OBJECTIVE: To perform a systematic review and meta-analysis of the efficacy of risk reduction interventions on HIV-related risk behaviors among people living with HIV/AIDS (PLWHA). METHODS: Studies included in the meta-analysis were randomized clinical trials (RCTs) of risk reduction interventions, which targeted PLWHA aged 18 year or older and assessed the changes of number of sexual partners, drug use, needle sharing, and/or alcohol abuse between pre- and post-intervention. The standardized mean differences (SMD) between study arms as well as between baseline and post-intervention, defined as the effect sizes (ES), were calculated in random effects models. Heterogeneity of studies was estimated by the I2 statistic. RESULTS: Twelve RCTs involving 3993 PLWHA were included in our analysis: seven reported impacts on the number of sexual partners, and three reported impacts on drug use, needle sharing, and alcohol abuse, respectively. There were no statistically significant impacts of risk reduction interventions on the number of total sexual partners (mean ES, -0.10; 95% confidence interval [CI], -0.26, 0.06; P=0.22) or on the subset of HIV-negative or unknown-status sexual partners (mean ES, 0.003; 95% CI, -0.54, 0.54; P=0.99). Overall, risk reduction intervention studies documented a reduction of drug abuse (mean ES: -0.26; 95% CI: -0.51, -0.01; P=0.04) among HIV-infected drug users, but this impact was mainly attributable to one study. Risk reduction interventions did not show a reduction of needle sharing (mean ES, -0.15; 95% CI, -0.43, 0.13; P=0.29) or of alcohol abuse (mean ES, -0.10; 95% CI, -0.36, 0.17; P=0.47). No heterogeneity or publication bias was found across individual studies. CONCLUSIONS: Our meta-analysis did not find a positive impacts of risk reduction interventions on number of sexual partners, drug use, needle sharing, or alcohol abuse among PLWHA, but the small number of studies meeting our review criteria limits these findings.
OBJECTIVE: To perform a systematic review and meta-analysis of the efficacy of risk reduction interventions on HIV-related risk behaviors among people living with HIV/AIDS (PLWHA). METHODS: Studies included in the meta-analysis were randomized clinical trials (RCTs) of risk reduction interventions, which targeted PLWHA aged 18 year or older and assessed the changes of number of sexual partners, drug use, needle sharing, and/or alcohol abuse between pre- and post-intervention. The standardized mean differences (SMD) between study arms as well as between baseline and post-intervention, defined as the effect sizes (ES), were calculated in random effects models. Heterogeneity of studies was estimated by the I2 statistic. RESULTS: Twelve RCTs involving 3993 PLWHA were included in our analysis: seven reported impacts on the number of sexual partners, and three reported impacts on drug use, needle sharing, and alcohol abuse, respectively. There were no statistically significant impacts of risk reduction interventions on the number of total sexual partners (mean ES, -0.10; 95% confidence interval [CI], -0.26, 0.06; P=0.22) or on the subset of HIV-negative or unknown-status sexual partners (mean ES, 0.003; 95% CI, -0.54, 0.54; P=0.99). Overall, risk reduction intervention studies documented a reduction of drug abuse (mean ES: -0.26; 95% CI: -0.51, -0.01; P=0.04) among HIV-infected drug users, but this impact was mainly attributable to one study. Risk reduction interventions did not show a reduction of needle sharing (mean ES, -0.15; 95% CI, -0.43, 0.13; P=0.29) or of alcohol abuse (mean ES, -0.10; 95% CI, -0.36, 0.17; P=0.47). No heterogeneity or publication bias was found across individual studies. CONCLUSIONS: Our meta-analysis did not find a positive impacts of risk reduction interventions on number of sexual partners, drug use, needle sharing, or alcohol abuse among PLWHA, but the small number of studies meeting our review criteria limits these findings.
Entities:
Keywords:
Alcohol abuse; Drug use; Meta-analysis; People living with HIV/AIDS (PLWHA); Positive prevention; Randomized clinical trial (RCT); Sexual partners
Authors: Rafaela R Robles; Juan C Reyes; Héctor M Colón; Hardeo Sahai; C Amalia Marrero; Tomás D Matos; José M Calderón; Elizabeth W Shepard Journal: J Subst Abuse Treat Date: 2004-09
Authors: Rebecca Bunnell; John Paul Ekwaru; Peter Solberg; Nafuna Wamai; Winnie Bikaako-Kajura; Willy Were; Alex Coutinho; Cheryl Liechty; Elizabeth Madraa; George Rutherford; Jonathan Mermin Journal: AIDS Date: 2006-01-02 Impact factor: 4.177
Authors: S C Kalichman; D Rompa; M Cage; K DiFonzo; D Simpson; J Austin; W Luke; J Buckles; F Kyomugisha; E Benotsch; S Pinkerton; J Graham Journal: Am J Prev Med Date: 2001-08 Impact factor: 5.043
Authors: Sharon M Coleman; Serena Rajabiun; Howard J Cabral; Judith B Bradford; Carol R Tobias Journal: AIDS Patient Care STDS Date: 2009-08 Impact factor: 5.078
Authors: Michelle Teti; Lisa Bowleg; Russell Cole; Linda Lloyd; Susan Rubinstein; Susan Spencer; Erika Aaron; Ann Ricksecker; Zekarias Berhane; Marla Gold Journal: AIDS Behav Date: 2009-04-09
Authors: Vivian F Go; Constantine Frangakis; Nguyen Le Minh; Tran Viet Ha; Carl A Latkin; Teerada Sripaipan; Carla E Zelaya; Wendy W Davis; David D Celentano; Vu Minh Quan Journal: J Acquir Immune Defic Syndr Date: 2017-02-01 Impact factor: 3.731
Authors: Sarah E Woolf-King; Madison Firkey; Jacklyn D Foley; Jonathan Bricker; Judith A Hahn; Elizabeth Asiago-Reddy; John Wikier; Dezarie Moskal; Alan Z Sheinfil; Jeremy Ramos; Stephen A Maisto Journal: AIDS Behav Date: 2022-03-18
Authors: Lu Yin; Na Wang; Sten H Vermund; Bryan E Shepherd; Yuhua Ruan; Yiming Shao; Han-Zhu Qian Journal: PLoS One Date: 2014-09-22 Impact factor: 3.240