Higa, D.H., N. Crepaz, K.J. Marshall, et al. AIDS and Behavior (February 2013), e-publication ahead of print.
To address gaps and facilitate implementation of effective behavioral interventions for men who have sex with men (MSM), the authors conducted a systematic review of HIV behavioral prevention interventions for MSM in the United States to identify how many targeted MSM; assess challenges to obtaining effective results in interventions that did not meet criteria to be deemed an evidence-based intervention (EBI); and compare non-EBI with EBIs. Of 33 MSM behavioral intervention studies identified, 27 percent (n=9) were EBIs. Seventy-three percent (n=24) were considered non-EBI, primarily because these did not show significant positive effects on a behavioral or biological outcome. Overall, compared with EBIs, non-EBIs significantly targeted HIV-negative MSM more frequently, and were less likely to be piloted or include peer and sexual communication components. The majority of non-EBIs were small group designs. Also, non-EBIs were significantly more likely to include substance use and use a non-HIV related comparison group. The authors provided several lessons learned from non-EBIs and considerations for MSM behavioral interventions, including involving MSM in the program design, pilot testing interventions, and utilizing peer and sexual communication components. Future behavioral interventions for MSM of color, particularly African Americans and Latinos, are necessary. Behavioral interventions targeting MSM need to be strengthened and should be included in comprehensive combination approaches.