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: 4.28). 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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    • "Despite some stabilization in HIV transmission in the U.S., the Centers for Disease Control and Prevention (CDC) estimated that, in 2009, men who have sex with men (MSM) accounted for 57% of all new diagnoses of HIV infection, and 75% of all diagnosed HIV infections among males (CDC, 2010). Although effective behavioral interventions to reduce HIV-associated transmission risks (e.g., unprotected anal intercourse [UAI]) have been developed (Herbst et al., 2007; Johnson et al., 2008; Kalichman et al., 2001; Lyles et al., 2007; Morin et al., 2008), community health and service providers have a continued need to identify locations where transmission-risk behaviors occur (Navejas, Neaigus , Torian, & Murrill, 2011). Venues where MSM gather are important locations where health and community service providers can engage MSM for education and prevention (Blank, Gallagher, Washburn, & private safer sex parties, men from safer sex parties were significantly less likely than others to report UAI (Reisner et al., 2009). "
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