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Effectiveness of Interventions to Prevent Sexually Transmitted Infections and Human Immunodeficiency Virus in Heterosexual Men
A Systematic Review
A. Rani Elwy, PhD;
Graham J. Hart, PhD;
Sarah Hawkes, PhD, MBBS;
Mark Petticrew, PhD
Arch Intern Med. 2002;162:1818-1830.
Our objective was to review systematically studies of interventions
to prevent transmission of sexually transmitted infections (STIs) and human
immunodeficiency virus (HIV) in heterosexual men. Of 1157 studies identified
through database and hand searching, 27 met our inclusion criteria. Most interventions
targeted specific groups of men (eg, those attending STI clinics) rather than
general populations. Few were conducted with men alone, and most focused on
behavioral and social psychological rather than morbidity outcomes. Of 8 interventions
designed to reduce STI incidence (including HIV), 5 were successful, 2 were
unsuccessful, and 1 had equivocal results. Of the 5 successful interventions,
1 was carried out in the workplace, 1 in the military, and 3 in STI clinics.They
included on-site individual counseling and HIV testing, mass communications
regarding risk reduction, and multiple-component motivation and skills education
in STI clinics. More high-quality research into the effectiveness of interventions
targeting heterosexual men is needed, especially methodologically sound trials
to evaluate effects on morbidity.
From the Medical Research Council, Social and Public Health Sciences
Unit, University of Glasgow, Glasgow, Scotland (Drs Elwy, Hart, and Petticrew),
and the London School of Hygiene and Tropical Medicine, London, England (Dr
Hawkes).
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