A Systematic Review of Behavioral Interventions to Prevent HIV Infection and Transmission among Heterosexual, Adult Men in Low- and Middle-Income Countries

March 2013 - Behavioral Prevention

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Townsend, L., C. Mathews, and Y. Zembe. Prevention Science (2013), Volume 14, pp. 88-105.

The authors of this review assessed 19 studies and summarized the effectiveness of several interventions for HIV prevention activities in low- and middle-income countries (LAMIC). All studies either targeted or measured condom use; the majority found increased condom use (n=13); with 12 of these interventions providing condoms. Individual counseling based on information, motivation, and behavior skills (IMB) was a relatively effective strategy to increase condom use. Thirteen studies included interventions to reduce multiple sexual partnerships, but findings showed little effect on decreasing them. However, interventions that did succeed in reducing the number of partners incorporated group, large-scale, or community-based activities based on IMB values. Five studies that addressed the effects of alcohol use found mixed results, but again, group settings, particularly those including IMB components, were successful in reducing harmful alcohol consumption. Only two studies addressed gender-based violence, and one intervention was found effective. The authors recommended supplying condoms as an intervention component and addressing challenges such as access to or inconsistency of condom use for some populations. In settings where multiple sexual partnerships are customary, interventions should address social norms. The authors concluded that interventions targeting heterosexual men in LAMIC should address multiple sexual partners and alcohol use, and utilize combinations of effective behavioral interventions. Additional interventions targeting heterosexual males in LAMIC are needed.

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