Leblanc Natalie M, Mitchell Jason W, De Santis Joseph P
School of Nursing and Health Sciences, University of Miami, Florida, USA.
Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA.
J Adv Nurs. 2017 Jul;73(7):1583-1603. doi: 10.1111/jan.13228. Epub 2017 Jan 6.
The aim of this study was to examine the components and use of negotiated safety in the context of HIV prevention and to identify reported factors associated with the concept.
There is an emerging interest in dyadic approaches to address HIV transmission. Although there are theoretical foundations for how interpersonal relationships influence individual behaviour, how these dyadic processes influence on health is still not wholly understood.
Integrative review of empirical and theoretical literature.
The Cumulative Index for Nursing and Allied Health Literature (CINAHL) MEDLINE and PsychINFO electronic databases were accessed.
Articles were read to gain a historical context of the term and identify varying interpretations of the concept. Factors warranting consideration in association with NS were identified and clinical and public health implications were noted.
Forty-eight studies were reviewed. Negotiated safety included the following components: (i) HIV sero-negative concordant men within a primary relationship; (ii) joint HIV screening and mutual disclosure of their HIV status; (iii) explicit relationship boundaries which establish either nonexclusively that allows for the dispensing of condoms within the primary relationship and consistent condom use for extra-dyadic sex; or dispensing of condoms within a primary partnership and exclusivity; and (iv) a breach clause that allows communication to re-establish the agreement if needed.
Negotiated safety is a prescriptive approach to HIV risk reduction among couples. Researchers and practitioners could benefit from promoting this approach to HIV prevention.
本研究旨在探讨在艾滋病预防背景下协商安全的构成要素及应用，并确定与该概念相关的报告因素。
对于采用二元方法解决艾滋病传播问题的兴趣日益浓厚。尽管人际关系如何影响个体行为有理论基础，但这些二元过程如何影响健康仍未完全被理解。
对实证和理论文献进行综合综述。
检索了护理及相关健康文献累积索引（CINAHL）、医学索引数据库（MEDLINE）和心理学文摘数据库（PsychINFO）。
阅读文章以了解该术语的历史背景，并确定对该概念的不同解释。确定了与协商安全相关的需要考虑的因素，并记录了其临床和公共卫生意义。
共综述了48项研究。协商安全包括以下要素：（i）在主要关系中的艾滋病毒血清阴性且一致的男性；（ii）联合艾滋病毒筛查及相互披露艾滋病毒感染状况；（iii）明确的关系界限，即要么建立非排他性的关系，允许在主要关系中使用避孕套，并在与关系外的人发生性行为时持续使用避孕套；要么在主要伴侣关系中使用避孕套并保持排他性；（iv）一个违约条款，允许在需要时通过沟通重新达成协议。
协商安全是一种针对夫妻降低艾滋病风险的规范性方法。研究人员和从业者可从推广这种艾滋病预防方法中受益。
