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Statements

Subject Item
n2:RIV%2F00216208%3A11320%2F14%3A10283470%21RIV15-MSM-11320___
rdf:type
n5:Vysledek skos:Concept
rdfs:seeAlso
http://dx.doi.org/10.1016/S2214-109X(14)70032-4
dcterms:description
We investigated whether a multicomponent, multilevel social and behavioural prevention strategy could reduce HIV incidence, increase HIV testing, reduce HIV risk behaviour, and change social and behavioural norms. For this phase 3 cluster-randomised controlled trial, 34 communities in four sites in Africa and 14 communities in Thailand were randomly allocated in matched pairs to receive 36 months of community-based voluntary counselling and testing for HIV (intervention group) or standard counselling and testing alone (control group) between January, 2001, and December, 2011. Data were collected at baseline (n=14 567) and after intervention (n=56 683) by cross-sectional random surveys of community residents aged 18-32 years. The primary outcome was HIV incidence estimated with a cross-sectional multi-assay algorithm. The estimated incidence of HIV in the intervention group was 1.52% versus 1.81% in the control group with an estimated reduction in HIV incidence of 13.9% (relative risk [RR] 0.86, 95% CI 0.73-1.02; p=0.082). HIV incidence was significantly reduced in women older than 24 years (RR=0.70, 0.54-0.90; p=0.0085), but not in other age or sex subgroups. Community-based voluntary counselling and testing increased testing rates by 25% overall (12-39; p=0.0003), by 45% (25-69; p<0.0001) in men and 15% (3-28; p=0.013) in women. No overall effect on sexual risk behaviour was recorded. Social norms regarding HIV testing were improved by 6% (95% CI 3-9) in communities in the intervention group. These results are sufficiently robust, especially when taking into consideration the combined results of modest reductions in HIV incidence combined with increases in HIV testing and reductions in HIV risk behaviour, to recommend the Project Accept approach as an integral part of all interventions (including treatment as prevention) to reduce HIV transmission at the community level. We investigated whether a multicomponent, multilevel social and behavioural prevention strategy could reduce HIV incidence, increase HIV testing, reduce HIV risk behaviour, and change social and behavioural norms. For this phase 3 cluster-randomised controlled trial, 34 communities in four sites in Africa and 14 communities in Thailand were randomly allocated in matched pairs to receive 36 months of community-based voluntary counselling and testing for HIV (intervention group) or standard counselling and testing alone (control group) between January, 2001, and December, 2011. Data were collected at baseline (n=14 567) and after intervention (n=56 683) by cross-sectional random surveys of community residents aged 18-32 years. The primary outcome was HIV incidence estimated with a cross-sectional multi-assay algorithm. The estimated incidence of HIV in the intervention group was 1.52% versus 1.81% in the control group with an estimated reduction in HIV incidence of 13.9% (relative risk [RR] 0.86, 95% CI 0.73-1.02; p=0.082). HIV incidence was significantly reduced in women older than 24 years (RR=0.70, 0.54-0.90; p=0.0085), but not in other age or sex subgroups. Community-based voluntary counselling and testing increased testing rates by 25% overall (12-39; p=0.0003), by 45% (25-69; p<0.0001) in men and 15% (3-28; p=0.013) in women. No overall effect on sexual risk behaviour was recorded. Social norms regarding HIV testing were improved by 6% (95% CI 3-9) in communities in the intervention group. These results are sufficiently robust, especially when taking into consideration the combined results of modest reductions in HIV incidence combined with increases in HIV testing and reductions in HIV risk behaviour, to recommend the Project Accept approach as an integral part of all interventions (including treatment as prevention) to reduce HIV transmission at the community level.
dcterms:title
Effect of community-based voluntary counselling and testing on HIV incidence and social and behavioural outcomes (NIMH Project Accept; HPTN 043): a cluster-randomised trial Effect of community-based voluntary counselling and testing on HIV incidence and social and behavioural outcomes (NIMH Project Accept; HPTN 043): a cluster-randomised trial
skos:prefLabel
Effect of community-based voluntary counselling and testing on HIV incidence and social and behavioural outcomes (NIMH Project Accept; HPTN 043): a cluster-randomised trial Effect of community-based voluntary counselling and testing on HIV incidence and social and behavioural outcomes (NIMH Project Accept; HPTN 043): a cluster-randomised trial
skos:notation
RIV/00216208:11320/14:10283470!RIV15-MSM-11320___
n3:aktivita
n19:I
n3:aktivity
I
n3:cisloPeriodika
5
n3:dodaniDat
n14:2015
n3:domaciTvurceVysledku
n15:5767679
n3:druhVysledku
n17:J
n3:duvernostUdaju
n7:S
n3:entitaPredkladatele
n11:predkladatel
n3:idSjednocenehoVysledku
13182
n3:idVysledku
RIV/00216208:11320/14:10283470
n3:jazykVysledku
n16:eng
n3:klicovaSlova
men; risk; stigma; transmission; intervention; thailand; prevention; antiretroviral therapy; male circumcision; sub-saharan africa
n3:klicoveSlovo
n4:male%20circumcision n4:thailand n4:sub-saharan%20africa n4:men n4:stigma n4:antiretroviral%20therapy n4:transmission n4:risk n4:prevention n4:intervention
n3:kodStatuVydavatele
NL - Nizozemsko
n3:kontrolniKodProRIV
[E7F444035F45]
n3:nazevZdroje
The Lancet Global Health
n3:obor
n12:FQ
n3:pocetDomacichTvurcuVysledku
1
n3:pocetTvurcuVysledku
19
n3:rokUplatneniVysledku
n14:2014
n3:svazekPeriodika
2
n3:tvurceVysledku
Zelaya, Carla E. Chingono, Alfred Piwowar-Manning, Estelle Kulich, Michal Coates, Thomas J. Celentano, David D. Sweat, Michael Donnell, Deborah Richter, Linda Fiamma, Agnes Chariyalertsak, Suwat Gray, Glenda Mbwambo, Jessie K. K. McGrath, Nuala Eshleman, Susan H. Szekeres, Greg van Rooyen, Heidi Morin, Stephen F. Laeyendecker, Oliver
n3:wos
000336424900015
s:issn
2214-109X
s:numberOfPages
11
n6:doi
10.1016/S2214-109X(14)70032-4
n18:organizacniJednotka
11320