Efficacy of HIV/STI behavioral interventions for heterosexual African American men in the United States: a meta-analysis

Abstract

This meta-analysis estimates the overall efficacy of HIV prevention interventions to reduce HIV sexual risk behaviors and sexually transmitted infections (STIs) among heterosexual African American men. A comprehensive search of the literature published during 1988-2008 yielded 44 relevant studies. Interventions significantly reduced HIV sexual risk behaviors and STIs. The stratified analysis for HIV sexual risk behaviors indicated that interventions were efficacious for studies specifically targeting African American men and men with incarceration history. In addition, interventions that had provision/referral of medical services, male facilitators, shorter follow-up periods, or emphasized the importance of protecting family and significant others were associated with reductions in HIV sexual risk behaviors. Meta-regression analyses indicated that the most robust intervention component is the provision/referral of medical services. Findings indicate that HIV interventions for heterosexual African American men might be more efficacious if they incorporated a range of health care services rather than HIV/STI-related services alone.

Fig. 1

Trial selection process for meta-analytic review of HIV/STI behavioral interventions for African-American males (January 1988–May 2008)

Fig. 2

Study specific and overall ES estimates (40 trials) of HIV sexual risk behavior outcomes for behavioral interventions targeting heterosexual African American men. Note. “Combo”-combined effect size of condom use (CU), unprotected sex (UPS), and author-defined HIV-risk behavior index (sex index) within a study. The boxes represent study weights (inverse variance of random-effects model)

Fig. 3

Study specific and overall ES estimates (11 trials) of STIs outcomes for behavioral interventions targeting heterosexual African American men. Note. The boxes represent study weights (inverse variance of random-effects model)