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美国男男性行为者的性传播感染预防性行为减少干预的随机对照试验。

Randomised controlled trial of a sexual risk reduction intervention for STI prevention among men who have sex with men in the USA.

机构信息

Human Development and Family Studies, University of Connecticut, Storrs, Connecticut, USA.

Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA.

出版信息

Sex Transm Infect. 2018 Feb;94(1):40-45. doi: 10.1136/sextrans-2016-052835. Epub 2017 Apr 12.

Abstract

OBJECTIVES

Novel interventions to address sexual risk taking and slow rates of STIs are urgently needed, in particular among black men who have sex with men (MSM) in the USA. Serosorting, or limiting condomless sex acts to partners of the same HIV status, is commonly practised among MSM, yet can lead to STI and remains largely unaddressed by public health agencies.

METHODS

A two-arm, randomised controlled trial was conducted from 2012 to 2015. This trial assessed the effects of a single-session, sexual partner selection and risk decision intervention (experimental arm) versus a single-session, Centers for Disease Control and Prevention-based, sexual risk reduction intervention (control arm) on psychosocial measures, sexual risk taking and STI.

RESULTS

At study follow-ups, multiple beneficial changes were observed on sexual risk beliefs measures (ie, changes in serosorting and condom use beliefs, and HIV risk perceptions) and sexual risk taking among the experimental arm relative to the control arm. Overall main effects, however, of the intervention on STI outcomes on year-long follow-ups were non-significant. There was evidence for short-term effects on STI outcomes, and self-report of multiple STIs and STI symptoms demonstrated positive effects over the follow-up period.

CONCLUSIONS

Brief interventions to address sexual risk taking can result in short-term beneficial outcomes and can be incorporated into currently existing infrastructure at healthcare agencies. Additional intervention will be necessary for demonstrating long-term results.

TRIAL REGISTRATION NUMBER

NCT02128594.

摘要

目的

需要新的干预措施来解决性行为风险和性传播感染(STI)传播缓慢的问题,尤其是在美国,与男性发生性关系的黑人男男性行为者(MSM)群体。血清学匹配,即与 HIV 状况相同的伴侣进行无保护性行为,是 MSM 中常见的做法,但可能导致 STI 感染,而且在很大程度上未得到公共卫生机构的重视。

方法

一项为期 2012 年至 2015 年的两臂随机对照试验进行了该研究。该试验评估了单次性伴侣选择和风险决策干预(实验组)与单次基于疾病控制与预防中心的性风险降低干预(对照组)对心理社会指标、性行为风险和 STI 的影响。

结果

在研究随访中,实验组相对于对照组在性行为风险信念措施上观察到了多种有益的变化(即血清学匹配和 condom 使用信念的变化,以及 HIV 风险认知)和性行为风险。然而,干预对 STI 结果的整体主要影响在为期一年的随访中并不显著。有证据表明短期干预对 STI 结果有影响,而且在随访期间,自我报告的多种 STI 和 STI 症状显示出积极的效果。

结论

针对性行为风险的简短干预可以带来短期的有益结果,并可纳入医疗保健机构现有的基础设施中。需要进一步的干预措施来证明长期效果。

试验注册号

NCT02128594。

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