Critical Review: When the Party is Over: A Systematic Review of Behavioral Interventions for Substance-Using Men Who Have Sex with Men.
Because problematic patterns of alcohol and other substance use are prevalent drivers of the HIV/AIDS epidemic, comprehensive interventions are needed for substance-using men who have sex with men (SUMSM). We conducted a systematic review of 12 randomized controlled trials (RCTs) of behavioral interventions for reducing condomless anal intercourse (CAI) in SUMSM. Three RCTs observed that cognitive behavioral or motivational interviewing interventions achieved a 24% to 40% decrease in CAI. Interventions also tended to demonstrate greater efficacy for reducing CAI and substance use among those who had lower severity of substance use disorder symptoms. Although behavioral interventions for SUMSM are one potentially important component of biobehavioral HIV/AIDS prevention, further research is needed to examine whether integrative approaches that cultivate resilience and target co-occurring syndemic conditions demonstrate greater efficacy. Multilevel intervention approaches are also needed to optimize the effectiveness of pre-exposure prophylaxis and HIV treatment as prevention with SUMSM.
*School of Nursing, Department of Community Health Systems, University of California, San Francisco, San Francisco, CA; †School of Medicine, Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA; ‡University of Pittsburgh Graduate School of Public Health, Department of Behavioral and Community Sciences, Pittsburgh, PA; and §Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA.
Adam W
AW
Carrico
Roland
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Zepf
Steven
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Meanley
Abigail
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Batchelder
Ronald
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Stall
D015928:Cognitive Behavioral Therapy; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000517:prevention & control* / Q000523:psychology; D019966:Substance-Related Disorders / Q000150:complications / Q000517:prevention & control / Q000523:psychology* / Q000628:therapy*