Effectiveness of HIV risk reduction interventions among men who have sex with men in China: a systematic review and meta-analysis.

<h4>Objective</h4>To evaluate the effect of risk reduction interventions on HIV knowledge, attitudes and behaviors among men who have sex with men (MSM) in China.<h4>Methods</h4>We performed a systematic review and meta-analysis of HIV risk reduction intervention studies amon...

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Main Authors: Hongyan Lu, Yu Liu, Kapil Dahiya, Han-Zhu Qian, Wensheng Fan, Li Zhang, Juntao Ma, Yuhua Ruan, Yiming Shao, Sten H Vermund, Lu Yin
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0072747
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author Hongyan Lu
Yu Liu
Kapil Dahiya
Han-Zhu Qian
Wensheng Fan
Li Zhang
Juntao Ma
Yuhua Ruan
Yiming Shao
Sten H Vermund
Lu Yin
author_facet Hongyan Lu
Yu Liu
Kapil Dahiya
Han-Zhu Qian
Wensheng Fan
Li Zhang
Juntao Ma
Yuhua Ruan
Yiming Shao
Sten H Vermund
Lu Yin
author_sort Hongyan Lu
collection DOAJ
description <h4>Objective</h4>To evaluate the effect of risk reduction interventions on HIV knowledge, attitudes and behaviors among men who have sex with men (MSM) in China.<h4>Methods</h4>We performed a systematic review and meta-analysis of HIV risk reduction intervention studies among Chinese MSM. The summary difference of standardized mean differences (SMD) between both study arms or between pre- and post-intervention assessments were defined as the effect size (ES); ES was calculated using standard meta-analysis in random effects models.<h4>Results</h4>Thirty-four eligible studies were included in the analysis, including two randomized clinical trials (RCT), six quasi-experimental studies, six pre-and-post intervention studies, and twenty serial cross-sectional intervention studies. These studies showed an increase in consistent condom use with any male sexual partners (mean ES, 0.46; 95% confidence interval [CI], 0.35-0.56), with regular sexual partners (mean ES, 0.41; 95% CI, 0.18-0.63), and casual sexual partners (mean ES, 0.52; 95% CI, 0.24-0.79). The analysis of ten studies that measured the impact on uptake of HIV testing also showed a positive result (mean ES, 0.55; 95% CI, 0.38-0.71). The risk reduction interventions also improved HIV/AIDS-related knowledge (mean ES, 0.77; 95% CI, 0.60-0.94) and attitudes (mean ES, 1.35; 95% CI, 0.91-1.79), but did not reduce prevalence of HIV (mean ES, 0.23; 95% CI, 0.02-0.45) and syphilis infections (mean ES, -0.01; 95% CI, -0.19-0.17). There was significant heterogeneity among these studies.<h4>Conclusions</h4>On aggregate, HIV risk reduction interventions were effective in reducing risky behaviors and improving knowledge and attitudes among Chinese MSM, but were not associated with a change in the prevalence of HIV and syphilis. Future studies should use incidence as definitive study outcome.
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spelling doaj-art-97d5b1db4b7342e1987dd0e1b9ac93e42025-08-20T02:36:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0188e7274710.1371/journal.pone.0072747Effectiveness of HIV risk reduction interventions among men who have sex with men in China: a systematic review and meta-analysis.Hongyan LuYu LiuKapil DahiyaHan-Zhu QianWensheng FanLi ZhangJuntao MaYuhua RuanYiming ShaoSten H VermundLu Yin<h4>Objective</h4>To evaluate the effect of risk reduction interventions on HIV knowledge, attitudes and behaviors among men who have sex with men (MSM) in China.<h4>Methods</h4>We performed a systematic review and meta-analysis of HIV risk reduction intervention studies among Chinese MSM. The summary difference of standardized mean differences (SMD) between both study arms or between pre- and post-intervention assessments were defined as the effect size (ES); ES was calculated using standard meta-analysis in random effects models.<h4>Results</h4>Thirty-four eligible studies were included in the analysis, including two randomized clinical trials (RCT), six quasi-experimental studies, six pre-and-post intervention studies, and twenty serial cross-sectional intervention studies. These studies showed an increase in consistent condom use with any male sexual partners (mean ES, 0.46; 95% confidence interval [CI], 0.35-0.56), with regular sexual partners (mean ES, 0.41; 95% CI, 0.18-0.63), and casual sexual partners (mean ES, 0.52; 95% CI, 0.24-0.79). The analysis of ten studies that measured the impact on uptake of HIV testing also showed a positive result (mean ES, 0.55; 95% CI, 0.38-0.71). The risk reduction interventions also improved HIV/AIDS-related knowledge (mean ES, 0.77; 95% CI, 0.60-0.94) and attitudes (mean ES, 1.35; 95% CI, 0.91-1.79), but did not reduce prevalence of HIV (mean ES, 0.23; 95% CI, 0.02-0.45) and syphilis infections (mean ES, -0.01; 95% CI, -0.19-0.17). There was significant heterogeneity among these studies.<h4>Conclusions</h4>On aggregate, HIV risk reduction interventions were effective in reducing risky behaviors and improving knowledge and attitudes among Chinese MSM, but were not associated with a change in the prevalence of HIV and syphilis. Future studies should use incidence as definitive study outcome.https://doi.org/10.1371/journal.pone.0072747
spellingShingle Hongyan Lu
Yu Liu
Kapil Dahiya
Han-Zhu Qian
Wensheng Fan
Li Zhang
Juntao Ma
Yuhua Ruan
Yiming Shao
Sten H Vermund
Lu Yin
Effectiveness of HIV risk reduction interventions among men who have sex with men in China: a systematic review and meta-analysis.
PLoS ONE
title Effectiveness of HIV risk reduction interventions among men who have sex with men in China: a systematic review and meta-analysis.
title_full Effectiveness of HIV risk reduction interventions among men who have sex with men in China: a systematic review and meta-analysis.
title_fullStr Effectiveness of HIV risk reduction interventions among men who have sex with men in China: a systematic review and meta-analysis.
title_full_unstemmed Effectiveness of HIV risk reduction interventions among men who have sex with men in China: a systematic review and meta-analysis.
title_short Effectiveness of HIV risk reduction interventions among men who have sex with men in China: a systematic review and meta-analysis.
title_sort effectiveness of hiv risk reduction interventions among men who have sex with men in china a systematic review and meta analysis
url https://doi.org/10.1371/journal.pone.0072747
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