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Don Operario1, Debin Wang2, Mei-Fen Yang1, Kathleen Blaney1, Jing Cheng2, Qian Hong2, Hongbo Zhang2, Gregory Szekeres3, Jerome Galea3, Thomas J. Coates3

1Brown University, RI, 2Anhui Medical University, CHINA, 3University of California Los Angeles, CA

Presentation Title Lorem Ipsum Dolor Sit Amet Consectetur Adipiscing Elit Maecenas Hendrerit

Overview

In a cluster randomized trial, we tested whether a program to train physicians in China on HIV and STI knowledge, diagnosis, treatment, and risk reduction counseling can potentially reduce HIV risk behavior and STI among high-risk STI patients.

Background

  • In China, HIV is increasingly characterized by sexual transmission in high-risk groups.
  • National AIDS policies in China support initiatives to promote ART and HIV testing, condom use, syringe distribution and drug treatment, and HIV stigma reduction.
  • Implementation of China’s national AIDS policies relies on physicians’ capacities to deliver HIV prevention and HIV/STI treatment services.
  • We developed a knowledge and skills-based training program (Ai Shi Zi) for physicians in China to reduce HIV and STI risk in high-risk patients.

Study Design

  • Setting: Anhui and Jiangsu provinces
  • 51 counties elected to participate (39 in Anhui, 12 in Jiangsu)
  • 27 counties received immediate training (intervention group); �24 counties in delayed control
  • 4-6 physicians in each county hospital participated in immediate or delayed-control training
  • 4-6 STI patients of each physician were recruited and assessed �at BL and 9-month follow-up on:
  • Gonorrhea and Chlamydia (BL STIs were treated)

Results

Conclusion

  • Integrating HIV and STI training into medical education in China can be an effective strategy for reducing the country’s HIV and STI epidemics
  • 38% lower odds of STI infection (gonorrhea and Chlamydia) at �9-month follow-up among intervention patients compared with controls
  • 78% lower odds of unprotected sex at 9-month follow-up among intervention patients compared with controls; however, unprotected sex remained high
  • Greater HIV knowledge, less stigmatizing attitudes toward PLWH, and greater satisfaction with physician among intervention patients compared with controls

Patient Outcomes

(9-month FU)

Intervention

Control

OR / b

95% CI

STI�Prevalence

11.4%

40.4%

OR = 0.62

(0.46-0.84)

Unprotected Sex, past 6 mo.

84%

95%

OR = 0.22

(0.12-0.42)

HIV�Knowledge

16.80

14.94

b = 2.13

(1.52-2.73)

Attitudes toward PLWH

8.50

7.15

b = 1.51

(0.97-2.05)

Satisfaction w/Physician

2.43

2.29

b = 0.22

(0.15-0.30)

  • Integrating HIV and STI training into medical education in China can be an effective strategy for reducing the country’s HIV and STI epidemics

Funding Source

or Key References

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