Publication year: 2011
Source: Social Science & Medicine, Available online 1 October 2011
Judy Y. Tan, Tania B. Huedo-Medina, Michelle R. Warren, Michael Carey, Blair T. Johnson
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.
Highlights
.► The first, rigorous quantitative synthesis of HIV/AIDS intervention efficacy in Asian nations. ► HIV is spreading rapidly in pockets across Asia; such A state of affairs calls for swift evidence-based measures. ► Results are based on 53 HIV interventions examining dimensions of the interventions and of the nations in which they were conducted. ► Results have the potential to advance HIV prevention scholarship and inform changes at the policy level.