Peer counselling versus standardâ ofâ care on reducing highâ risk behaviours among newly diagnosed HIVâ positive men who have sex with men in Beijing, China: a randomized intervention study
Liu, Yu; Vermund, Sten H; Ruan, Yuhua; Liu, Hongjie; Rivet Amico, K; Simoni, Jane M; Shepherd, Bryan E; Shao, Yiming; Qian, Han‐zhu
2018-02
Citation
Liu, Yu; Vermund, Sten H; Ruan, Yuhua; Liu, Hongjie; Rivet Amico, K; Simoni, Jane M; Shepherd, Bryan E; Shao, Yiming; Qian, Han‐zhu (2018). "Peer counselling versus standardâ ofâ care on reducing highâ risk behaviours among newly diagnosed HIVâ positive men who have sex with men in Beijing, China: a randomized intervention study." Journal of the International AIDS Society (2): n/a-n/a.
Abstract
IntroductionReducing highâ risk behaviours (i.e. multiple partnership, condomless anal/vaginal sex, alcohol use before sex, illicit drug use) after HIV diagnosis is critical for curtailing HIV transmission. We designed an intervention to explore peerâ counselling in reducing highâ risk behaviours among newly diagnosed HIVâ positive Chinese men who have sex with men (MSM).MethodsWe randomized 367 newly diagnosed HIVâ positive men to either standardâ ofâ care (SOC; n = 183) or peerâ counselling intervention (n = 184), and followed them for 12 months (visit at 0â , 3â , 6â , 9â and 12â month). SOC participants received counselling on highâ risk behaviour reduction by clinic staff. Intervention participants received both SOC and peer counselling. A generalized estimating equation was used to compare preâ post diagnosis highâ risk behaviour change; logistic regression was used to assess the likelihood of practicing highâ risk behaviours between intervention and SOC participants. Both intentâ toâ treat and perâ protocol (fullâ dosage) approaches were used for the analyses.ResultsFor preâ and postâ diagnosis comparisons, multiple partnership fell from 50% to 16% (p < 0.001), alcohol use before sex from 23% to 9% (p = 0.001), illicit drug use from 33% to 6% (p < 0.001), condomless anal sex from 47% to 4% (insertive from 23% to 2%; receptive from 36% to 3%; p < 0.001). In the intentâ toâ treat analysis accounting for repeated measures, peer counselling was more likely to reduce insertive anal sex (AOR = 0.65; 95% CI: 0.45 to 0.94), condomless anal sex (AOR = 0.27; 95% CI: 0.10 to 0.64) and illicit drug use (AOR = 0.32; 95% CI: 0.16 to 0.64). In the perâ protocol analysis, peer counselling was associated with a lower likelihood of using illicit drug (OR = 0.23; 95% CI: 0.07 to 0.81) and having condomless vaginal sex with women (OR = 0.12; 95% CI: 0.07 to 0.98).ConclusionsWe observed a 14 to 43% decrease in the prevalence of selected highâ risk behaviours after HIV diagnosis. Peer counselling had a greater impact in reducing condomless anal sex with men, illicit drug use and condomless vaginal sex with women over time. Future studies with exclusive peerâ counselling arm are necessary to test its efficacy and effectiveness among Chinese MSM.Clinical Trial Number: NCT01904877Publisher
Springer Wiley Periodicals, Inc.
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1758-2652 1758-2652
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