HIV/STI Prevention Interventions: A Systematic Review and Meta-analysis

Area of Science:

• Public Health
• Epidemiology
• Behavioral Science

Background:

• Behavioral interventions are crucial for preventing HIV and sexually transmitted infections (STIs).
• Assessing the effectiveness and evidence quality of these interventions for people living with HIV (PLWH) in high-income countries is essential.

Purpose of the Study:

• To systematically review and meta-analyze HIV prevention interventions for PLWH in high-income settings.
• To evaluate the effectiveness and quality of evidence for various intervention types.

Main Methods:

• Searched MEDLINE, EMBASE, PsycINFO, and CDC Compendium for interventions published between January 1998 and September 2015.
• Assessed evidence quality using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.
• Included 46 articles and 63 datasets involving 14,096 individuals.

Main Results:

• Few interventions demonstrated high/moderate quality evidence and statistically significant effects.
• Group-level health education interventions effectively reduced HIV/STI incidence compared to attention controls.
• Comprehensive risk counseling and services reduced sexual risk behaviors compared to active and attention controls.
• Other interventions showed no significant effect or had low/very low evidence quality.

Conclusions:

• The majority of HIV prevention interventions for PLWH in high-income settings have low or very low quality evidence.
• Rigorous evaluation and high-quality reporting are critical for future HIV intervention studies.