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Cluster-randomized controlled trial of an HIV/sexually transmitted infection risk-reduction intervention for South African men

Author

Listed:
  • Jemmott, J.B.
  • Jemmott, L.S.
  • O'Leary, A.
  • Ngwane, Z.
  • Icard, L.D.
  • Heeren, G.A.
  • Mtose, X.
  • Carty, C.

Abstract

Objectives. We tested the efficacy of a sexual risk-reduction intervention for men in South Africa, where heterosexual exposure is the main mode of HIV transmission. Methods. Matched-pairs of neighborhoods in Eastern Cape Province, South Africa, were randomly selected and within pairs randomized to 1 of 2 interventions based on social cognitive theory and qualitative research: HIV/sexually transmitted infection (STI) risk-reduction, targeting condom use, or attentionmatched control, targeting health issues unrelated to sexual risks. Sexually active men aged 18 to 45 years were eligible. The primary outcome was consistent condom use in the past 3 months. Results. Of 1181 participants, 1106 (93.6%) completed the 12-month follow-up. HIV and STI risk-reduction participants had higher odds of reporting consistent condom use (odds ratio [OR] = 1.32; 95% confidence interval [CI] = 1.03, 1.71) and condom use at last vaginal intercourse (OR = 1.40; 95% CI = 1.08, 1.82) than did attention-control participants, adjusting for baseline prevalence. No differences were observed on unprotected intercourse or multiple partnerships. Findings did not differ for sex with steady as opposed to casual partners. Conclusions. Behavioral interventions specifically targeting men can contribute to efforts to reduce sexual risk behaviors in South Africa.

Suggested Citation

  • Jemmott, J.B. & Jemmott, L.S. & O'Leary, A. & Ngwane, Z. & Icard, L.D. & Heeren, G.A. & Mtose, X. & Carty, C., 2014. "Cluster-randomized controlled trial of an HIV/sexually transmitted infection risk-reduction intervention for South African men," American Journal of Public Health, American Public Health Association, vol. 104(3), pages 467-473.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2013.301578_8
    DOI: 10.2105/AJPH.2013.301578
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    Cited by:

    1. Wendee M. Wechsberg & Isa van der Drift & Brittni N. Howard & Bronwyn Myers & Felicia A. Browne & Courtney Peasant Bonner & Tara Carney & Jacqueline Ndirangu & Yukiko Washio, 2022. "Gender and Context Matter: Behavioral and Structural Interventions for People Who Use Alcohol and Other Drugs in Africa," IJERPH, MDPI, vol. 19(14), pages 1-24, July.
    2. Melanie Prague & Rui Wang & Alisa Stephens & Eric Tchetgen Tchetgen & Victor DeGruttola, 2016. "Accounting for interactions and complex inter‐subject dependency in estimating treatment effect in cluster‐randomized trials with missing outcomes," Biometrics, The International Biometric Society, vol. 72(4), pages 1066-1077, December.

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