RESUMO
OBJECTIVE: To determine feasibility and effectiveness of the intervention on HIV/AIDS among MSM based on venues and peer network. METHODS: The intervention trial was conducted in Mianyang and Yibin in Sichuan province, where the cultural and social environment were similar. These two cities have no HIV/AIDS intervention conducted yet before this study. The intervention was conducted in Mianyang, while Yibin was regarded as control, in which education materials related HIV/AIDS and VCT service were available. Intervention in Mianyang included MSM venue intervention distributing the education materials, condom and promoting HIV-test and STIs clinic referral by 40 MSM as Popular Opinion Leaders who received the knowledge and intervention skill training.Meanwhile, Popular Opinion Leader intervention was implemented in MSM peer network to advocate safe sex. After 6-month intervention the survey was conducted to assess the effectiveness of intervention. RESULTS: The scores of knowledge related HIV/STDs and self-efficacy of condom use was 1.293 (95%CI: 0.657 - 1.292, P < 0.05) and 1.556 (95%CI: 0.656 - 2.456, P < 0.05) higher in post-intervention than in pre-intervention which was (12.42 +/- 0.232) and (10.25 +/- 0.327) respectively in Mianyang, while no significant changing in Yibin during the time. Score of knowledge related HIV/STDs increase 0.577 (95%CI: -0.173 - 1.327, P > 0.05) in post-intervention compared with (10.40 +/- 0.412) in pre-intervention and score of self-efficacy of condom use decreased 0.362 from 9.86 +/- 0.547 in pre-intervention (95%CI: -1.458 - 0.534, P > 0.05). In the six months prior to survey, the rate of unprotected sexual intercourse with male casual sexual partners in last 3 times decreased to 11.0% (22/200) (OR(adjusted) = 0.472, 95%CI: 0.265 - 0.841, P < 0.05) from 19.5% (39/200) baseline in Manyang, while in Yibin that increased to 19.0% (38/200) from 17.5% (35/200) in baseline (OR(adjusted) = 1.153, 95%CI: 0.660 - 2.014, P > 0.05). The rate of HIV-test increased significantly from 9.0% (18/200) to 22.0% (44/200) (OR = 2.852, 95%CI: 1.583 - 5.138, P < 0.05) in intervention city and Accordingly in the control, that was 24.5% (29/200) in baseline and 24.0% (28/200) in post-intervention (OR = 0.960, 95%CI: 0.548 - 1.682, P > 0.05). No difference was found in number of male sexual partner pre- and post-intervention both in intervention and control city. CONCLUSION: The intervention based on MSM venues and peer network among MSM is feasible and can increase knowledge related HIV/STDs and self-efficacy and as well as condom use and HIV testing.
Assuntos
Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Comportamento Sexual , Adolescente , Adulto , China , Humanos , Masculino , Assunção de Riscos , Adulto JovemRESUMO
The men who have sex with men (MSM) population in China has experienced a recent increase in HIV incidence. Due to the dual stigma and discrimination towards homosexuality and HIV infection, most MSM living with HIV/AIDS are hard to reach by offline intervention initiatives. We recruited HIV-positive MSM participants in Chengdu, China and assessed whether they disclosed their HIV status to partners, motivated a partner to receive testing, used condoms consistently, or initiated antiretroviral therapy. Participants were quasi-randomized to either the intervention or control arm. The intervention group was given instructions for an online program with four modules: an information exchange website, a bulletin board system, individualized online counseling with trained peer educators, and an animation game. All participants were re-assessed at 6 months. The study enrolled 202 HIV-positive MSM. The intervention group had significant increases in disclosing their HIV status to their partners (76.0% vs 61.2%, P=0.0388) and motivating partners to accept HIV testing (42.3% vs 25.5%, P=0.0156) compared with the control group, but there were no between-group differences in receiving early treatment or using condoms consistently. We found that a web-based intervention targeting HIV-positive MSM was an effective tool in increasing the uptake of HIV testing within this high-risk population.