Environment and Health Group, Cambridge, Massachusetts.
Infectious Diseases Clinic, Traveler's Health Service, Tufts University School of Medicine, Boston, Massachusetts.
Gerontologist. 2020 Aug 14;60(6):1159-1168. doi: 10.1093/geront/gnz098.
Sexually transmitted diseases (STDs) are increasing among older adults concomitant with a rise in divorce after the age of 50 years. The objective of this study was to examine the effectiveness of a web-based human immunodeficiency virus (HIV)/STD risk reduction intervention for divorced and separated women aged more than 50 years.
Two hundred nineteen divorced or separated women, aged 50 years and older, participated in 60-day randomized pre-post control group study. Recruitment occurred via health agencies in Boston and Columbia, SC, and Craigslist advertisements placed in Boston, Columbia, Charleston, New York City, Washington DC, Baltimore, Chicago, Atlanta, Orlando, and Miami.
Intervention group reported greater intention to practice safe sex compared to the control group (B = .55, p = .03). Intention to practice safe sex differed by perceived stress (B = .15, p = .005), with no difference between control and intervention groups for those with low levels of stress. For high levels of stress, intervention group reported greater intention to practice safe sex compared to controls. Sexual risk was reduced by 6.10 points (SD: 1.10), and self-efficacy for sexual discussion was increased by 2.65 points (SD: 0.56) in the intervention group.
A web-based intervention represents a promising tool to reduce HIV/STD risk among older women. Offering HIV/STD education in the context of other topics of interest to at-risk older women, such as divorce, may solve the problem of at-risk older women not seeking out prevention information due to lack of awareness of their heightened risk.
性传播疾病(STDs)在 50 岁以上的成年人中呈上升趋势,同时离婚率也在上升。本研究的目的是检验一种基于网络的人类免疫缺陷病毒(HIV)/性传播疾病(STD)风险降低干预措施对 50 岁以上离婚和分居女性的有效性。
219 名 50 岁及以上离婚或分居的女性参加了为期 60 天的随机对照预-后研究。招募工作是通过波士顿和南卡罗来纳州哥伦比亚的卫生机构以及波士顿、哥伦比亚、查尔斯顿、纽约市、华盛顿特区、巴尔的摩、芝加哥、亚特兰大、奥兰多和迈阿密的 Craigslist 广告进行的。
与对照组相比,干预组报告的安全性行为意向更大(B =.55,p =.03)。安全性行为意向因感知压力而异(B =.15,p =.005),对于压力水平较低的人,对照组和干预组之间没有差异。对于高压力水平的人,干预组报告的安全性行为意向大于对照组。性风险降低了 6.10 分(标准差:1.10),性讨论的自我效能感提高了 2.65 分(标准差:0.56)在干预组中。
基于网络的干预措施代表了一种减少老年女性 HIV/STD 风险的有前途的工具。在其他与高危老年女性相关的话题(如离婚)的背景下提供 HIV/STD 教育,可能会解决高危老年女性由于缺乏对自身风险增加的认识而不寻求预防信息的问题。