The Effectiveness of Individual-, Group-, and Community-Level HIV Behavioral Risk-Reduction Interventions for Adult Men Who Have Sex with Men

Prevention Research Branch, Division of HIV/AIDS Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
American Journal of Preventive Medicine (Impact Factor: 4.28). 05/2007; 32(4 Suppl):S38-67. DOI: 10.1016/j.amepre.2006.12.006
Source: PubMed

ABSTRACT This article presents the results of a systematic review of the effectiveness and economic efficiency of individual-, group-, and community-level behavioral interventions intended to reduce the risk of acquiring sexually transmitted HIV in adult men who have sex with men (MSM). These results form the basis for recommendations by the Task Force on Community Preventive Services on the use of these interventions. Sexual risk behavior and condom use were the outcomes used to assess effectiveness. Intervention effectiveness on biological outcomes could not be assessed because too few studies of adequate quality have been published. The evidence found in our review shows that individual-level, group-level, and community-level HIV behavioral interventions are effective in reducing the odds of unprotected anal intercourse (range 27% to 43% decrease) and increasing the odds of condom use for the group-level approach (by 81%). The Task Force concluded that the findings are applicable to MSM aged 20 years or older, across a range of settings and populations, assuming that interventions are appropriately adapted to the needs and characteristics of the MSM population of interest. Based on findings from economic evaluation studies, the Task Force also concluded that group- and community-level HIV behavioral interventions for adult MSM are not only cost effective but also result in actual cost savings. Additional information about other effects, barriers to implementation, and research gaps is provided in this paper. The recommendations based on these systematic reviews are expected to serve the needs of researchers, planners, and other public health decision makers.

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    • "Adapting existing evidence-based HIV interventions among young African American GBT individuals via their gay family networks may be propitious. Cultural relevance and the use of structural rather than individual interventions have been identified as important aspects of effective HIV interventions to increase safe-sex behaviors with African American youth in the South (e.g., Beatty, Wheeler, & Gaiter, 2004; St. Lawrence et al., 1995) as well as MSM (Coates, Richter, & Caceres, 2008; Herbst et al., 2007; Wilton et al., 2009). Interventions for at-risk populations benefit from research on perceived community norms and the role of disclosure of HIV status and sexual and gender minority identities as well as the influence of stigma prevention behaviors (Mays, Cochran, & Zamudio, 2004). "
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    ABSTRACT: Gay families are constructed support networks that gay, bisexual, and transgender individuals of color form, often in response to societal marginalization and rejection from biological families. Research on these family structures has been scarce, with little focus on the experience of African American gay family networks in the South. The current grounded theory qualitative study focused on the experiences of 10 African American male and transgender individuals between the ages of 18 and 29 from gay families in the Mid-South, and explored the ways these families addressed safe-sex issues and human immunodeficiency virus (HIV) risk prevention. Results revealed that families can play a role in either increasing HIV risk (e.g., ignoring HIV issues, encouraging such unsafe behaviors as exchanging sex for money or drugs, stigmatizing HIV-positive people) or decreasing it (e.g., intensive, family-level prevention efforts at safe-sex practices and family support for HIV treatment adherence). The potential of these family networks for HIV prevention and adherence efforts is considered.
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    • "This approach is congruent with the deeply held value of " respeto " in Latino culture, which places a high value on learning from an expert respected authority (Andres-Hyman, Ortiz, Anez, Paris, & Davidson, 2006; Peragallo et al., 2005). Previous research has found conflicting evidence on the benefits of peer versus expert facilitators (Albarracin et al., 2008; Durantini et al., 2006; Herbst et al., 2007a). The primary health care model guided the delivery of the intervention, using nurses and the local clinic to organize and conduct the intervention. "
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    • "Men who have sex with men (MSM) are the group most affected by the HIV epidemic in the UK [11] and their sexual risk taking behaviour is reported to be increasing [12,13]. As part of a comprehensive strategy across HIV prevention and care, behavioural interventions remain an important tool in the global fight against HIV [14]. One-to-one behavioural interventions, such as motivational interviewing (MI) have been recommended [15,16] to reduce HIV in high risk groups. "
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