Behavioral interventions to reduce HIV-related sexual risk behavior: review and synthesis of meta-analytic evidence

Abstract

Over the past 25 years, scores of behavioral interventions to reduce HIV-related sexual risk behavior have been developed and evaluated. The purpose of the current study was to synthesize what is known about such interventions by systematically reviewing and synthesizing extant meta-analyses of the literature. Comprehensive search procedures resulted in a set of 18 meta-analyses that targeted HIV-related sexual risk behavior in a defined target population. The median meta-analysis in the review contained k = 19 primary studies with a cumulative N = 9,423 participants. All meta-analyses (11/11) that examined condom use found a statistically significant increase (median effect: OR = 1.34); 9/11 for reducing unprotected sex (median effect: OR = .76); 3/8 for reducing numbers of sexual partners (median effect: OR = .87); 4/6 for reduction of STDs (median effect: OR = .74); and 5/5 for reducing composite sexual risk (median effect: OR = .78). Summaries of moderator analyses suggested particular participant, intervention, and methodological characteristics that may influence the success of interventions. Implications include achieving a broader understanding of intervention moderators as well as increasing effectiveness trials and translation/dissemination of efficacious interventions to those populations most at risk.