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HIV prevention research for men who have sex with men: a systematic review and meta-analysis.
Journal of Acquired Immune Deficiency Syndrome 2002;30(Suppl 1):S118-S.
Johnson WD, Hedges LV, Ramirez G, Semaan S, Norman LR, Sogolow E, Sweat
MD, Diaz RM.
Abstract
A systematic review of HIV prevention reports published or distributed in the
United States as of June 1998 yielded 9 rigorous controlled trials reporting
intervention effects on unprotected sex for men who have sex with men. A
summary measure of these effects was favorable (odds ratio,.69), statistically
significant (95% confidence interval, 0.56-0.86), and very homogeneous. This
summary value indicates a 26% reduction in the proportion of men engaging
in unprotected anal intercourse. The most clearly favorable effects were
observed among interventions that promoted interpersonal skills, were delivered
in community-level formats, or focused on younger populations or those at
higher behavioral risk. These studies demonstrate that interventions can
promote risk reduction among men who have sex with men. Yet given the epidemiology
of HIV in the United States, the small number of rigorous controlled intervention
trials for this population is striking. Many more rigorous evaluations of
HIV prevention efforts with men who have sex with men are needed to ascertain
with confidence the effects of specific intervention components, population
characteristics, and methodologic features.