title: The efficacy of HIV/STI behavioral interventions for African American females in the United States: a meta-analysis.
abstract: OBJECTIVE
  We evaluated the efficacy of HIV behavioral interventions for African American females in the United States, and we identified factors associated with intervention efficacy.
  
  
  METHODS
  We conducted a comprehensive literature review covering studies published from January 1988 to June 2007, which yielded 37 relevant studies. Data were analyzed using mixed-effects models and meta-regression.
  
  
  RESULTS
  Overall, behavioral interventions had a significant impact on reductions in HIV-risk sex behaviors (odds ratio [OR] = 0.63; 95% confidence interval [CI] = 0.54, 0.75; n = 11 239; Cochrane Q(32) = 84.73; P < .001) and sexually transmitted infections (STIs; OR = 0.81; 95% CI = 0.67, 0.98; n = 8760; Cochrane Q(16) = 22.77; P = .12). Greater intervention efficacy was observed in studies that specifically targeted African American females used gender- or culture-specific materials, used female deliverers, addressed empowerment issues, provided skills training in condom use and negotiation of safer sex, and used role-playing to teach negotiation skills.
  
  
  CONCLUSIONS
  Behavioral interventions are efficacious at preventing HIV and STIs among African American females. More research is needed to examine the potential contribution of prevention strategies that attend to community-level and structural-level factors affecting HIV infection and transmission in this population.
authors.affiliation: Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, 1600 Clifton Road, Mailstop E-37, Atlanta, GA 30333, USA. ncrepaz@cdc.gov
authors.forename: Nicole
authors.initials: N
authors.lastname: Crepaz
authors.forename: Khiya J
authors.initials: KJ
authors.lastname: Marshall
authors.forename: Latrina W
authors.initials: LW
authors.lastname: Aupont
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Jacobs
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Linda S
authors.initials: LS
authors.lastname: Kay
authors.forename: Patricia
authors.initials: P
authors.lastname: Jones
authors.forename: Donna Hubbard
authors.initials: DH
authors.lastname: McCree
authors.forename: Ann
authors.initials: A
authors.lastname: O'Leary
mesh_terms: D001741:Black or African American / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016017:Odds Ratio; D040242:Risk Reduction Behavior; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D014481:United States