学校艾滋病健康教育效果的系统评价

A systematic review of school-based health education for HIV prevention among the adolescents in China

目的评价学校艾滋病健康教育对预防青少年感染艾滋病病毒(Human immunodeficiency virus,HIV)的有效性。方法系统检索国内外数据库,手工检索纳入文献的参考文献,检索时间到2011年9月。纳入以感染率或行为指标,评价学校艾滋病健康教育效果的随机对照试验(Randomized controlled trials,RCT)或非随机对照试验(Non-RCT)研究。评价纳入研究的质量后,定量描述结果,对指标进行Meta分析。结果共纳入RCT研究3个,Non-RCT研究1个。Meta分析显示,学校艾滋病健康教育和未干预比较,对青少年性行为的影响无差异,相对危险度(Relative risk,RR)值为1.25,95%可信区间(Confidence interval,CI)为0.77～2.03;学校艾滋病健康教育提高青少年相关知识的效果优于未干预,标准化均数差(Standard mean difference,SMD)为0.63,95%CI为0.15～1.11。结论当前缺乏学校艾滋病健康教育可降低青少年HIV感染的证据,尚无证据表明学校艾滋病健康教育促进青少年行为改变的效果优于未干预。学校健康教育可提高青少年艾滋病相关知识。

Objective To evaluate the effectiveness of school-based health education for HIV prevention among the adolescents in China. Methods Systematic literature search in electronic databases was conducted for randomized controlled trials （RCT） and non-randomized controlled trials （Non-RCT） to assess the effectiveness of school-based health education in reducing HIV infection and risk behaviors of the Chinese adolescents. Relevant research references were also scanned. The search was ended in September of 2011. After assessing methodological quality of the included studies, a quantitative review of the effectiveness of school-based health education related to HIV/AIDS was conducted, and meta-analysis .with available data was carried out by using random-effect model. Results Three RCT and 1 Non-RCT were included in the systematic review. The effect of school-based health education on the prevalence or incidence of HIV infections among the adolescents was not reported in any inellded study. Meta-analysis showed no significant effectiveness of school-based health education for behavioral change among the adolescents in comparison with those who did not receive any intervention （RR= 1.25,95%CI： 0. 77--2.03）. In addition, meta-analysis showed that school-based health education was better increasing HIV related knowledge （SWM= 0.63, 95% CI： 0. 15--1.11） among the adolescents than among those who did not receive any intervention. Conclusion Currently, there is no evidence which shows that school-based health education is better than non-intervention in decreasing HIV infection and risk behaviors among the adolescents. However, school health education is effective in increasing HIV knowledge among adoleccent.