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Meta-Analysis
. 2020 Feb 10;10(1):2197.
doi: 10.1038/s41598-020-58767-0.

Effectiveness of interventions for changing HIV related risk behaviours among key populations in low-income setting: A Meta-Analysis, 2001-2016

Keshab Deuba  1   2   3 , Diksha Sapkota  4 , Upendra Shrestha  5 , Rachana Shrestha  6 , Bir Bahadur Rawal  7 , Komal Badal  8 , Kathleen Baird  4 , Anna Mia Ekström  9   10
Affiliations
Meta-Analysis

Effectiveness of interventions for changing HIV related risk behaviours among key populations in low-income setting: A Meta-Analysis, 2001-2016

Keshab Deuba et al. Sci Rep. .

Abstract

The aim of this review was to conduct a meta-analysis to assess the effectiveness of behavioural interventions to reduce HIV-related risk behaviours among key populations: people who inject drugs, female sex workers, men who have sex with men and transgender in Nepal over the last two decades. Using four electronic databases, we performed a systematic search of the literature on HIV interventions implemented in Nepal and published from January 2001 to December 2016. In addition, grey literature was also scrutinised for potential articles. The search focussed specifically on behavioural interventions (peer education and HIV testing services) targeted for key populations. Random-effects models were used to calculate the pooled odds ratio for dichotomous outcomes (condom use in last sex or unsafe injection practices), pooled HIV prevalence and subgroup analyses by age groups and epidemic zones in Nepal. Forty-three studies with 15,642 participants were included (people who inject drugs: 7105; men who have sex with men and transgender: 2637; female sex workers: 5900). Pooled prevalence showed a higher occurrence of HIV among people who inject drugs (12%) followed by men who have sex with men/transgender (5%) and female sex workers (2%) respectively. There was a significant increase in the odds of condom use among female sex workers, men who have sex with men and transgender who received peer education interventions in both informal and formal setting compared to those who did not. Similarly, the odds of condom use among female sex workers, men who have sex with men and transgender improved significantly among those who received HIV counselling and testing services as compared to those who did not use such services. Subgroup analyses also verified the effectiveness of these interventions for both young and adult key populations and across all three epidemic zones. However, none of the included interventions were found to be effective for reducing unsafe injection practices among people who inject drugs. HIV prevention interventions in Nepal have effectively reduced risky behaviours among female sex workers, men who have sex with men and transgender over the last two decades but not among people who inject drugs. This calls for continued implementation of existing efforts as well as for new interventions adapted to the needs of people who inject drugs.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart using the PRISMA statement.
Figure 2
Figure 2
Effectiveness of peer-driven interventions (informal setting) across epidemic zones among FSW.
Figure 3
Figure 3
Effectiveness of peer-driven interventions (informal setting) across age groups among FSW.
Figure 4
Figure 4
Effectiveness of peer driven interventions (formal setting) across epidemic zones among FSW.
Figure 5
Figure 5
Effectiveness of peer driven interventions (formal setting) across age groups among FSW.
Figure 6
Figure 6
Effectiveness of HTS visit among FSW across epidemic zones.
Figure 7
Figure 7
Effectiveness of HTS visit among female sex workers across age groups.
Figure 8
Figure 8
Effectiveness of peer-led intervention (informal setting) among MSM and TG across age groups.
Figure 9
Figure 9
Effectiveness of peer-led interventions (formal setting) for MSM and TG across age groups.
Figure 10
Figure 10
Effectiveness of HTS among MSM and TG across age groups.
Figure 11
Figure 11
Effectiveness of peer-led intervention (informal setting) among PWID across age groups.
Figure 12
Figure 12
Effectiveness of peer-led intervention (formal setting) among PWID across age groups.
Figure 13
Figure 13
Effectiveness of HTS among PWID across age groups.
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References

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