Evidence of effectiveness of behavioural interventions to reduce transmission among men who have sex with men: a review of review-level evidence

Maggie Lawrence, Karen Lorimer, Lisa Kidd, Kerri McPherson, Flora Cornish, Sandi Cayless

Research output: Contribution to conferencePaper

Abstract

Objectives: A review of review-level evidence was conducted to synthesise evidence of effectiveness of interventions to reduce transmission among men who have sex with men (MSM). Methods: A comprehensive search included electronic databases, including MEDLINE, EMBASE, PsycInfo and others, including grey literature resources, were searched, from 2000 to present, hand searches of the reference lists of retrieved documents. Result: Four meta-analyses met the criteria and examined individual-, group- and community-level behavioural interventions. The meta-analyses contained k = 65 primary studies with a cumulative N =~44,000. All meta-analyses (n = 4) that examined unprotected anal intercourse (UAI) found significant effect sizes from interventions compared against no or minimal intervention for reductions in UAI: range 10–43%. There was also consistent evidence of an increased use of condoms during anal intercourse, with group-level interventions being associated with the greatest increases (81%). Greater intervention effects were found among: younger MSM of mean age <30 years compared with mean age>31 years, and interventions which addressed losses rather than gains; however, there was mixed evidence regarding the association between the duration of interventions and reductions in UAI. Conclusions: There was strong and consistent evidence for all levels of interventions being associated with reductions in UAI and increases in condom use. Whilst these data offer high-level evidence for some associated effects of behavioural interventions, the effective duration of interventions remains unclear. The focus on UAI as an outcome measure across reviews offered limited data on the effectiveness of other behavioural strategies, such as serosorting and negotiated safety.
Original languageEnglish
Number of pages1
Publication statusPublished - 12 Jun 2011

Keywords

  • MSM
  • unprotected sex
  • UAI
  • electronic databases
  • behavioural interventions

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