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A Systematic Review and Meta-Analysis of Behavioral Interventions to Reduce HIV Risk Behaviors of Hispanics in the United States and Puerto Rico

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Abstract

This systematic review examines the overall efficacy of HIV behavioral interventions designed to reduce HIV risk behaviors or incident sexually transmitted diseases (STDs) among Hispanics residing in the United States or Puerto Rico. Data from 20 randomized and nonrandomized trials (N = 6,173 participants) available through January 2006 were included in this review. Interventions successfully reduced the odds of unprotected sex and number of sex partners, increased the odds of condom use, and decreased the odds of acquiring new STD infections. Interventions successful in reducing the odds of any sex risk behavior used non-peer deliverers; included ≥4 intervention sessions; taught condom use or problem solving skills; or addressed barriers to condom use, sexual abstinence, or peer norms. Interventions that included the Hispanic cultural belief of machismo or those developed based on ethnographic interviews were successful in reducing the odds of sex risk behaviors among non-drug users. Interventions targeting injection drug users (IDUs; N = 3,569) significantly reduced the odds of injection drug use and the odds of sharing cotton or cookers, but did not significantly reduce the odds of engaging in risky sex behavior or needle sharing. Further development of culturally appropriate HIV prevention interventions for Hispanic populations, particularly men and persons living with HIV, are warranted.

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Notes

  1. Requests were sent by e-mail to 23 principal investigators of intervention studies that focused on Hispanics identified through our search of conference abstracts and referrals from experts. Eighteen authors (78%) responded to our requests by either providing additional information about their study design (five authors), sending summary data to facilitate calculation of effect sizes (11 authors), or supplying the names of additional researchers (two authors). Four authors submitted in press intervention evaluation reports to the PRS Team for review and potential inclusion in this review (Carballo-Diéguez et al., 2005; Peragallo et al., 2005; Robles et al., 2004; Villarruel, Jemmott, & Jemmott, 2006).

  2. The number of studies included in the stratified analyses was reduced from 20 to 19 because the study reported by O’Donnell et al. (1995; 1998) did not report unprotected sex, condom use, or number of sex partners.

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Acknowledgements

The following current and former PRS team members contributed to this review (listed alphabetically): Julia B. DeLuca, Angela B. Hutchinson, Angela Kim, Paola Marrero-Gonzales, Mary Mullins, Sima Rama, R. Thomas Sherba, and Sekhar Thadiparthi. The authors also extend special thanks to the following researchers for providing additional information or outcome data regarding their interventions: Alex Carballo-Diéguez, Felipe Castro, Marie Harvey, Deborah Koniak-Griffin, Sarah McGraw, Carl O’Donnell, Anita Raj, Rafaela Robles, Robert Schilling, Merrill Singer, and Antonia Villarruel. The authors also thank Mary Spink Neumann, Carolyn G. Beeker, and three anonymous reviewers for providing insightful comments.

This work was supported by the Prevention Research Branch, Division of HIV/AIDS Prevention and was not funded by any other organization. Preliminary findings of this review were presented at the 111th Annual Convention of the American Public Health Association in Washington, DC (November, 2004), and at the 2005 National HIV Prevention Conference in Atlanta, GA (June, 2005).

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Correspondence to Jeffrey H. Herbst.

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Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the U.S. Centers for Disease Control and Prevention.

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Herbst, J.H., Kay, L.S., Passin, W.F. et al. A Systematic Review and Meta-Analysis of Behavioral Interventions to Reduce HIV Risk Behaviors of Hispanics in the United States and Puerto Rico. AIDS Behav 11, 25–47 (2007). https://doi.org/10.1007/s10461-006-9151-1

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