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

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: 4.53). 05/2007; 32(4 Suppl):S38-67. DOI: 10.1016/j.amepre.2006.12.006
Source: PubMed


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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    • "research/compendium/rr/index.html) for use with this vulnerable population. Thus, there is a profound need for efficacious HIV prevention interventions for use with Hispanic/Latino MSM (Carballo-Dieguez et al., 2005; Herbst, Beeker, et al., 2007). "
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    ABSTRACT: Hispanic/Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs); however, no efficacious behavioral HIV/STD prevention interventions are currently available for use with this vulnerable population. We describe the enhancement of HOLA en Grupos, a community-based behavioral HIV/STD prevention intervention for Spanish-speaking Hispanic/Latino MSM that is currently being implemented and evaluated in North Carolina with support from the Centers of Disease Control and Prevention (CDC). Our intervention enhancement process included incorporating local data on risks and context; identifying community needs and priorities; defining intervention core elements and key characteristics; developing a logic model; developing an intervention logo; enhancing intervention activities and materials; scripting intervention delivery; expanding the comparison intervention; and establishing a materials review committee. If the CDC-sponsored evaluation determines that HOLA en Grupos is efficacious, it will be the first such behavioral HIV/STD prevention intervention to be identified for potential use with Hispanic/Latino MSM, thereby contributing to the body of evidence-based resources that may be used for preventing HIV/STD infection among these MSM and their sex partners.
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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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    • "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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