合肥市男男性行为者同伴群干预降低艾滋病高危行为队列研究

A peer group intervention on HIV-risk behavior among men who have sex with men in Hefei: A prospective cohort study

目的探讨"发起人主导-同伴驱动相结合的"同伴群干预模式对降低男男性行为人群HIV高危行为的作用。方法采用同伴驱动方法招募过去12个月中有过肛交或口交的MSM,建立同伴群干预队列。通过培训同伴群中的"发起人"和MSM志愿者,由他们组织实施4个主题的干预活动(行为危险评估、行为改变计划、行为改变实践和经验分享),干预时间为2个月。通过比较干预前和干预结束第3个月干预对象艾滋病知识和性行为等变化,评估同伴群干预对降低MSM人群HIV高危行为的作用。结果 127名MSM参加干预研究,干预结束第3个月随访到106人,随访率为83.5%。干预对象艾滋病知识由干预前(14.9±2.419)提高到干预后的(17.6±1.343)分,差异有统计学意义;最近3次与男性性伴、男性固定性伴、男性性伴发生肛交行为时,安全套使用率分别由干预前的60.1%、48.4%和51.3%,提高到评估调查时的70.3%、54.2%和66.7%,差异均有统计学意义;最近1次与男性性伴、男性固定性伴发生无保护肛交行为报告率干预前为34.9%、42.5%,干预后下降到17.0%、26.4%,差异均有统计学意义。结论 "发起人主导-同伴驱动相结合"的同伴群干预可降低MSM人群无保护肛交行为。

Objective To explore effect of the ＂ Initiator - Leading and Respondent - Driven＂ group intervention on HIV - risk behavior among MSM. Methods The cohort study based on MSM peer group was conducted through respondent driven sampling in Hefei. Totally, 127 eligible MSM were recruited to participate in intervention study by the initiators lead-ing and their peers referring. Firstly, initiators and volunteers were trained. Secondly, 4 - sessions peer group intervention was carried out by initiators and volunteers among their peer groups within two months. Lastly, all participants were asked to complete self - administrated questionnaire both at pre - and post - intervention. Results Of 127 participants, 106 were followed up at 3 month after intervention and the rate of follow up was 83. 5% . The score of HIV/STDs related knowledge of participants increased from 14. 93 ±2. 419 to 17. 60 ± I. 343 after 2 - month intervention. The rates of condom use during last three sexual episodes with male primary sexual partners,male casual sexual partners and male sexual partners increased from 60. 1% , 48. 4% and 51. 3% at baseline to 70. 3% , 54. 2% and 66. 7% at follow up respectively t while the rate of unprotected anal sex during last sex episode with male primary sexual partners and male casual sexual partners decreased from 34. 9% and 42. 5% at baseline to 17. 0% and 26. 4% at follow up respectively. Conclusion The ＂ Initiator - Lead-ing and Respondent - driven＂ group intervention could decrease the unprotected anal sex among MSM.