Sexual Risk Reduction Interventions Do Not Inadvertently Increase the Overall Frequency of Sexual Behavior (original) (raw)

2006, JAIDS Journal of Acquired Immune Deficiency Syndromes

A meta-analytic review of the influence of HIV-risk reduction interventions on sexual occasions, number of partners, and abstinence was conducted, in order to assess whether condom-related interventions inadvertently undermine sexual health promotion efforts by increasing the frequency of sexual behavior. Included studies examined sexual-risk-reduction strategies, used a controlled design, and provided sufficient information to calculate effect sizes. Data from 174 studies (206 interventions, N=116,735 participants) were included. In general, HIV-risk reduction interventions (including condom education /promotion programs) neither increased nor decreased sexual occasions or number of partners reported. Participants in intervention conditions were less likely to be sexually active than those in control conditions. When samples included more Black participants, interventions reduced the number of sexual occasions; interventions were more successful at reducing the number of partners in samples that included more men who have sex with men (MSM) or individuals engaged in sex trading. Samples that included more MSM were more likely to adopt abstinence as a risk reduction strategy. Consistent with behavioral science theory, interventions that included more information, motivational enhancement, and skills training also led to greater risk reduction. HIV-risk reduction interventions do not increase the overall frequency of sexual activity. To the contrary, for some particularly at risk sub-groups, interventions reduce the frequency of sexual events and partners, especially when interventions include components recommended by behavioral science theory.