性感染症を予防するための行動カウンセリングの介入:米国の予防サービスタスクフォースの最新証拠報告と体系的なレビュー
Jillian T Henderson1, Caitlyn A Senger1, Michelle Henninger1
1Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon.
JAMA
|August 19, 2020
まとめ
行動カウンセリングの介入は,プライマリケアでの性感染症 (STD) を効果的に軽減します. より長いカウンセリングセッションは,よりSTIの減少を示しましたが,長期的な持続性についてはさらなる研究が必要です.
科学分野:
- 公衆衛生
- 予防 医療
- 行動科学
背景:
- 予防可能な性感染症 (STD) の増加率は,米国において健康と経済に重大な課題をもたらしています.
- 行動カウンセリングは STI 予防の重要な戦略であり,特にリスクの高い集団に当てはまります.
研究 の 目的:
- 性感染症の予防のための行動カウンセリングの有効性に関する現在の証拠をまとめます.
- 米国予防サービスタスクフォース (USPSTF) のSTI予防戦略に関するガイドラインを報告する.
主な方法:
- 2013年から2020年にかけてのランダム化および非ランダム化制御試験の体系的レビューとメタ解析.
- 性感染症のリスクの高い若者と成人を対象とした初等保健施設での研究を含める.
- STIの診断と行動の変化に対する介入の有効性を評価するために,プーリングされた確率比を用いたデータ抽出と合成.
主要な成果:
- 行動カウンセリングの介入は,STIの発生率の有意な減少と関連していました (OR,0. 66).
- コンドームの使用の増加などの自己報告された行動の変化にもつながった (OR, 1.31).
- より長いカウンセリングセッション (> 2時間) は,STIの発生率の減少を示し,長期的な持続性に関する証拠は限られている.
結論:
- プライマリケアで提供される行動カウンセリングの介入は,性感染症の発生率を減らすのに有効です.
- カウンセリングの期間と強さは,STIの減少の大きさに影響を与える可能性があります.
- これらの介入の長期的な効果を理解するためにさらなる研究が必要である.
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