A meta-analysis of the efficacy of HIV/AIDS prevention interventions in Asia, 1995–2009

Abstract

The HIV/AIDS epidemic continues to grow in pockets across Asia, despite early successes at curtailing its spread in countries like Thailand. Recent evidence documents dramatic increases in incidence among risk groups and, alarmingly, the general population. This meta-analysis summarizes the sexual risk-reduction interventions for the prevention of HIV-infection that have been evaluated in Asia. Sexual risk-reduction outcomes (condom use, number of sexual partners, incident sexually transmitted infections [STI], including HIV) from 46 behavioral intervention studies with a comparison condition and available by August 2010 were included. Overall, behavioral interventions in Asia consistently reduced sexual risk outcomes. Condom use improved when interventions sampled more women, included motivational content, or did not include STI testing and treatment. Incident HIV/STI efficacy improved most when interventions sampled more women, were conducted more recently, or when they included STI counseling and testing. Sexual frequency efficacy improved more in interventions that were conducted in countries with lower human development capacities, when younger individuals were sampled, or when condom-skills training was included. Behavioral interventions for reducing sexual risk in Asia are efficacious; yet, the magnitude of the effects co-varies with specific intervention and structural components. The impact of structural factors on HIV intervention efficacy must be considered when implementing and evaluating behavioral interventions. Implications and recommendations for HIV/AIDS interventions are discussed.

Behavioural interventions to reduce sexual risk for HIV in heterosexual couples: a meta-analysis

“…The results of this meta-analysis are consistent with prior studies indicating that interventions achieve better risk-reduction results when they take place in countries with a lower HDI index; interventions appear to work best where need is greatest,50 51 at least on relatively short-term assessments. Interventions with more intervention content, as measured by the number of intervention sessions, also trended toward greater efficacy in increasing condom use 52.…”

Single-Session Behavioral Interventions for Sexual Risk Reduction: A Meta-Analysis

“…A recent meta-analysis of behavioral interventions conducted in various settings and multiple countries found intervention effects for increased condom use and reduced STI/HIV incidence (3). Similar results appeared in meta-analyses of multi-session risk reduction interventions conducted with adolescents(4), men and women in Latin American and Caribbean countries(5), and in Asia (6). Despite these successes, sexual risk reduction interventions are typically presented in multiple sessions, and as a result may create issues with participant retention over time.…”

Towards an integrated framework for accelerating the end of the global HIV epidemic among young people

“…In delivering behavioural HIV interventions, community mobilisation strategies may provide the most promising opportunity to increase large-scale uptake of HIV prevention strategies (Sweat et al 2011; Tan et al 2012; Townsend, Mathews, and Zembe 2013). Prior studies demonstrated that the uptake of HTC can be enhanced in communities with diverse cultures and infrastructures (Sweat et al 2011).…”