Peer 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

摘要

Abstract IntroductionReducing 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). MethodsWe 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. ResultsFor pre- and post-diagnosis comparisons, multiple partnership fell from 50% to 16% ( p ConclusionsWe 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.