AIDS and Behavior

, Volume 17, Issue 6, pp 1963–1978 | Cite as

An International Systematic Review and Meta-analysis of Multisession Psychosocial Interventions Compared with Educational or Minimal Interventions on the HIV Sex Risk Behaviors of People Who Use Drugs

  • Nicholas Meader
  • Salaam Semaan
  • Marie Halton
  • Henna Bhatti
  • Melissa Chan
  • Alexis Llewellyn
  • Don C. Des Jarlais
Substantive Review

Abstract

This systematic review and meta-analysis examines the effectiveness of multisession psychosocial interventions compared with educational interventions and minimal interventions in reducing sexual risk in people who use drugs (51 studies; 19,209 participants). We conducted comprehensive searches (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and PsychINFO 1998–2012). Outcomes (unprotected sex, condom use, or a composite outcome) were extracted by two authors and synthesised using meta-analysis. Subgroup analyses and meta-regression were conducted to explore heterogeneity. Multisession psychosocial interventions had modest additional benefits compared to educational interventions (K = 46; OR 0.86; 95 % CI 0.77, 0.96), and large positive effects compared to minimal interventions (K = 7; OR 0.60; 95 % CI 0.46, 0.78). Comparison with previous meta-analyses suggested limited progress in recent years in developing more effective interventions. Multisession psychosocial and educational interventions provided similar modest sexual risk reduction justifying offering educational interventions in settings with limited exposure to sexual risk reduction interventions, messages, and resources.

Keywords

HIV/AIDS prevention People who use drugs Harm reduction Meta-analysis Sexual risk behavior 

Notes

Acknowledgments

The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. Don Des Jarlais was supported in part by Grant R01 AI 083035 from the US National Institutes of Health. No conflicts of interest were declared by any authors.

Supplementary material

10461_2012_403_MOESM1_ESM.doc (66 kb)
Supplementary material 1 (DOC 67 kb)
10461_2012_403_MOESM2_ESM.doc (230 kb)
Supplementary material 2 (DOC 230 kb)

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Nicholas Meader
    • 1
  • Salaam Semaan
    • 2
  • Marie Halton
    • 3
  • Henna Bhatti
    • 3
  • Melissa Chan
    • 5
  • Alexis Llewellyn
    • 1
  • Don C. Des Jarlais
    • 4
  1. 1.Centre for Reviews and DisseminationUniversity of YorkYorkUK
  2. 2.Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB PreventionAtlantaUSA
  3. 3.National Collaborating Centre for Mental Health, Royal College of Psychiatrists Research UnitLondonUK
  4. 4.Beth Israel Medical Center, Baron Edmond de Rothschild Chemical Dependency InstituteNew YorkUSA
  5. 5.University of Hong KongPokfulamHong Kong

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