Efficacy of human immunodeficiency virus prevention interventions among men who have sex with men in China: A meta-analysis

OBJECTIVES: This study aimed to determine the efficacy of HIV prevention interventions among men who have sex with men (MSM) in China. Human immunodeficiency virus (HIV) knowledge, HIV testing, condom use, sexual risk activity, incidence of sexually transmitted diseases, and HIV incidence were used as outcomes. METHODS: Meta-analytic techniques were used to compute and aggregate effect sizes for 22 studies, published between 2004 and 2011, which met inclusion criteria. Variables with the potential to moderate intervention efficacy were also tested. RESULTS: The overall mean weighted effect size was d = 0.627 (95% confidence interval [CI], 0.460-0.793; Z = 7.38; P < 0.001) for HIV knowledge, d = 0.394 (95% CI, 0.274-0.514; Z = 6.44; P < 0.001) for condom use with men, and d = 0.590 (95% CI, 0.420-0.761; Z = 6.80; P < 0.001) for HIV testing, which indicates a statistically significant impact through intervention. Statistically significant effect sizes were also found for condom use with women and for number of sexual partners. Interventions for condom use conducted in Southwest China (the region in China with the highest prevalence of HIV) were significantly less efficacious. Interventions for condom use were significantly more efficacious when the respondent-driven sampling recruitment method and popular opinion leader intervention strategy were used. CONCLUSIONS: Human immunodeficiency virus prevention interventions were efficacious among MSM in China. Additional efforts are needed to control the growing HIV/acquired immunodeficiency syndrome infection among MSM in China. Future interventions need to use more rigorous intervention methodologies (e.g., respondent-driven sampling method, and popular opinion leader intervention strategy).

• Epidemiology and Determinants of Health
  • Epidemiology
• Population(s)
  • Men who have sex with men
• Prevention
  • Sexual risk behaviour
  • Education/media campaigns
• Testing
  • Testing