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HIV: Interventions to Reduce Sexual Risk Behaviors or Increase Protective Behaviors to Prevent Acquisition of HIV in Men Who Have Sex with Men – Individual-Level Interventions

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What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 4 studies (search period 1988 - 2005).

The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to HIV/AIDS prevention.

Context

There is no information for this section.

Summary of Results

Detailed results from the systematic review are available in the published evidence review pdf icon [PDF - 868 kB].

  • Participants reported significant reductions in unprotected anal intercourse (UAI).
    • These effects were significant at both short-term (median 6 months) and long-term (median 12 months) follow-ups.
    • Individual-level interventions also resulted in a 59% reduction in odds of having UAI with non-primary partners (3 interventions), and a 48% reduction in odds of having UAI with partners who don’t have the same HIV status (4 interventions).

Summary of Economic Evidence

An economic review of this intervention did not find any relevant studies.

Applicability

Based on the evidence, this finding should be applicable across a range of settings and MSM populations in the United States, assuming interventions are appropriately adapted to the needs and characteristics of the population.

Evidence Gaps

Additional research and evaluation are needed to answer the following questions and fill existing gaps in the evidence base.

  • How effective are interventions among particular groups?
    • Nonwhite MSM, and in particular, African-American and Latino populations who are disproportionately affected by HIV
    • Non–gay-identified MSM, who may have different HIV prevention needs than gay-identified men
    • MSM who are substance users
  • Given the included studies were set in locations such as gay bars, community-based organizations, health clinics, and research study sites, how effective are they in other settings (e.g., "circuit parties")?
  • What are intervention effects on health outcomes (e.g., STDs and HIV)? What are the most effective ways to measure such biological outcomes?
  • What are the minimal and optimal variables for intervention effectiveness (e.g., number of sessions, program duration, type of skills training)?
  • How have advances in technology and medicine over the past decade altered the social and behavioral landscape of the MSM community? Has commitment to reducing sex risk behaviors declined since HIV became a more manageable condition?
  • Has the Internet led to elevated levels of sex risk behavior among MSM seeking and meeting sex partners?

Study Characteristics

In the included studies, HIV behavioral interventions at the individual level

  • Sought to modify knowledge, attitudes, beliefs, self-efficacy, and emotional well-being
  • Involved individualized risk-reduction counseling or motivational interviewing delivered by a trained counselor, educator, peer, or other professional

Following are characteristics of studies included in the reviews of HIV behavioral interventions at individual, group, and community levels.

  • Most of the included studies were conducted in the United States, though some were conducted in Brazil, the United Kingdom, New Zealand, or Canada.
  • Of the 19 included studies, 13 were conducted before 1996, the year highly active antiretroviral treatment (HAART) was introduced.
  • Participants were recruited in a variety of settings, including clinics, community-based organizations, and gay community venues such as bars and public cruising areas.
  • Most studies evaluated interventions with follow-ups longer than 3 months, and only two studies failed to achieve at least 80% retention.
  • The median age across all study samples was 33 years, and in the 15 studies reporting education, at least 50% of participants had some college.

Publications