Kerrigan Deanna, Barrington Clare, Donastorg Yeycy, Perez Martha, Galai Noya
The Johns Hopkins Bloomberg School of Public Health, 624 N Broadway HH 257, Baltimore, MD, 21205, USA.
The University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.
AIDS Behav. 2016 Sep;20(9):1919-27. doi: 10.1007/s10461-016-1376-z.
Female sex workers (FSW) are disproportionately affected by HIV. Yet, few interventions address the needs of FSW living with HIV. We developed a multi-level intervention, Abriendo Puertas (Opening Doors), and assessed its feasibility and effectiveness among a cohort of 250 FSW living with HIV in the Dominican Republic. We conducted socio-behavioral surveys and sexually transmitted infection and viral load testing at baseline and 10-month follow-up. We assessed changes in protected sex and adherence to antiretroviral therapy (ART) with logistic regression using generalized estimating equations. Significant pre-post intervention changes were documented for adherence (72-89 %; p < 0.001) and protected sex (71-81 %; p < 0.002). Higher intervention exposure was significantly associated with changes in adherence (AOR 2.42; 95 % CI 1.23-4.51) and protected sex (AOR 1.76; 95 % CI 1.09-2.84). Illicit drug use was negatively associated with both ART adherence and protected sex. Abriendo Puertas is feasible and effective in improving behavioral HIV outcomes in FSW living with HIV.
女性性工作者感染艾滋病毒的比例过高。然而，很少有干预措施能满足感染艾滋病毒的女性性工作者的需求。我们开发了一种多层次干预措施“打开大门”，并在多米尼加共和国对250名感染艾滋病毒的女性性工作者队列中评估了其可行性和有效性。我们在基线和10个月随访时进行了社会行为调查以及性传播感染和病毒载量检测。我们使用广义估计方程通过逻辑回归评估了安全性行为和抗逆转录病毒疗法（ART）依从性的变化。干预前后在依从性（72 - 89%；p < 0.001）和安全性行为（71 - 81%；p < 0.002）方面记录到了显著变化。更高的干预暴露与依从性变化（调整后比值比[AOR] 2.42；95%置信区间[CI] 1.23 - 4.51）和安全性行为变化（AOR 1.76；95% CI 1.09 - 2.84）显著相关。非法药物使用与ART依从性和安全性行为均呈负相关。“打开大门”干预措施在改善感染艾滋病毒的女性性工作者的艾滋病毒相关行为结果方面是可行且有效的。
