Online Program

A systematic review of interventions to reduce alcohol use in men who have sex with men

Monday, November 4, 2013

Benjamin Grin, BA, Program in Public Health, Brown University, Providence, RI
Don Operario, PhD, Department of Behavioral and Social Sciences, Brown University, School of Public Health, Providence, RI
Christopher Kahler, PhD, Center for Alcohol and Addiction Studies, Brown University, Providence, RI
Brandon Marshall, PhD, Department of Epidemiology, Brown University, Providence, RI
Jacob van den Berg, PhD, Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI
Nickolas Zaller, PhD, Alpert Medical School, The Miriam Hospital/Brown University, Providence, RI
Background: There is substantial evidence linking alcohol use to poor health outcomes, including HIV transmission, in men who have sex with men (MSM). No prior study has systematically evaluated the effects of interventions to reduce alcohol use in MSM.

Methods: Using systematic review methodology, we searched PubMed (MEDLINE) for randomized controlled trials published between 1980 and 2013 testing interventions to reduce alcohol use in MSM. We included RCTs in which MSM comprised at least 50% of the study sample and where outcomes specific to alcohol use were reported.

Results: After screening 1,868 abstracts, we identified 7 trials (N=2,672 participants) that met inclusion criteria. Methodological quality and intervention content varied between studies. Programs targeted diverse MSM sub-populations, including MSM with alcohol use disorders, homeless MSM, bar attendees, and gay couples. Of 7 studies, 3 found protective effects compared with control on follow-up alcohol use behaviors. One study targeted HIV-positive patients only, another targeted problem-drinking MSM, and the third focused on gay couples. A fourth study in problem-drinking MSM found significant effects for two intervention conditions but lacked a randomized control group. Only 2 studies assessed for intervention effects on sexual risk behavior. Meta-analysis was not possible because of design and measurement heterogeneity.

Discussion: This review found limited evidence for efficacy of alcohol use interventions in MSM. Rigorous formative research is urgently needed to develop more effective interventions for reducing alcohol use in this population. Future intervention trials should pay particular attention to measurement of intervention effects on HIV risk behaviors.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Identify efficacious interventions to reduce alcohol use in men who have sex with men (MSM) Evaluate the methodological quality of interventions to reduce alcohol use in MSM Discuss implementation strategies and research directions for reducing alcohol use in MSM

Keyword(s): Alcohol Use, Gay Men

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a Brown MPH student, I designed and implemented a cross-sectional study to examine knowledge about acute HIV infection in gay and bisexual male college students for my thesis research. I currently work as a full-time research assistant on an NIAAA-funded study of the co-occurence of alcohol use and HIV risk in sexual minority populations. My research interests include the application of public health research to HIV risk reduction interventions and clinical HIV medicine.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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