Efficacy of HIV/STI Behavioral Interventions for Heterosexual African American Men in the United States: A Meta-Analysis

Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-37, Atlanta, GA 30333, USA.
AIDS and Behavior (Impact Factor: 3.49). 01/2012; 16(5):1092-114. DOI: 10.1007/s10461-011-0100-2
Source: PubMed


This meta-analysis estimates the overall efficacy of HIV prevention interventions to reduce HIV sexual risk behaviors and sexually transmitted infections (STIs) among heterosexual African American men. A comprehensive search of the literature published during 1988-2008 yielded 44 relevant studies. Interventions significantly reduced HIV sexual risk behaviors and STIs. The stratified analysis for HIV sexual risk behaviors indicated that interventions were efficacious for studies specifically targeting African American men and men with incarceration history. In addition, interventions that had provision/referral of medical services, male facilitators, shorter follow-up periods, or emphasized the importance of protecting family and significant others were associated with reductions in HIV sexual risk behaviors. Meta-regression analyses indicated that the most robust intervention component is the provision/referral of medical services. Findings indicate that HIV interventions for heterosexual African American men might be more efficacious if they incorporated a range of health care services rather than HIV/STI-related services alone.

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    • "In general, African men in the USA accounted for 47 % of new HIV infections among all men in 2009 (CDC 2009). A contributing factor to this disparity is that the extent to which behaviors such as substance use contribute to inordinate rates of both incarceration and the occurrence of STIs among African American male inmate populations (Choopanya et al. 2002; Khan et al. 2009; Henny et al. 2012; Stephens and Braithwaite 2014). "
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    ABSTRACT: The objective of this study is to determine the extent to which regular use of marijuana and alcohol may influence African American inmate’s beliefs, views, and practices regarding condoms. In this article, we report and discuss the implications of our findings for the planning of HIV prevention interventions for African American male inmate populations. Relationships between individual condom use and belief variables were examined using linear regression models. All models specified regularity of marijuana or alcohol use with respect to detailed condom use or belief outcomes as predictor variables. Analysis from 126 male inmates recruited from three medium security prisons and one Area Transition Center in Georgia are presented herein. Results note that frequency of marijuana use predicted and was associated with inmate’s reporting how often they use a condom during sex (Beta = −0.261, P < 0.009), suggesting that the more respondents reported smoking marijuana, the less likely they were to indicating using condoms during sex. Regularity of alcohol consumption was almost predictive of inmates indicating that they could always talk to any potential sex partner to make him/her understand why they should use condoms (p < 0.082) and stating that they could always say no to sexual intercourse with someone they had just met even if they were very attracted to that person (p < 0.063).
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    • "Alas, this route is fraught with challenges and complexities, as results from a recent meta-analysis of STI/HIV interventions for BHM illustrate. That study's finding that BHM's desire to protect family members and significant others was one of the most effective intervention elements for reducing BHM's sexual risk behaviors, prompted its authors to conclude that " machismo may help encourage a sense of responsibility to reduce HIV risk that is aligned with [BHM&apos;s] sense of manhood " (Henny et al., 2012, p. 1098). Perhaps, but greater caution is warranted in using " machismo " to promote safer sex. "
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    ABSTRACT: Although Black heterosexual men (BHM) in the United States rank among those most affected by HIV, research about how safer sex messages shape their safer sex behaviors is rare, highlighting the need for innovative qualitative methodologies such as critical discursive psychology (CDP). This CDP study examined how: (a) BHM construct safer sex and masculinity; (b) BHM positioned themselves in relation to conventional masculinity; and (c) discursive context (individual interview vs. focus group) shaped talk about safer sex and masculinity. Data included individual interviews (n = 30) and 4 focus groups (n = 26) conducted with 56 self-identified Black/African American heterosexual men, ages 18 to 44. Analyses highlighted 5 main constructions: (a) condoms as signifiers of "safe" women; (b) blaming women for STI/responsibility for safer sex; (c) relationship/trust/knowledge; (d) condom mandates; and (e) public health safer sex. Discourses positioned BHM in terms of conventional masculinity when talk denied men's agency for safer sex and/or contraception, or positioned women as deceitful, or apathetic about sexual risk and/or pregnancy. Notably, discourses also spotlighted alternative masculinities relevant to taking responsibility for safer sex or sexual exclusivity. Discursive context, namely the homosocial nature of focus group discussions, shaped how participants conversed about safer sex, and masculinity but not the content of that talk. In denying BHM's responsibility for safer sex, BHM's discourses about safer sex and masculinity often mirror public health messages, underscoring a critical need to sync these discourses to reduce sexual risk, and develop gender-transformative safer sex interventions for BHM. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
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    • "These variables may not have received the attention needed to achieve the greatest efficacy, resulting in long-term behaviour change remaining unachieved (Romero et al. 2011). The theoretical framework presented here includes knowledge and beliefs, components of the framework for VOICES/ VOCES (O'Donnell et al. 1998) and several other established interventions (Henny et al. 2012). Utilisation of an approach encompassing the health belief model (HBM) and the information, motivation and behavioural skills (IMB) model is comprehensive (Rosenstock, Strecher, and Becker 1988; Rosenstock 1974). "
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