Mary Ellen Mackesy-Amiti, Judith A Levy, Casey M Luc, Jonbek Jonbekov
{"title":"MASLIHAT 艾滋病预防干预措施减少了莫斯科注射毒品的塔吉克男性移民的性传播感染。","authors":"Mary Ellen Mackesy-Amiti, Judith A Levy, Casey M Luc, Jonbek Jonbekov","doi":"10.1101/2024.08.15.24312070","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In a cluster-randomized controlled trial, the \"Migrants' Approached Self-Learning Intervention in HIV/AIDS for Tajiks\" (MASLIHAT) reduced intervention participants' sexual risk behaviour including any condomless sex, condomless sex with female sex workers, and multiple sexual partners. This analysis investigates if observed changes in sexual risk behaviors translated into fewer reported STIs among participants over 12-month follow-up.</p><p><strong>Methods: </strong>The MASLIHAT intervention was tested in a cluster-randomized controlled trial with sites assigned to either the MASLIHAT intervention or comparison health education training (TANSIHAT). Participants and network members (n=420) were interviewed at baseline and 3-month intervals for one year to assess HIV/STI sex and drug risk behaviour. We conducted mixed effects robust Poisson regression analyses to test for differences between conditions in self-reported STIs during 12 months of follow-up, and to test the contribution of sexual risk behaviours to STI acquisition. We then tested the mediating effects of sexual behaviours during the first six months following the intervention on STIs reported at the 9 and 12-month follow-up interviews.</p><p><strong>Results: </strong>Participants in the MASLIHAT condition were significantly less likely to report an STI during follow-up (IRR=0.27, 95% CI 0.13-0.58). Condomless sex with a non-main (casual or commercial) partner was significantly associated with STI acquisition (IRR=2.30, 95% CI 1.26-4.21). Adjusting for condomless sex with a non-main partner, the effect of MASLIHAT intervention participation was reduced (IRR=0.36, 95% CI 0.16-0.80), signalling possible mediation. Causal mediation analysis indicated that the intervention's effect on reported STI was partially mediated by reductions among MASLIHAT participants in condomless sex with a non-main partner.</p><p><strong>Conclusions: </strong>The MASLIHAT peer-education intervention reduced reported STIs among Tajik labour migrants partly through reduced condomless sex with casual and commercial partners.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov , 2021-04-16, NCT04853394 .</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343258/pdf/","citationCount":"0","resultStr":"{\"title\":\"Peer Education Intervention Reduced Sexually Transmitted Infections Among Male Tajik Labor Migrants Who Inject Drugs: Results of a Cluster-randomized Controlled Trial.\",\"authors\":\"Mary Ellen Mackesy-Amiti, Judith A Levy, Casey M Luc, Jonbek Jonbekov\",\"doi\":\"10.1101/2024.08.15.24312070\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In a cluster-randomized controlled trial, the \\\"Migrants' Approached Self-Learning Intervention in HIV/AIDS for Tajiks\\\" (MASLIHAT) reduced intervention participants' sexual risk behaviour including any condomless sex, condomless sex with female sex workers, and multiple sexual partners. This analysis investigates if observed changes in sexual risk behaviors translated into fewer reported STIs among participants over 12-month follow-up.</p><p><strong>Methods: </strong>The MASLIHAT intervention was tested in a cluster-randomized controlled trial with sites assigned to either the MASLIHAT intervention or comparison health education training (TANSIHAT). Participants and network members (n=420) were interviewed at baseline and 3-month intervals for one year to assess HIV/STI sex and drug risk behaviour. We conducted mixed effects robust Poisson regression analyses to test for differences between conditions in self-reported STIs during 12 months of follow-up, and to test the contribution of sexual risk behaviours to STI acquisition. We then tested the mediating effects of sexual behaviours during the first six months following the intervention on STIs reported at the 9 and 12-month follow-up interviews.</p><p><strong>Results: </strong>Participants in the MASLIHAT condition were significantly less likely to report an STI during follow-up (IRR=0.27, 95% CI 0.13-0.58). Condomless sex with a non-main (casual or commercial) partner was significantly associated with STI acquisition (IRR=2.30, 95% CI 1.26-4.21). Adjusting for condomless sex with a non-main partner, the effect of MASLIHAT intervention participation was reduced (IRR=0.36, 95% CI 0.16-0.80), signalling possible mediation. Causal mediation analysis indicated that the intervention's effect on reported STI was partially mediated by reductions among MASLIHAT participants in condomless sex with a non-main partner.</p><p><strong>Conclusions: </strong>The MASLIHAT peer-education intervention reduced reported STIs among Tajik labour migrants partly through reduced condomless sex with casual and commercial partners.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov , 2021-04-16, NCT04853394 .</p>\",\"PeriodicalId\":94281,\"journal\":{\"name\":\"medRxiv : the preprint server for health sciences\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-12-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343258/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"medRxiv : the preprint server for health sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1101/2024.08.15.24312070\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"medRxiv : the preprint server for health sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1101/2024.08.15.24312070","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的：在莫斯科工作期间注射毒品的塔吉克男性劳工移民感染艾滋病毒和性传播疾病（STI）的风险很高，这会损害他们及其性伴侣的健康。在一项分组随机对照试验中，"塔吉克斯坦移民艾滋病自学干预方法"（MASLIHAT）减少了干预参与者的性风险行为，包括无套性行为、与女性性工作者（CS/FSW）的无套性行为以及多个性伴侣。本分析调查了干预措施对性风险行为的影响是否会在 12 个月的随访中转化为参与者性传播感染发病率的降低：MASLIHAT干预措施在一项分组随机对照试验中进行了测试，试验地点被分配给MASLIHAT干预措施或对比健康教育培训（TANSIHAT）。对参与者和网络成员（420 人）进行了为期一年的基线访谈和每隔三个月的访谈，以评估 HIV/STI性行为和毒品风险行为。在目前的分析中，我们仅关注性传播感染，并进行了混合效应稳健泊松回归分析，以检验 12 个月随访期间不同情况下自我报告的性传播感染的差异，并检验性风险行为对性传播感染的影响。结构方程模型研究了性行为可能对两种情况下观察到的性传播感染感染率差异的中介作用：结果：MASLIHAT条件下的参与者在随访期间报告性传播感染的可能性明显较低（IRR=0.27，95% CI 0.13-0.58）。在 3 种相关的性风险行为中，只有 CS/FSW 与性传播感染的发生有显著相关性（IRR=3.30，95% CI 1.57-3.93）。对 CS/FSW 进行调整后，MASLIHAT 干预参与的影响降低了（IRR=0.37，95% CI 0.17-0.84），表明可能存在中介作用。结构方程模型表明，干预对性传播感染发病率的影响是通过 MASLIHAT 参与者 CS/FSW 的减少而产生的：MASLIHAT 同伴教育干预措施通过减少 CS/FSW 降低了塔吉克移民劳工的性传播感染率。
Peer Education Intervention Reduced Sexually Transmitted Infections Among Male Tajik Labor Migrants Who Inject Drugs: Results of a Cluster-randomized Controlled Trial.
Background: In a cluster-randomized controlled trial, the "Migrants' Approached Self-Learning Intervention in HIV/AIDS for Tajiks" (MASLIHAT) reduced intervention participants' sexual risk behaviour including any condomless sex, condomless sex with female sex workers, and multiple sexual partners. This analysis investigates if observed changes in sexual risk behaviors translated into fewer reported STIs among participants over 12-month follow-up.
Methods: The MASLIHAT intervention was tested in a cluster-randomized controlled trial with sites assigned to either the MASLIHAT intervention or comparison health education training (TANSIHAT). Participants and network members (n=420) were interviewed at baseline and 3-month intervals for one year to assess HIV/STI sex and drug risk behaviour. We conducted mixed effects robust Poisson regression analyses to test for differences between conditions in self-reported STIs during 12 months of follow-up, and to test the contribution of sexual risk behaviours to STI acquisition. We then tested the mediating effects of sexual behaviours during the first six months following the intervention on STIs reported at the 9 and 12-month follow-up interviews.
Results: Participants in the MASLIHAT condition were significantly less likely to report an STI during follow-up (IRR=0.27, 95% CI 0.13-0.58). Condomless sex with a non-main (casual or commercial) partner was significantly associated with STI acquisition (IRR=2.30, 95% CI 1.26-4.21). Adjusting for condomless sex with a non-main partner, the effect of MASLIHAT intervention participation was reduced (IRR=0.36, 95% CI 0.16-0.80), signalling possible mediation. Causal mediation analysis indicated that the intervention's effect on reported STI was partially mediated by reductions among MASLIHAT participants in condomless sex with a non-main partner.
Conclusions: The MASLIHAT peer-education intervention reduced reported STIs among Tajik labour migrants partly through reduced condomless sex with casual and commercial partners.
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