Interventions to reduce sexual risk for human immunodeficiency virus in adolescents: a meta-analysis of trials, 1985-2008.
ABSTRACT To provide an updated review of the efficacy of behavioral interventions to reduce sexual risk of human immunodeficiency virus (HIV) among adolescents.
We searched electronic databases, leading public health journals, and the document depository held by the Synthesis of HIV/AIDS Risk Reduction Project. Studies that fulfilled the selection criteria and were available as of December 31, 2008, were included.
Studies that investigated any behavioral intervention advocating sexual risk reduction for HIV prevention, sampled adolescents (age range, 11-19 years), measured a behavioral outcome relevant to sexual risk, and provided sufficient information to calculate effect sizes.
Data from 98 interventions (51,240 participants) were derived from 67 studies, dividing for qualitatively different interventions and gender when reports permitted it.
Condom use, sexual frequency, condom use skills, interpersonal communication skills, condom acquisition, and incident sexually transmitted infections (STIs).
Relative to controls, interventions succeeded at reducing incident STIs, increasing condom use, reducing or delaying penetrative sex, and increasing skills to negotiate safer sex and to acquire prophylactic protection. Initial risk reduction varied depending on sample and intervention characteristics but did not decay over time.
Comprehensive behavioral interventions reduce risky sexual behavior and prevent transmission of STIs. Interventions are most successful to the extent that they deliver intensive content.
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ABSTRACT: We systematically reviewed school-based skills building behavioural interventions for the prevention of sexually transmitted infections. References were sought from 15 electronic resources, bibliographies of systematic reviews/included studies and experts. Two authors independently extracted data and quality-assessed studies. Fifteen randomized controlled trials (RCTs), conducted in the United States, Africa or Europe, met the inclusion criteria. They were heterogeneous in terms of intervention length, content, intensity and providers. Data from 12 RCTs passed quality assessment criteria and provided evidence of positive changes in non-behavioural outcomes (e.g. knowledge and self-efficacy). Intervention effects on behavioural outcomes, such as condom use, were generally limited and did not demonstrate a negative impact (e.g. earlier sexual initiation). Beneficial effect on at least one, but never all behavioural outcomes assessed was reported by about half the studies, but this was sometimes limited to a participant subgroup. Sexual health education for young people is important as it increases knowledge upon which to make decisions about sexual behaviour. However, a number of factors may limit intervention impact on behavioural outcomes. Further research could draw on one of the more effective studies reviewed and could explore the effectiveness of 'booster' sessions as young people move from adolescence to young adulthood.Health Education Research 02/2012; 27(3):495-512. · 1.66 Impact Factor
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ABSTRACT: The aim of this study was to describe the prevalence of syphilis by geographical region and the frequency of behaviours and symptoms related to sexually transmitted diseases (STD). A cross-sectional study was performed with Brazilian conscripts in 2007. They answered a self-administered questionnaire on demographic issues, sexual practices, condom use and STD symptoms. They had a blood sample collected for a syphilis test. A total of 35 460 conscripts answered the questionnaire and 75.5% reported previous sexual intercourse. Overall syphilis prevalence was 0.53% (95% CI 0.45% to 0.61%). By geographical region: northern (0.85%), northeast (0.82%), midwest (0.49%), southeast (0.34%) and southern region (0.26%). The final logistic regression model showed an association among having had syphilis and being 17 years old (OR 1.3; 95% CI 1.05 to 1.73), having up to 8 years of schooling (OR 1.5; 95% CI 1.03 to 2.22), living in the northern/northeast region (OR 1.2; 95% CI 1.04 to 1.36), being men who have sex with men (OR 4.5; 95% CI 2.59 to 7.81), reporting a previous history of STD (OR 2.7; 95% CI 1.03 to 6.99) and genital ulcers (OR 2.6; 95% CI 1.59 to 4.26). Addressing young people at the time of military enlistment may be a good time to consider new strategies for accessing and counselling this population, thus allowing the implementation of a more appropriate healthcare policy.Sexually transmitted infections 02/2012; 88(1):32-4. · 2.18 Impact Factor
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ABSTRACT: This guideline provides evidence-based guidance on the content of safer sex advice and the provision of brief behaviour change interventions deliverable in genitourinary (GU) medicine clinics. Much of the advice is applicable to other healthcare settings including general practice and clinics providing HIV care. Advice on condom use and effectiveness, oral sex and other sexual practices, testing for sexually transmitted infections (STI) and partner reduction is provided. Advice specific to the transmission of HIV infection including seroadaptive behaviours and negotiated safety is also included. An accompanying review of the evidence supporting the guideline with a complete reference list is available online. A patient information leaflet based on the advice statements developed is also available through the BASHH website.International Journal of STD & AIDS 06/2012; 23(6):381-8. · 1.00 Impact Factor