The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61447

Jeffrey H Herbst, PhD¹, R. Thomas Sherba, MPH², Lev Zohrabyan, MD MPH², Angela B. Hutchinson, MPH¹, Nicole Crepaz, PhD¹, and Ron Stall, PhD, MPH¹. (1) NCHSTP, Division of HIV/AIDS Prevention, Prevention Research Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E37, Atlanta, GA 30333, 404-639-5389, jherbst@cdc.gov, (2) CDC/NCHSTP/DHAP-IRS/PRB, Northrop Grumman, 1600 Clifton Road NE, Atlanta, GA 30333

A meta-analysis was performed to evaluate whether international and U.S.-based interventions targeting men who have sex with men (MSM) are associated with reductions in unprotected anal intercourse (UAI). We also sought to examine whether delivery method (individual/small group vs. community) are differentially associated with reductions in UAI. A systematic search of the published and unpublished HIV/AIDS prevention intervention literature (written in English) from 1984 through 2002 sought studies that included 100% gay or bisexual men, employed randomized or controlled designs, had separate comparison group and post-intervention follow-up, and reported sufficient data to calculate effect size. The search yielded 18 controlled trials (6 international and 12 U.S.) reporting intervention effects on UAI. The results of a random-effects model showed that significant reductions in UAI were found in U.S.-based studies (OR=0.61, 95% CI, 0.47-0.78) but not international studies (OR=0.91, 95% CI, 0.63-1.30). Among the U.S. interventions, both community (4 studies; OR=0.61, 95% CI, 0.49-0.77) and individual/small group (8 studies; OR=0.62 95% CI, 0.45-0.86) interventions were associated with significant reductions in UAI. The public health implication of these findings is that community level interventions can be as effective as individual or group interventions in reducing risky sexual behaviors among MSM, and public health officials should consider implementing community interventions as they have the potential of making a greater impact by reaching a larger number of at-risk individuals. Explanations will be discussed regarding the nonsignificant results found for international studies, including study heterogeneity attributed to differences in study location, delivery method, and cultural differences.

Learning Objectives:

• Familiarization of HIV prevention interventions conducted in the United States and abroad targeting men who have sex with men (MSM).
• Informed that community interventions can be as effective as individual or group interventions in reducing risky sexual behaviors among MSM.
• Community-level interventions have the potential of making a greater impact by reaching a large number of at-risk individuals.

Keywords: HIV Interventions, Gay Men

Awards: Excellence in Abstract Submission among All Presenters--Award Winner - Honorable Mention

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.