Behavioural interventions to reduce sexual risk for HIV in heterosexual couples: a meta-analysis.

OBJECTIVES: The current study was conducted to synthesise evaluations of couple-based HIV prevention interventions, assess the efficacy of these interventions in reducing sexual risk, and identify moderators of intervention efficacy. METHODS: A comprehensive literature search identified 29 interventions (22 reports; N=5168 couples) that met the inclusion criteria, including enrolment of both members of a heterosexual couple, measurement of condom use at baseline and follow-up, and sufficient statistical information to calculate effect sizes. Effect sizes were analysed using fixed-effects and random-effects assumptions; factors related to intervention efficacy were identified using metaregression. RESULTS: Overall, there were significant increases in condom use from baseline to follow-up (d+=0.78, 95% CI 0.48 to 1.09) and significant decreases in partner concurrency (d+=0.37, 95% CI 0.13 to 0.60). Condom use increased to a greater extent when studies were conducted toward the beginning of the epidemic, were located in countries scoring lower on the Human Development Index, enrolled serodiscordant couples, and delivered intervention content in multiple contexts. Couples who had been together longer, reported higher incidence of sexually transmitted infection, were provided voluntary counselling and testing, and provided outcome measures during face-to-face interviews also reported larger increases in condom use. CONCLUSIONS: Couple-based interventions are efficacious in reducing unprotected sex within the context of romantic relationships. Future research should continue to improve risk reduction for couples.

Service priorities and unmet service needs among people living with HIV/AIDS: results from a nationwide interview of HIV/AIDS housing organizations.

Housing for people living with HIV/AIDS (PLWHA) has been linked to a number of positive physical and mental health outcomes, in addition to decreased sexual and drug-related risk behavior. The current study identified service priorities for PLWHA, services provided by HIV/AIDS housing agencies, and unmet service needs for PLWHA through a nationwide telephone survey of HIV/AIDS housing agencies in the USA. Housing, alcohol/drug treatment, and mental health services were identified as the three highest priorities for PLWHA and assistance finding employment, dental care, vocational assistance, and mental health services were the top needs not being met. Differences by geographical region were also examined. Findings indicate that while housing affords PLWHA access to services, there are still areas (e.g., mental health services) where gaps in linkages to care exist.

The role of men's physical attractiveness in women's perceptions of sexual risk: danger or allure?

The rate of casual sexual encounters is increasing on college campuses. To decrease sexual risk behavior, information used to judge sexual risk in others needs to be identified. Women rated male targets on willingness to have unprotected sex with the target and likelihood that the target has a sexually transmitted infection. Physical attractiveness was the strongest predictor of ratings, accounting for all the target variance in willingness to have unprotected sex. However, risk factors reported by the target were inconsistent predictors of perceived sexual risk. Findings are discussed within the context of safer sex interventions for college students.

A role for depression in sexual risk reduction for women? A meta-analysis of HIV prevention trials with depression outcomes.

Rates of HIV/AIDS and depression in women are significant public health concerns. The current meta-analysis tested the hypothesis that depression levels moderate change in sexual risk behavior in women participating in HIV prevention interventions. Features of the interventions were also explored as possible factors in decreasing levels of depression and sexual risk behavior. Included were HIV primary prevention interventions that measured sexual risk behavior and depression at baseline and follow-up and reported separate results for women. Ten studies (fourteen intervention groups and ten control groups; N = 4,195 women) met the inclusion criteria. The majority of participants were African American; mean age was 28-years old. Both depression and sexual risk behavior decreased significantly in treatment and control groups from baseline to follow-up. Sexual risk decreased more to the extent that interventions sampled (a) participants with higher baseline levels of depression, (b) older women, (c) Hispanics/Latinas, and/or (d) members of risk groups (e.g., drug users, homeless). Interventions that included (e) condom provision, (f) information about condoms, and/or (g) HIV counseling and testing were also more successful in decreasing sexual risk. Finally (h), interventions were more likely to reduce sexual risk behavior when they decreased depression to a large extent relative to baseline levels. Interventions were more likely to decrease depression when they (a) had samples of only women, (b) targeted risk groups, and/or (c) provided self-management and coping skills. Reducing depression appears to play a role in decreasing sexual risk behavior, suggesting that interventions should actively address depression.

Us versus Them in Context: Meta-Analysis as a Tool for Geotemporal Trends in Intergroup Relations.

The increasing availability of studies from many nations offers important potential insights into group-based psychology and behavior, conflict, and violence. Nonetheless, to date, few cross-national or cultural comparisons of study findings have been made, representing a gap in our understanding of the historical causes and courses of intergroup conflict in current comparative approaches. Meta-analytic methods offer researchers the ability to combine data from studies with groups as well as across time. Our review of statistical methods available for comparative analyses in intergroup research found strengths and limitations for understanding group differences, conflict, and violence, and meta-analytic methods address these limitations by exploring potential structural-level moderators and by identifying how temporal and geographical variations may relate directly to group-based variables. Such methods can contribute to our understanding of broad structural effects on group-based variables by elucidating the mechanisms underlying them.