TY - JOUR AU - Kuringe, Evodius AU - Christensen, Alice AU - Materu, Jacqueline AU - Drake, Mary AU - Majani, Esther AU - Casalini, Caterina AU - Mjungu, Deusdedit AU - Mbita, Gaspar AU - Kalage, Esther AU - Komba, Albert AU - Nyato, Daniel AU - Nnko, Soori AU - Shao, Amani AU - Changalucha, John AU - Wambura，Mwita PY - 2022 DA - 2022/9/19 TI -现金转移与艾滋病预防联合干预措施在减少坦桑尼亚少女和年轻妇女的高危性行为方面的有效性:聚类随机对照试验JO - JMIR公共卫生监测SP - e30372 VL - 8 IS - 9kw -青少年KW -女性KW -艾滋病毒感染/流行病学KW -艾滋病毒感染/预防和控制KW -单纯疱疹病毒2型KW -发病率KW -动机KW -坦桑尼亚AB -背景:贫困和社会不平等加剧了撒哈拉以南非洲少女和年轻妇女(AGYW)的艾滋病毒风险。现金转移可以影响健康的结构性决定因素，从而降低艾滋病毒风险。目的:本研究评估了现金转移与艾滋病预防(CHP)联合干预措施在坦桑尼亚减少AGYW高危性行为方面的有效性。单纯疱疹病毒2型(HSV-2)感染的发生率被用作性风险行为的代理。方法:在坦桑尼亚Shinyanga地区的3个阶层(城市、农村高风险人群和农村低风险人群)的15对匹配的社区(1:1干预控制)中进行了一项聚类随机对照试验。目标人群是15-23岁的校外老年男性，他们已经完成了10小时的社会和行为改变沟通课程。符合条件的社区被随机分配接受CHP，并按季度进行现金转移(干预组)或仅接受CHP干预(对照组)，不加掩饰。研究招募和基线调查于2017年10月30日至2017年12月1日进行。 Participants completed an audio computer-assisted self-interview, HIV counselling and testing, and HSV-2 testing at baseline and during follow-up visits at 6, 12, and 18 months after the baseline survey. A Cox proportional hazards model with random effects specified at the level of clusters (shared frailty) adjusted for matching pairs and other baseline imbalances was fitted to assess the effects of cash transfer on the incidence of HSV-2 infection (primary outcome). Secondary outcomes included HIV prevalence at follow-up, self-reported intergenerational sex, and self-reported compensated sex. All secondary outcomes were measured at each study visit. Results: Of the 3026 AGYW enrolled in the trial (1482 in the intervention and 1544 in the control), 2720 AGYW (1373 in the intervention and 1347 in the control) were included in the final analysis. Overall, HSV-2 incidence was not significantly different at all follow-up points between the study arms in the adjusted analysis (hazard ratio 0.96, 95% CI 0.67-1.38; P=.83). However, HSV-2 incidence was significantly lower in the rural low-risk populations who received the cash transfer intervention (hazard ratio 0.45, 95% CI 0.29-0.71; P=.001), adjusted for potential confounders. Conclusions: Although this trial showed no significant impact of the cash transfer intervention on HSV-2 incidence among AGYW overall, the intervention significantly reduced HSV-2 incidence among AGYW in rural low-risk communities. Factors such as lesser poverty and more asset ownership in urban and rural high-risk communities may have undermined the impact of cash transfer. Trial Registration: ClinicalTrials.gov NCT03597243; https://clinicaltrials.gov/show/NCT03597243 SN - 2369-2960 UR - https://publichealth.www.mybigtv.com/2022/9/e30372 UR - https://doi.org/10.2196/30372 UR - http://www.ncbi.nlm.nih.gov/pubmed/36121686 DO - 10.2196/30372 ID - info:doi/10.2196/30372 ER -