Lim Raymond Boon Tar, Tham Dede Kam Tyng, Tai Bee Choo, Adaikan P Ganesan, Wong Mee Lian
From the *Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation; and †Department of Obstetrics and Gynaecology, Yoo Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.
Sex Transm Dis. 2017 Sep;44(9):539-546. doi: 10.1097/OLQ.0000000000000642.
We assessed the efficacy of a multi-component sexual health promotion program on condom use and human immunodeficiency virus (HIV)/sexually transmitted infection (STI) testing among heterosexual men (HSM) patronizing entertainment establishments who engaged in casual or paid sex in Singapore.
This was a quasi-experimental trial with a comparison group using cross-sectional surveys at baseline and 6 months postintervention. A locality patronized by local HSM was assigned the intervention, a comparable and distant area served as the comparison site. Using time location sampling, cross-sectional samples of these men were assessed on sexual behaviors using an anonymous questionnaire at baseline (n = 604) and 6 months postintervention (n = 360) in both groups. The coprimary outcomes were condom use at last vaginal and oral sex with casual partner respectively. Mixed effects Poisson regression model accounting for clustering by establishment was used to compute the adjusted prevalence ratio (aPR) of the outcomes postintervention.
At postintervention, the intervention group was more likely than the comparison group to report condom use at last vaginal (aPR, 1.41; 95% confidence interval [CI], 1.05-1.89) and oral (aPR, 1.70; 95% CI. 1.11-2.61) sex, respectively, with casual partner. Similar findings were found for consistent condom use in the last 6 months for vaginal (aPR, 1.67; 95% CI, 1.13-2.48) and oral (aPR, 1.97; 95% CI, 1.16-3.32) sex, respectively, with casual partner. The HIV/STI testing was not significantly higher in the intervention than the comparison group (aPR, 1.43; 95% CI, 0.98-2.09).
This trial was effective in promoting condom use with casual partners but not HIV/STI testing among HSM in Singapore.
我们评估了一项多成分性健康促进项目对在新加坡光顾娱乐场所且有随意性行为或有偿性行为的异性恋男性（HSM）使用避孕套及进行人类免疫缺陷病毒（HIV）/性传播感染（STI）检测的效果。
这是一项有对照组的准实验性试验，在基线和干预后6个月进行横断面调查。一个当地HSM常光顾的地区被指定为干预地点，一个可比的较远地区作为对照地点。通过时间地点抽样，在两组的基线（n = 604）和干预后6个月（n = 360）使用匿名问卷对这些男性的性行为进行横断面抽样评估。共同主要结局分别是与临时伴侣进行最后一次阴道性交和口交时使用避孕套的情况。采用考虑场所聚类的混合效应泊松回归模型来计算干预后结局的调整患病率比（aPR）。
干预后，干预组与对照组相比，更有可能分别报告在与临时伴侣进行最后一次阴道性交（aPR，1.41；95%置信区间[CI]，1.05 - 1.89）和口交（aPR，1.70；95% CI，1.11 - 2.61）时使用避孕套。在过去6个月与临时伴侣进行阴道性交（aPR，1.67；95% CI，1.13 - 2.48）和口交（aPR，1.97；95% CI，1.16 - 3.32）时持续使用避孕套也有类似发现。干预组的HIV/STI检测率虽高于对照组，但差异无统计学意义（aPR，1.43；95% CI，0.98 - 2.09）。
该试验在促进新加坡HSM与临时伴侣使用避孕套方面有效，但在促进HIV/STI检测方面无效。
