Perrine, Carrieri Patrizia
Moroccan Association for the Fight against AIDS (ALCS), Casablanca, Morocco.
INSERM, U912 (SESSTIM), Marseille, France.
BMC Infect Dis. 2015 May 5;15:208. doi: 10.1186/s12879-015-0936-6.
Truck drivers constitute an important bridging group in the HIV epidemic in Morocco. This study examined the effect of a community-based educational intervention in Morocco on HIV testing and counseling, in representative samples of truck drivers before (2007) and after (2012) the intervention.
Face-to-face structured interviews, adapted from UNAIDS documents, collected data on socio-demographic characteristics, HIV testing and counseling, and HIV risk behaviors in both the 2007 and 2012 surveys. Information about exposure to the intervention was also collected in the latter. Individuals exposed to the intervention were compared with those unexposed (i.e. unexposed in 2012, and all the 2007 pre-intervention sample).
The 2012 group included 459 men with a median [IQR] age of 38 [31-44] years, 53% of whom reported exposure to the educational intervention. The percentage of participants tested for HIV and receiving HIV counseling in the last 12 months, was significantly higher in the 2012 group (29.6% vs 4.3% in 2007). Data from the 2012 survey confirmed a significant positive trend between being HIV tested and receiving counseling and the number of times a participant was exposed to the intervention (once: (OR = 5.17(2.38-11.25)), twice or more (OR = 19.16(10.33 - 35.53)). These results were confirmed after adjustment for employment, knowledge that the HIV test results would remain confidential, inconsistent condom use with occasional partners or sex workers, and when including individuals from 2007 considered unexposed.
Community-based educational interventions targeting truck drivers can be effective in increasing coverage of HIV testing and counseling, particularly if they are repeated and cover a considerable portion of this at-risk population. These results are encouraging for other countries which urgently need to implement prevention interventions for most-at-risk populations. Furthermore, they clearly show the power of community-based organization interventions in settings where resources for HIV prevention remain limited.
在摩洛哥的艾滋病流行中，卡车司机是一个重要的桥梁群体。本研究在干预前（2007年）和干预后（2012年）对摩洛哥卡车司机的代表性样本进行调查，以检验基于社区的教育干预对艾滋病毒检测和咨询的影响。
根据联合国艾滋病规划署的文件改编的面对面结构化访谈，收集了2007年和2012年调查中关于社会人口学特征、艾滋病毒检测和咨询以及艾滋病毒风险行为的数据。在2012年的调查中还收集了有关接触干预措施的信息。将接触干预措施的个体与未接触的个体（即2012年未接触的个体以及2007年所有干预前样本）进行比较。
2012年的群体包括459名男性，年龄中位数[四分位间距]为38[31 - 44]岁，其中53%报告接触过教育干预。2012年组中在过去12个月接受艾滋病毒检测和咨询的参与者百分比显著高于2007年组（29.6%对2007年的4.3%）。2012年调查的数据证实，进行艾滋病毒检测和接受咨询与参与者接触干预措施的次数之间存在显著的正相关趋势（接触一次：（比值比=5.17（2.38 - 11.25）），接触两次或更多次（比值比=19.16（10.33 - 35.53））。在对就业情况、知晓艾滋病毒检测结果将保密、与偶尔性伴侣或性工作者不一致使用避孕套的情况进行调整后，以及纳入2007年被视为未接触的个体后，这些结果得到了证实。
针对卡车司机的基于社区的教育干预措施在提高艾滋病毒检测和咨询覆盖率方面可能是有效的，特别是如果这些干预措施反复实施并覆盖了相当一部分该高危人群。这些结果对于迫切需要对高危人群实施预防干预措施的其他国家来说是令人鼓舞的。此外，它们清楚地显示了在艾滋病毒预防资源仍然有限的环境中基于社区组织干预措施的力量。
