Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, United Kingdom.
PLoS One. 2023 May 24;18(5):e0284324. doi: 10.1371/journal.pone.0284324. eCollection 2023.
STIs in older adults (adults aged 50 years and older) are on the rise due to variable levels of sex literacy and misperceived susceptibility to infections, among other factors. We systematically reviewed evidence on the effect of non-pharmacological interventions for the primary prevention of sexually transmitted infections (STIs) and high-risk sexual behaviour in older adults.
We searched EMBASE, MEDLINE, PSYCINFO, Global Health and the Cochrane Library from inception until March 9th, 2022. We included RCTs, cluster-randomised trials, quasi-RCTs, interrupted time series (ITS) and controlled and uncontrolled before-and-after studies of non-pharmacological primary prevention interventions (e.g. educational and behaviour change interventions) in older adults, reporting either qualitative or quantitative findings. At least two review authors independently assessed the eligibility of articles and extracted data on main characteristics, risk of bias and study findings. Narrative synthesis was performed.
Ten studies (two RCTs, seven quasi-experiment studies and one qualitative study) were found to be eligible for this review. These interventions were mainly information, education and communication activities (IECs) aimed at fostering participants' knowledge on STIs and safer sex, mostly focused on HIV. Most studies used self-reported outcomes measuring knowledge and behaviour change related to HIV, STIs and safer sex. Studies generally reported an increase in STI/HIV knowledge. However, risk of bias was high or critical across all studies.
Literature on non-pharmacological interventions for older adults is sparse, particularly outside the US and for STIs other than HIV. There is evidence that IECs may improve short-term knowledge about STIs however, it is not clear this translates into long-term improvement or behaviour change as all studies included in this review had follow-up times of 3 months or less. More robust and higher-quality studies are needed in order to confirm the effectiveness of non-pharmacological primary prevention interventions for reducing STIs in the older adult population.
由于性知识水平参差不齐和对感染的误解等因素，老年人（50 岁及以上的成年人）中的性传播感染（STI）正在上升。我们系统地回顾了关于非药物干预措施预防老年人 STI 和高危性行为的效果的证据。
我们从开始到 2022 年 3 月 9 日在 EMBASE、MEDLINE、PSYCINFO、全球卫生和 Cochrane 图书馆中进行了搜索。我们纳入了 RCT、整群随机试验、准 RCT、中断时间序列（ITS）和对照及未对照的非药物初级预防干预措施（例如教育和行为改变干预）的研究，报告了定性或定量结果。至少两名综述作者独立评估了文章的资格，并提取了主要特征、偏倚风险和研究结果的数据。进行了叙述性综合。
发现 10 项研究（2 项 RCT、7 项准实验研究和 1 项定性研究）符合本综述的条件。这些干预措施主要是信息、教育和沟通活动（IECs），旨在提高参与者对 STI 和安全性行为的知识，主要针对 HIV。大多数研究使用自我报告的结果来衡量与 HIV、STI 和安全性行为相关的知识和行为变化。研究普遍报告 STI/HIV 知识有所增加。然而，所有研究的偏倚风险都很高或关键。
关于老年人非药物干预措施的文献很少，特别是在美国以外和 HIV 以外的 STI 方面。有证据表明，IEC 可能会提高短期 STI 知识，但尚不清楚这是否会转化为长期改善或行为改变，因为本综述中纳入的所有研究的随访时间都在 3 个月或更短。需要更有力和更高质量的研究来证实非药物初级预防干预措施在减少老年人群中的 STI 方面的有效性。
Zotero 插件