HIV prevention programs with heterosexuals.
OBJECTIVE
Efficacious HIV prevention programs designed for heterosexual adults were identified.


METHODS
Thirty-two programs designed with a comparison group and aimed at preventing heterosexual transmission for HIV were identified utilizing computerized data bases and key informants.


RESULTS
Three types of efficacious interventions were identified: (1) those based on social cognitive theories that aimed to improve HIV-related knowledge, attitudes, norms, and behavioral practices (n = 27); (2) treatment of sexually transmitted diseases (STDs) (n = 3); and (3) pre- and post-test HIV testing and counseling programs (n = 2). The high incidence of HIV and STD in international settings has resulted in these trials demonstrating the greatest reductions in risk for HIV, reflected in biological markers of infection. Only five of 12 studies with injecting drug users were successful in reducing sexual risk behaviors. The optimal STD treatment strategy (syndromic case management, mass treatment) varies across communities. HIV testing and counseling appears an efficacious strategy, particularly for seropositive adults, yet current models have not considered the impact of new technologies on HIV testing paradigms.


CONCLUSIONS
Each successful prevention strategy faces significant challenges before broad dissemination of the intervention approach can be achieved.
Rotheram-Borus
M J
MJ
AIDS Institute, Center for HIV Identification, Prevention, and Treatment Services, Department of Psychiatry, University of California, Los Angeles 90024, USA. rotheram@ucla.edu
Cantwell
S
S
Newman
P A
PA
D003376:Counseling; D015658:HIV Infections / Q000150:complications / Q000517:prevention & control*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D001523:Mental Disorders / Q000150:complications; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications