title: An international systematic review and meta-analysis of multisession psychosocial interventions compared with educational or minimal interventions on the HIV sex risk behaviors of people who use drugs.
abstract: This systematic review and meta-analysis examines the effectiveness of multisession psychosocial interventions compared with educational interventions and minimal interventions in reducing sexual risk in people who use drugs (51 studies; 19,209 participants). We conducted comprehensive searches (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and PsychINFO 1998-2012). Outcomes (unprotected sex, condom use, or a composite outcome) were extracted by two authors and synthesised using meta-analysis. Subgroup analyses and meta-regression were conducted to explore heterogeneity. Multisession psychosocial interventions had modest additional benefits compared to educational interventions (K = 46; OR 0.86; 95% CI 0.77, 0.96), and large positive effects compared to minimal interventions (K = 7; OR 0.60; 95% CI 0.46, 0.78). Comparison with previous meta-analyses suggested limited progress in recent years in developing more effective interventions. Multisession psychosocial and educational interventions provided similar modest sexual risk reduction justifying offering educational interventions in settings with limited exposure to sexual risk reduction interventions, messages, and resources.
authors: Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK. nick.meader@york.ac.uk
authors: Nicholas
authors: N
authors: Meader
authors: Salaam
authors: S
authors: Semaan
authors: Marie
authors: M
authors: Halton
authors: Henna
authors: H
authors: Bhatti
authors: Melissa
authors: M
authors: Chan
authors: Alexis
authors: A
authors: Llewellyn
authors: Don C
authors: DC
authors: Des Jarlais
mesh_terms: D015658:HIV Infections / Q000150:complications / Q000517:prevention & control*; D006801:Humans; D010353:Patient Education as Topic; D040242:Risk Reduction Behavior; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology; D047568:Unsafe Sex / Q000517:prevention & control* / Q000523:psychology