Kegeles S M, Hays R B, Coates T J
Center for AIDS Prevention Studies, University of California, San Francisco 94105, USA.
Am J Public Health. 1996 Aug;86(8):1129-36. doi: 10.2105/ajph.86.8_pt_1.1129.
Since young gay men are engaging in alarmingly high rates of unsafe sex and few seek help for changing risky behaviors, community-level programs to prevent infection with the human immunodeficiency virus (HIV) among them are urgently needed.
We developed and implemented a community-level HIV prevention program in a midsized Oregon community. The peer-led program had three components: out-reach, small groups, and a publicity campaign. Independently from the prevention program, a cohort of young gay men (n = 300) was surveyed in this and in a similar comparison community pre- and postintervention.
Following intervention, the proportion of men engaging in any unprotected anal intercourse decreased from 41.0% to 30.0% (-27% from baseline), decreased from 20.2% to 11.1% (-45% from baseline) with nonprimary partners, and decreased from 58.9% to 44.7% (-24% from baseline) with boyfriends. No significant changes occurred in the comparison community over the same period.
This prevention approach effectively led to HIV risk reduction. To reach risk-taking young gay men, HIV prevention activities must be embedded in social activities and community life.
鉴于年轻男同性恋者进行不安全性行为的比例高得惊人,且很少有人寻求帮助来改变危险行为,因此迫切需要开展社区层面的项目来预防他们感染人类免疫缺陷病毒(HIV)。
我们在俄勒冈州一个中等规模的社区开发并实施了一项社区层面的HIV预防项目。该由同伴主导的项目有三个组成部分:外展、小组活动和宣传活动。在干预前后,独立于预防项目之外,在这个社区以及一个类似的对照社区对一组年轻男同性恋者(n = 300)进行了调查。
干预后,有过任何无保护肛交行为的男性比例从41.0%降至30.0%(较基线下降27%),与非主要性伴发生无保护肛交行为的比例从20.2%降至11.1%(较基线下降45%),与男友发生无保护肛交行为的比例从58.9%降至44.7%(较基线下降24%)。同期对照社区未发生显著变化。
这种预防方法有效地降低了HIV感染风险。为了接触到有风险行为的年轻男同性恋者,HIV预防活动必须融入社交活动和社区生活之中。