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Effectiveness of HIV Risk Reduction Interventions among Men who have Sex with Men in China: A Systematic Review and Meta-Analysis

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  • Hongyan Lu
  • Yu Liu
  • Kapil Dahiya
  • Han-Zhu Qian
  • Wensheng Fan
  • Li Zhang
  • Juntao Ma
  • Yuhua Ruan
  • Yiming Shao
  • Sten H Vermund
  • Lu Yin

Abstract

Objective: To evaluate the effect of risk reduction interventions on HIV knowledge, attitudes and behaviors among men who have sex with men (MSM) in China. Methods: We performed a systematic review and meta-analysis of HIV risk reduction intervention studies among Chinese MSM. The summary difference of standardized mean differences (SMD) between both study arms or between pre- and post-intervention assessments were defined as the effect size (ES); ES was calculated using standard meta-analysis in random effects models. Results: Thirty-four eligible studies were included in the analysis, including two randomized clinical trials (RCT), six quasi-experimental studies, six pre-and-post intervention studies, and twenty serial cross-sectional intervention studies. These studies showed an increase in consistent condom use with any male sexual partners (mean ES, 0.46; 95% confidence interval [CI], 0.35–0.56), with regular sexual partners (mean ES, 0.41; 95% CI, 0.18–0.63), and casual sexual partners (mean ES, 0.52; 95% CI, 0.24–0.79). The analysis of ten studies that measured the impact on uptake of HIV testing also showed a positive result (mean ES, 0.55; 95% CI, 0.38–0.71). The risk reduction interventions also improved HIV/AIDS-related knowledge (mean ES, 0.77; 95% CI, 0.60–0.94) and attitudes (mean ES, 1.35; 95% CI, 0.91–1.79), but did not reduce prevalence of HIV (mean ES, 0.23; 95% CI, 0.02–0.45) and syphilis infections (mean ES, −0.01; 95% CI, −0.19–0.17). There was significant heterogeneity among these studies. Conclusions: On aggregate, HIV risk reduction interventions were effective in reducing risky behaviors and improving knowledge and attitudes among Chinese MSM, but were not associated with a change in the prevalence of HIV and syphilis. Future studies should use incidence as definitive study outcome.

Suggested Citation

  • Hongyan Lu & Yu Liu & Kapil Dahiya & Han-Zhu Qian & Wensheng Fan & Li Zhang & Juntao Ma & Yuhua Ruan & Yiming Shao & Sten H Vermund & Lu Yin, 2013. "Effectiveness of HIV Risk Reduction Interventions among Men who have Sex with Men in China: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-15, August.
  • Handle: RePEc:plo:pone00:0072747
    DOI: 10.1371/journal.pone.0072747
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    References listed on IDEAS

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    1. Eric P F Chow & Ka I Iu & Xiaoxing Fu & David P Wilson & Lei Zhang, 2012. "HIV and Sexually Transmissible Infections among Money Boys in China: A Data Synthesis and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 7(11), pages 1-16, November.
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