Abstract：
OBJECTIVE: This study assessed the effectiveness of HERMITAGE (HIV\'s Evolution in Russia-Mitigating Infection Transmission and Alcoholism in a Growing Epidemic), an adapted secondary HIV prevention intervention, compared with an attention control condition in decreasing sexually transmitted infections (STIs) and sex and drug risk behaviors among Russian HIV-infected heavy drinkers.
METHODS: We conducted a single-blinded, two-armed, randomized controlled trial with 12-month follow-up.
METHODS: The study was conducted in St Petersburg, Russia. Participants were recruited from four HIV and addiction clinical sites. The intervention was conducted at Botkin Infectious Disease Hospital.
METHODS: HIV-infected individuals with past 6-month risky sex and heavy alcohol consumption (n = 700) were randomized to the HERMITAGE intervention (n = 350) or an attention control condition (n = 350).
METHODS: A Healthy Relationships Intervention stressing disclosure of HIV serostatus and condom use, adapted for a Russian clinical setting with two individual sessions and three small group sessions.
METHODS: The primary outcome was incident STI by laboratory test at 12-month follow-up. Secondary outcomes included change in unprotected sex and several alcohol and injection drug use (IDU) variables.
RESULTS: Participants had the following baseline characteristics: 59.3% male, mean age 30.1, 60.4% past year IDU, 15.4% prevalent STI and mean CD4 cell count 413.3/μl. Assessment occurred among 75 and 71% of participants at 6 and 12 months, respectively. STIs occurred in 20 subjects (8.1%) in the intervention group and 28 subjects (12.0%) in the control group at 12-month follow-up; logistic regression analyses found no significant difference between groups (adjusted odds ratio 0.63; 95% confidence interval = 0.34-1.18; P = 0.15). Both groups decreased unsafe behaviors, although no significant differences were found between groups.
CONCLUSIONS: The HERMITAGE HIV risk reduction intervention does not appear to reduce sexually transmitted infections and HIV risk behaviors in Russian HIV-infected heavy drinkers compared with attention controls.
METHODS: We conducted a single-blinded, two-armed, randomized controlled trial with 12-month follow-up.
METHODS: The study was conducted in St Petersburg, Russia. Participants were recruited from four HIV and addiction clinical sites. The intervention was conducted at Botkin Infectious Disease Hospital.
METHODS: HIV-infected individuals with past 6-month risky sex and heavy alcohol consumption (n = 700) were randomized to the HERMITAGE intervention (n = 350) or an attention control condition (n = 350).
METHODS: A Healthy Relationships Intervention stressing disclosure of HIV serostatus and condom use, adapted for a Russian clinical setting with two individual sessions and three small group sessions.
METHODS: The primary outcome was incident STI by laboratory test at 12-month follow-up. Secondary outcomes included change in unprotected sex and several alcohol and injection drug use (IDU) variables.
RESULTS: Participants had the following baseline characteristics: 59.3% male, mean age 30.1, 60.4% past year IDU, 15.4% prevalent STI and mean CD4 cell count 413.3/μl. Assessment occurred among 75 and 71% of participants at 6 and 12 months, respectively. STIs occurred in 20 subjects (8.1%) in the intervention group and 28 subjects (12.0%) in the control group at 12-month follow-up; logistic regression analyses found no significant difference between groups (adjusted odds ratio 0.63; 95% confidence interval = 0.34-1.18; P = 0.15). Both groups decreased unsafe behaviors, although no significant differences were found between groups.
CONCLUSIONS: The HERMITAGE HIV risk reduction intervention does not appear to reduce sexually transmitted infections and HIV risk behaviors in Russian HIV-infected heavy drinkers compared with attention controls.
摘要：
目的：这项研究评估了HERMITAGE（俄罗斯HIV的进化-在不断增长的流行病中减轻感染传播和酒精中毒）的有效性，适应的二级艾滋病毒预防干预，与注意控制条件相比，在俄罗斯感染艾滋病毒的重度饮酒者中减少性传播感染（STIs）以及性和药物风险行为。
方法：我们进行了单盲，双臂,12个月随访的随机对照试验。
方法：这项研究在圣彼得堡进行，俄罗斯。参与者来自四个HIV和成瘾临床站点。干预在Botkin传染病医院进行。
方法：过去6个月危险性行为和大量饮酒的HIV感染者（n=700）被随机分配到HERMITAGE干预（n=350）或注意控制条件（n=350）。
方法：健康关系干预强调披露艾滋病毒血清状况和使用避孕套，适应俄罗斯的临床环境，有两个单独的会议和三个小组会议。
方法：主要结果是12个月随访时实验室检测的性传播感染。次要结果包括无保护性行为的变化以及一些酒精和注射药物使用（IDU）变量。
结果：参与者具有以下基线特征：59.3％的男性，平均年龄30.1岁，去年IDU为60.4%，15.4%普遍STI和平均CD4细胞计数413.3/μl。在6个月和12个月时，75％和71％的参与者进行了评估。分别。在12个月的随访中，干预组的20名受试者（8.1％）和对照组的28名受试者（12.0％）发生了性传播感染；逻辑回归分析发现两组之间没有显着差异（调整后的比值比0.63；95％置信区间=0.34-1.18；P=0.15）。两组都减少了不安全行为，尽管组间没有发现显著差异。
结论：与注意对照组相比，在俄罗斯感染HIV的重度饮酒者中，HERMITAGEHIV风险降低干预似乎并未减少性传播感染和HIV风险行为。
方法：我们进行了单盲，双臂,12个月随访的随机对照试验。
方法：这项研究在圣彼得堡进行，俄罗斯。参与者来自四个HIV和成瘾临床站点。干预在Botkin传染病医院进行。
方法：过去6个月危险性行为和大量饮酒的HIV感染者（n=700）被随机分配到HERMITAGE干预（n=350）或注意控制条件（n=350）。
方法：健康关系干预强调披露艾滋病毒血清状况和使用避孕套，适应俄罗斯的临床环境，有两个单独的会议和三个小组会议。
方法：主要结果是12个月随访时实验室检测的性传播感染。次要结果包括无保护性行为的变化以及一些酒精和注射药物使用（IDU）变量。
结果：参与者具有以下基线特征：59.3％的男性，平均年龄30.1岁，去年IDU为60.4%，15.4%普遍STI和平均CD4细胞计数413.3/μl。在6个月和12个月时，75％和71％的参与者进行了评估。分别。在12个月的随访中，干预组的20名受试者（8.1％）和对照组的28名受试者（12.0％）发生了性传播感染；逻辑回归分析发现两组之间没有显着差异（调整后的比值比0.63；95％置信区间=0.34-1.18；P=0.15）。两组都减少了不安全行为，尽管组间没有发现显著差异。
结论：与注意对照组相比，在俄罗斯感染HIV的重度饮酒者中，HERMITAGEHIV风险降低干预似乎并未减少性传播感染和HIV风险行为。
