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Review and meta-analysis of HIV prevention intervention research for heterosexual adult populations in the United States.
Journal of Acquired Immune Deficiency Syndrome 2002;30(Suppl 1):S106-S117.
Neumann MS, Johnson WD, Semaan S, Flores SA, Peersman G, Hedges LV,
Sogolow E.
Abstract
A meta-analysis was performed to examine the effects of 14 behavioral and social
interventions for heterosexual adults on their adoption of safer sex behaviors
or incidence of sexually transmitted diseases (STDs). The intervention studies
were identified through a systematic search and review strategy. Data were
extracted and combined by using well-defined methods and appropriate statistical
techniques. For inclusion in this article, studies had to be based in the
United States, written in English, first reported between 1988 and 1996,
and aimed at reducing sex-related HIV risks. In addition to measuring behavioral
or STD incidence outcomes, studies also had used experimental or quasi-experimental
designs with control or comparison groups and reported sufficient outcome
data to allow calculation of odds ratios. The meta-analytic results show
statistically significant effects in reducing sex-related risks (10 studies;
odds ratio [OR], 0.81; 95% confidence interval [CI], 0.69-0.95), particularly
non-use of condoms (8; OR, 0.69; 95% CI, 0.53-0.90). The interventions also
had significant effects in reducing STD infections (6 studies; OR, 0.74;
95% CI, 0.62-0.89). These analyses indicate that science-based prevention
interventions have positive effects among populations at risk through heterosexual
transmission and that these positive effects are found with biologic and
self-reported behavioral measures.