title: Behavioral interventions to reduce HIV risk behavior for MSM and transwomen in Southeast Asia: a systematic review.
abstract: This systematic review aims to gain insights from existing literature from Southeast Asian countries to improve future HIV prevention programs for men who have sex with men (MSM) and transgender women (transwomen). We conducted a systematic search in six international databases for literature published prior to 1 January 2015. We included studies describing behavioral interventions targeting MSM and/or transwomen, and conducted in at least one Southeast Asian country. Five out of 575 screened studies met the inclusion criteria and reported a significant intervention effect on at least one outcome measure, that is, condom use (with casual or commercial partner), water-based lubricant use, number of sex partners, HIV prevention knowledge, or willingness to use pre-exposure prophylaxis. Peer education/outreach was the most commonly employed type of intervention in the five included studies and was usually delivered as an element of a larger intervention package, together with condom distribution and the provision of drop-in centers. Motivational interviewing was effective, while internet-based interventions appeared to be a viable platform for intervention delivery. Nevertheless, research on behavioral interventions among MSM and transwomen in Southeast Asia is limited. Future interventions should be culturally appropriate, theoretically grounded, and rigorously evaluated. Only then can we best address the HIV epidemic among MSM and transwomen in this region.
authors.affiliation: a Department of Public Health , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands.|c Public Health Study Program , Lambung Mangkurat University , Banjarbaru , Indonesia.
authors.forename: Adi
authors.initials: A
authors.lastname: Nugroho
authors.affiliation: a Department of Public Health , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands.
authors.forename: Vicki
authors.initials: V
authors.lastname: Erasmus
authors.affiliation: b Department of Infectious Disease Control , Municipal Public Health Service of Rotterdam-Rijnmond , Rotterdam , The Netherlands.
authors.forename: Tizza P
authors.initials: TP
authors.lastname: Zomer
authors.affiliation: a Department of Public Health , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands.
authors.forename: Qing
authors.initials: Q
authors.lastname: Wu
authors.affiliation: a Department of Public Health , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands.
authors.forename: Jan Hendrik
authors.initials: JH
authors.lastname: Richardus
mesh_terms: D001210:Asia, Southeastern; D017280:Condoms / Q000600:supply & distribution; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D020407:Internet; D008297:Male; D062405:Motivational Interviewing; D000067074:Peer Influence; D012309:Risk-Taking; D021841:Safe Sex; D063106:Transgender Persons / Q000523:psychology*
keywords: MSM; Southeast Asia; behavioral intervention; review; transgender