McCusker J, Willis G, McDonald M, Sereti S M, Lewis B F, Sullivan J L
Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital Centre, Montreal, Quebec, Canada.
J Community Health. 1996 Feb;21(1):11-22. doi: 10.1007/BF01682760.
HIV counselling and testing was provided to 4267 individuals between September 1987 and June 1992 at a multi-site program, including community clinics, drug treatment programs, and a men's prison in central Massachusetts. Half of those tested reported the risk behaviors targeted by the programs: injection drug use (38.1%) and sexual contact with a drug injector (12.6%). The objectives of this study were to examine 1) factors associated with repeat HIV testing among these initially seronegative, and 2) behavior change following counselling and testing. Initially 7.4% were HIV positive, and 12.4% of those testing negative were retested within one year. Risk behavior was the only strong independent predictor of retesting (odds ratios of 3.8 and 4.2 for men reporting sex with men and recent drug injectors, respectively). Changes in risk behaviors between the time of the initial test and the second test were assessed (n = 207). Among those who continued to inject drugs at follow-up there was a reduction in the percent visiting shooting galleries (p = 0.05); no other significant behavior changes were reported. While selection bias may be responsible in part for the minimal behavior change observed, continued monitoring of risk behavior and counselling are warranted.
1987年9月至1992年6月期间，在一个多地点项目中，为4267人提供了艾滋病病毒咨询和检测服务，该项目包括社区诊所、药物治疗项目以及马萨诸塞州中部的一所男子监狱。接受检测的人中，有一半报告了该项目所针对的风险行为：注射吸毒（38.1%）以及与注射吸毒者发生性接触（12.6%）。本研究的目的是：1）调查这些最初血清学检测呈阴性者中与重复进行艾滋病病毒检测相关的因素；2）咨询和检测后的行为变化。最初，7.4%的人艾滋病病毒呈阳性，检测呈阴性的人中有12.4%在一年内接受了重新检测。风险行为是重新检测的唯一有力独立预测因素（与男性发生性行为者和近期注射吸毒者重新检测的优势比分别为3.8和4.2）。评估了初次检测和第二次检测期间风险行为的变化（n = 207）。在随访中继续注射毒品的人中，前往射击馆的百分比有所下降（p = 0.05）；未报告其他显著的行为变化。虽然观察到的最小行为变化可能部分归因于选择偏倚，但仍有必要持续监测风险行为并提供咨询服务。
