将性快感融入性健康干预有什么附加价值？系统评价和荟萃分析

​What is the added value of incorporating pleasure in sexual health interventions?

A systematic review and meta-analysis

—原载《公共科学图书馆：综合》2022年2月11日在线发表—

<PLOS ONE>, Published online: February 11, 2022

【摘要】尽管在性和生殖健康与权利（SRHR）方面投入了数十亿美元，但目前尚不清楚将性快感（人们发生性行为的关键驱动因素）纳入性健康干预措施的效果。我们按照PRISMA指南对2005年1月1日至2020年6月1日期间发表的相关文章的7个数据库进行了系统评价和荟萃分析。我们在系统评价中纳入了33种独特的干预措施。八项报告安全套使用结果的干预措施与方法随机效应模型一起进行了荟萃分析。质量评估是通过Cochrane Collaborations的RoB2工具进行的。该研究已在Prospero上进行了预注册（ID：CRD42020201822）。我们确定了包含快乐的33种独特干预措施（基线时18886名参与者）。所有干预措施都针对降低HIV/STI风险，没有发生在怀孕预防或计划生育的背景下。我们发现，大多数干预措施针对的是作者归类为高风险的人群。我们能够对8项研究（基线时6634名参与者）报告安全套使用作为结果进行荟萃分析，发现Cohen的d=0·37的总体中等、积极和显着影响（95% CI 0·20–0·54 , p< 0·001; I2=48%; τ2=0·043, p=0·06)。将性快感纳入SRHR干预措施可以改善性健康结果。我们的荟萃分析提供了关于快乐结合干预对安全套使用的积极影响的证据，这对减少HIV和STI具有直接影响。我们的定性研究发现，快感可以对不同的信息和基于知识的态度产生积极影响的证据。未来的工作需要进一步阐明SRHR内以及不同结果和人群中性快感的影响。考虑到所有可用的证据，我们建议负责性健康和生殖健康的机构考虑将性快感因素纳入其计划。

【Abstract】 Despite billions of dollars invested into Sexual and Reproductive Health and Rights (SRHR) efforts, the effect of incorporating sexual pleasure, a key driver of why people have sex, in sexual health interventions is currently unclear. We carried out a systematic review and meta-analysis following PRISMA guidelines across 7 databases for relevant articles published between 1 January 2005–1 June, 2020. We included 33 unique interventions in our systematic review. Eight interventions reporting condom use outcomes were meta-analyzed together with a method random effects model. Quality appraisal was carried out through the Cochrane Collaborations’ RoB2 tool. This study was pre-registered on Prospero (ID: CRD42020201822). We identified 33 unique interventions (18886 participants at baseline) that incorporate pleasure. All included interventions targeted HIV/STI risk reduction, none occurred in the context of pregnancy prevention or family planning. We find that the majority of interventions targeted populations that authors classified as high-risk. We were able to meta-analyze8 studies (6634 participants at baseline) reporting condom use as an outcome and found an overall moderate, positive, and significant effect of Cohen’s d =0·37 (95% CI 0·20–0·54, p < 0·001; I2 = 48%; τ2 = 0·043, p = 0·06). Incorporating sexual pleasure within SRHR interventions can improve sexual health outcomes. Our meta-analysis provides evidence about the positive impact of pleasure-incorporating interventions on condom use which has direct implications for reductions in HIV and STIs. Qualitatively, we find evidence that pleasure can have positive effects across different informational and knowledge-based attitudes as well. Future work is needed to further elucidate the impacts of pleasure within SRHR and across different outcomes and populations. Taking all the available evidence into account, we recommend that agencies responsible for sexual and reproductive health consider incorporating sexual pleasure considerations within their programming.

论文原文： Mirela Zaneva, Anne Philpott , Arushi Singh, Gerda Larsson, Lianne Gonsalves (2022). What is the added value of incorporating pleasure in sexual health interventions? A systematic review and meta-analysis. PLOS ONE, Published online: February 11, 2022.  

https://doi.org/10.1371/journal.pone.0261034

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