%0期刊文章%@ 1438-8871 %I JMIR出版物%V 18%卡塔尔世界杯8强波胆分析 N 7% Pe 195% T基于计算机的咨询计划(CARE+西班牙语)的语言和文化适应，以支持艾滋病毒/艾滋病感染者坚持治疗和降低风险:随机对照试验%A Kurth,Ann E %A Chhun,Nok %A Cleland,Charles M %A Crespo-Fierro,Michele Parés-Avila,José A A Lizcano,John A %A Norman,Robert G %A Shedlin,Michele G %A Johnston,Barbara E %A Sharp,Victoria L %+耶鲁大学护理学院，美国康涅狄格州奥兰治市西校区路400号，邮编06477,1 203 785 2393，ann.kurth@yale.edu %K抗逆转录病毒治疗坚持%K基于计算机的咨询%K文化适应%K HIV %K语言适应%K阳性预防%K技术接受模型%K病毒载量%D 2016 %7 13.07.2016 %9原始论文%J J医学互联网Res %G英语%X背景:美国的人类免疫缺陷病毒(HIV)疾病不成比例地影响少数民族，包括拉丁美洲人。在拉丁美洲人中，包括语言在内的障碍与抗逆转录病毒治疗(ART)依从性较低有关，但抗逆转录病毒治疗和临床就诊依从性干预很少用西班牙语开发或提供。目的:目的是采用一种基于计算机的咨询工具，在英语成年人人群中降低HIV-1病毒载量和性风险传播，用于艾滋病毒阳性的西班牙语人群的常规临床访问(CARE+西班牙语);技术接受模型(TAM)是指导程序开发的理论框架。方法:于2010年6月4日至2012年3月29日进行纵向随机对照试验。参与者从纽约市由三家诊所组成的综合艾滋病毒治疗中心招募。资格标准是(1)成人(年龄≥18岁)，(2)拉丁裔出生或血统，(3)会说西班牙语(单语或多语)，(4)使用抗逆转录病毒药物。线性和广义混合线性效应模型用于分析主要结果，包括抗逆转录病毒治疗依从性、性传播风险行为和HIV-1病毒载量。 Exit interviews were offered to purposively selected intervention participants to explore cultural acceptability of the tool among participants, and focus groups explored the acceptability and system efficiency issues among clinic providers, using the TAM framework. Results: A total of 494 Spanish-speaking HIV clinic attendees were enrolled and randomly assigned to the intervention (arm A: n=253) or risk assessment-only control (arm B, n=241) group and followed up at 3-month intervals for one year. Gender distribution was 296 (68.4%) male, 110 (25.4%) female, and 10 (2.3%) transgender. By study end, 433 of 494 (87.7%) participants were retained. Although intervention participants had reduced viral loads, increased ART adherence and decreased sexual transmission risk behaviors over time, these findings were not statistically significant. We also conducted 61 qualitative exit interviews with participants and two focus groups with a total of 16 providers. Conclusions: A computer-based counseling tool grounded in the TAM theoretical model and delivered in Spanish was acceptable and feasible to implement in a high-volume HIV clinic setting. It was able to provide evidence-based, linguistically appropriate ART adherence support without requiring additional staff time, bilingual status, or translation services. We found that language preferences and cultural acceptability of a computer-based counseling tool exist on a continuum in our urban Spanish-speaking population. Theoretical frameworks of technology’s usefulness for behavioral modification need further exploration in other languages and cultures. Trial Registration: ClinicalTrials.gov NCT01013935; https://clinicaltrials.gov/ct2/show/NCT01013935 (Archived by WebCite at http://www.webcitation.org/6ikaD3MT7) %M 27417531 %R 10.2196/jmir.5830 %U //www.mybigtv.com/2016/7/e195/ %U https://doi.org/10.2196/jmir.5830 %U http://www.ncbi.nlm.nih.gov/pubmed/27417531