Original Paper

AIDS and Behavior

, Volume 17, Issue 4, pp 1231-1244

A Systematic Review to Identify Challenges of Demonstrating Efficacy of HIV Behavioral Interventions for Gay, Bisexual, and Other Men Who Have Sex with Men (MSM)

  • Darrel H. HigaAffiliated withPrevention Research Branch, Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention Email author 
  • , Nicole CrepazAffiliated withPrevention Research Branch, Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention
  • , Khiya J. MarshallAffiliated withPrevention Research Branch, Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention
  • , Linda KayAffiliated withPrevention Research Branch, Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention
  • , H. Waverly VosburghAffiliated withPrevention Research Branch, Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention
  • , Pilgrim SpikesAffiliated withPrevention Research Branch, Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention
  • , Cynthia M. LylesAffiliated withPrevention Research Branch, Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention
  • , David W. PurcellAffiliated withPrevention Research Branch, Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention

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Abstract

Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV but few MSM-specific evidence-based interventions (EBIs) have been identified for this vulnerable group. We conducted a systematic review to identify reasons for the small number of EBIs for MSM. We also compared study, intervention and sample characteristics of EBIs versus non-EBIs to better understand the challenges of demonstrating efficacy evidence. Thirty-three MSM-specific studies were evaluated: Nine (27 %) were considered EBIs while 24 (73 %) were non-EBIs. Non-EBIs had multiple methodological limitations; the most common was not finding a significant positive effect. Compared to EBIs, non-EBIs were less likely to use peer intervention deliverers, include sexual communication in their interventions, and intervene at the community level. Incorporating characteristics associated with EBIs may strengthen behavioral interventions for MSM. More EBIs are needed for substance-using MSM, MSM of color, MSM residing in the south and MSM in couples.

Keywords

HIV prevention Men who have sex with men Behavioral interventions Systematic review