Open AccessPeer counselling versus standard‐of‐care on reducing high‐risk behaviours among newly diagnosed HIV ‐positive men who have sex with men in Beijing, China: a randomized intervention study
Author(s) -
Liu Yu,
Vermund Sten H,
Ruan Yuhua,
Liu Hongjie,
Rivet Amico K,
Simoni Jane M,
Shepherd Bryan E,
Shao Yiming,
Qian HanZhu
Publication year - 2018
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.1002/jia2.25079
Subject(s) - medicine , anal sex , men who have sex with men , intervention (counseling) , generalized estimating equation , family medicine , brief intervention , randomized controlled trial , logistic regression , demography , human immunodeficiency virus (hiv) , clinical psychology , psychiatry , syphilis , statistics , mathematics , sociology
Abstract Introduction Reducing high‐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 peer‐ counselling in reducing high‐risk behaviours among newly diagnosed HIV ‐positive Chinese men who have sex with men ( MSM ). Methods We randomized 367 newly diagnosed HIV ‐positive men to either standard‐of‐care ( SOC ; n = 183) or peer‐counselling intervention (n = 184), and followed them for 12 months (visit at 0‐, 3‐, 6‐, 9‐ and 12‐month). SOC participants received counselling on high‐risk behaviour reduction by clinic staff. Intervention participants received both SOC and peer counselling. A generalized estimating equation was used to compare pre‐post diagnosis high‐risk behaviour change; logistic regression was used to assess the likelihood of practicing high‐risk behaviours between intervention and SOC participants. Both intent‐to‐treat and per‐protocol (full‐dosage) approaches were used for the analyses. Results For pre‐ and post‐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 intent‐to‐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 per‐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). Conclusions We observed a 14 to 43% decrease in the prevalence of selected high‐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 peer‐counselling arm are necessary to test its efficacy and effectiveness among Chinese MSM . Clinical Trial Number: NCT01904877